Body acne medication: What to use and when

Which breakouts can you treat at home?

Acne develops when pores become blocked with oil and dead skin cells. Blackheads and whiteheads are plugged pores; inflamed pimples can contain pus. Nodules are painful lumps under the skin, while cysts are deep, painful, pus filled lumps. Both can leave scars. Home treatment is reasonable for a few recent blemishes or a mixture of blackheads, whiteheads and pimples that are not deep or painful. Do not wait through a home treatment trial for deep, painful acne.13

Which medication does what?

Start benzoyl peroxide at the lowest available strength rather than assuming stronger is better. Lower concentrations and wash formulas are less irritating. For back acne, a 5.3% benzoyl peroxide foaming wash is less likely to cause irritation, dryness or peeling than stronger options. A 10% foaming wash is also available without a prescription. Sensitive skin is a reason to pay attention to tolerability, not to increase the concentration.135

How to start benzoyl peroxide

1. 1Check the packet. Some products are for the face only; others are suitable for the back and chest. Confirm whether yours is a wash or a leave on treatment.
2. 2Test a small amount on one or two small treatment areas for three days. If there is no reaction or discomfort, continue as directed.
3. 3Start once daily to see how your skin reacts. Follow the package or prescription directions rather than adding extra applications.
4. 4For a wash, wet the affected skin, apply the product gently, then rinse and pat dry. Follow its contact time: some gel washes specify one to two minutes, while general guidance for back acne foaming washes uses two to five minutes.
5. 5For a leave on gel, gently clean and dry the skin, then apply a thin layer to the affected area. Wash your hands before and after application.

A back lotion applicator helps with areas you cannot reach, giving the bathroom cabinet a rare piece of equipment with an actual job. Asking someone to help apply treatment is another option. Keep benzoyl peroxide away from hair, clothing, towels and bedding because it can bleach them. If you miss an application, skip it when the next one is nearly due; do not double the dose.26

Can you add adapalene?

Adapalene 0.1% gel used with benzoyl peroxide can improve back acne treatment. General back acne guidance uses adapalene daily after showering or before bed. Retinoids treat the whole acne affected area rather than individual spots, helping prevent new clogged pores. Check with a pharmacist or doctor before combining acne medicines, because combinations can increase dryness and irritation. If a prescribed retinoid irritates your skin, ask your dermatologist about using less, applying it less often or applying moisturizer first.1345

When are tablets needed?

Widespread back acne or acne that is not clearing with topical treatment can need tablets. Options include antibiotics such as doxycycline, a combined oral contraceptive when appropriate, or isotretinoin. Oral antibiotics treat moderate to severe inflammatory pimples, but not nodular acne. Doctors generally prescribe them for the shortest necessary period, usually several months, alongside another treatment such as benzoyl peroxide. Isotretinoin is an oral retinoid that shrinks oil glands. Choosing between these treatments requires assessment of the acne type and the medicine's suitability, not just the number of spots.234

What else helps the treatment work?

Shower and change into clean clothes after exercise. Wear loose cotton or sweat wicking tops and reduce rubbing from backpacks or sports equipment. Workout clothes need washing after every use, so the gym routine continues in the laundry basket. Wash sheets and towels at least weekly. Cleanse gently with an oil free body wash labelled noncomedogenic, meaning formulated not to clog pores. Scrubbing and picking can worsen acne, and squeezing can cause scars or infection.17

Use gentle, fragrance free skin care rather than abrasive scrubs, astringents or back brushes. Protect exposed skin with noncomedogenic, broad spectrum, water resistant sunscreen with SPF 30 or higher. Benzoyl peroxide increases sensitivity to sunlight, so avoid sunbeds and prolonged sun exposure.145

What side effects mean you should stop?

Benzoyl peroxide can cause dryness, peeling, warmth or slight stinging. Mild irritation can improve with less frequent use; ask a pharmacist or doctor if symptoms persist or bother you. Burning, blistering, swelling or a rash needs prompt medical advice. Stop using benzoyl peroxide and get urgent medical help for hives, throat tightness, difficulty breathing, faintness or swelling of the face, lips or tongue. Do not apply it to infected or broken skin, or near your eyes or mouth.56

Benzoyl peroxide can usually be used during pregnancy, but check with your doctor first. During breastfeeding, ask a pharmacist or doctor before use and do not apply it to the breasts. Children under 12 need a doctor's advice before using benzoyl peroxide. Tell your clinician about existing medicines and supplements before starting treatment.56

How long should you wait for results?

Benzoyl peroxide can start working within four to six weeks. Back acne treatment can show a noticeable difference in six to eight weeks, with complete clearing taking three to four months. If your back is no better after six to eight weeks, arrange a dermatology review rather than repeatedly increasing treatment. Seek help sooner for worsening acne, deep painful lumps, severe inflammation, fever or recurring breakouts. Folliculitis, an inflammation or infection of hair follicles, can resemble acne and needs an accurate diagnosis.1467