Can I control body acne?

Why does body acne keep appearing?

Acne develops when hair follicles, the openings where hairs grow, become blocked with excess oil and dead skin cells. Bacteria can grow inside and cause inflammation and pus. Hormone changes, some medicines and greasy skin or hair products can contribute. Spots range from small bumps to large, painful lumps under the skin. Acne can also leave changes in skin colour or texture and scars.4

On the back, sweat trapped under clothing and friction from shirts, backpacks or sports equipment can worsen breakouts. Family history also affects your likelihood of developing acne. Stress can make acne worse, but blackheads and pimples are not caused by dirt. Scrubbing harder does not address the blockage inside the follicle. Chocolate and greasy foods are often blamed, although there is little evidence that foods have much effect on acne in most people.25

How do I start treating it?

Acne treatments come as washes, gels and creams, giving the packaging department several ways to describe something you put on skin. Benzoyl peroxide reduces acne causing bacteria and improves spots and blocked pores. Choose a product labelled for the body area you are treating: some products are only for the face. Start with the lowest available strength to check your skin's tolerance.36

1. 1Check the label before starting. A wash is rinsed off; a leave on gel stays on the skin. Follow the instructions for your exact product.
2. 2Clean gently. General acne care includes washing twice daily with a gentle cleanser, without scrubbing.
3. 3Use the benzoyl peroxide wash as directed. For a back acne emollient foam wash, daily use with two to five minutes of contact before rinsing can help. Other gel washes have instructions for one to two minutes, so do not substitute one product's timing for another's.
4. 4If using a leave on benzoyl peroxide gel instead, gently clean and dry the area, apply a thin layer, and wash your hands afterwards.
5. 5If a clinician adds a retinoid, follow its application instructions. A lotion applicator can help get treatment onto hard to reach areas of the back.

Would another active ingredient help?

Adapalene is a retinoid, a medicine that clears clogged pores and treats blackheads, whiteheads and some pimples. Adapalene 0.1% gel can improve back acne treatment alongside benzoyl peroxide. It is commonly applied daily after showering or before bed. Check with a pharmacist or doctor before combining acne medicines, because combinations can increase dryness and irritation.136

Salicylic acid opens clogged pores and exfoliates skin, helping treat whiteheads and pimples. Azelaic acid opens pores, acts on acne causing bacteria and reduces inflammation; it can also treat dark spots left after acne clears. These are treatment options, not a shopping list to use all at once. A pharmacist can help select an acne treatment.46

What should I change after exercise?

• Wear loose cotton or sweat wicking clothes, and change into clean, dry clothing after sweating.
• Shower after exercise. If you cannot shower immediately, gently wipe sweaty skin with an oil free cleansing wipe and change clothes.
• Wash workout clothes after each use, and wash sheets and towels at least weekly.
• Reduce rubbing from backpacks and sports equipment where possible.
• Avoid harsh cleansers, abrasive scrubs, loofahs and back brushes. Do not pick or squeeze spots, which can cause scars or infection.

Choose gentle, fragrance free skin care and products labelled oil free or noncomedogenic. Noncomedogenic means not clogging pores, which is useful information concealed inside a word that needs most of the label. Hair oils rubbing onto the back and certain lotions or creams can contribute to breakouts.145

Sun exposure can darken acne and make it last longer. Cover exposed skin with an oil free, noncomedogenic sunscreen offering broad spectrum protection, SPF 30 or higher and water resistance. Shade and protective clothing also help, especially when using a retinoid.16

What if treatment irritates my skin?

Benzoyl peroxide can cause dryness, peeling, redness or itchy, hot or painful skin. Using it less often can help; seek advice if symptoms persist or bother you. More medicine will not work faster. Avoid broken or infected skin and contact with eyes or mouth. Benzoyl peroxide can bleach hair and fabrics. Stop using it and get emergency help for breathing difficulty or swelling of the throat or tongue.3

Tell your dermatologist about previous retinoid irritation. They can adjust the amount or frequency, or advise applying moisturizer first. Retinoids can also be used as maintenance treatment once acne is controlled. For prescribed treatment, make changes with your dermatologist's help rather than altering the plan yourself.6

If pregnant, check with your doctor before using benzoyl peroxide; it can usually be used during pregnancy. When breastfeeding, check first and avoid applying it to the breasts. Most adults and children aged 12 or older can use benzoyl peroxide. Discuss other medicines and acne treatments with a pharmacist or doctor before combining them.3

How long should I wait, and when do I need help?

Back acne treatment can start showing results in six to eight weeks, with complete clearing taking three to four months. If there is no difference after six to eight weeks, see a dermatologist. Seek help sooner for deep or painful lumps, scarring, severe inflammation, repeatedly returning acne or breakouts affecting your mental health. Hot, swollen skin or fever also needs medical assessment.145

A dermatologist can check whether the bumps are acne: folliculitis, an infection of hair follicles, can look similar. More severe acne can need prescription creams, combination treatments or oral medicines such as antibiotics or isotretinoin. Antibiotics are used for the shortest necessary period and alongside another acne treatment to reduce antibiotic resistance, when bacteria no longer respond to a medicine.46