How to get rid of acne on back and shoulders

What causes acne on back and shoulders?

Acne starts when hair follicles, the openings where hairs grow, become blocked with oil and dead skin cells. Bacteria can grow in the blockage and cause inflammation and pus. The upper back and shoulders are common breakout sites because they have many oil glands. Hormone changes can contribute, including during puberty, periods and pregnancy. Greasy skin or hair products, tight clothing, humidity and some medicines can also contribute to breakouts.12

Acne is not caused by dirt, despite the impressive career that myth has enjoyed. Stress can make acne worse, but does not itself cause acne. There is little evidence that chocolate or greasy foods have much effect on acne in most people, so treating the skin is more useful than assuming every breakout came from dinner.3

Which acne treatment should you use?

Benzoyl peroxide and salicylic acid are practical pharmacy options for treating mild acne yourself. If irritation is a concern, a benzoyl peroxide wash or lower concentration is less irritating than stronger formulations. A pharmacist can help you choose a treatment. Do not assume every acne product has the same directions: a cleanser and a cream left on the skin are different formats.12

How to care for acne prone skin on the back

1. 1Wash gently in the morning and evening with a gentle cleanser. Do not scrub, because irritation can make acne worse.
2. 2Use your acne treatment following its own directions. If a clinician recommends a retinoid, apply it across the affected area rather than only to visible pimples.
3. 3Moisturize with an oil free, noncomedogenic product. Noncomedogenic means formulated not to clog pores.
4. 4After exercise, change out of tight workout clothes and shower. Blot sweat with a clean towel rather than rubbing it away.
5. 5Protect exposed shoulders and back from the sun with clothing, shade and sunscreen. Choose an oil free, noncomedogenic sunscreen.

Do not pick, squeeze or pop spots. Picking can damage follicles, push bacteria deeper into the skin and cause additional inflamed blemishes, infection or scars. Large, hard lumps beneath the skin are nodules; larger, soft lumps containing fluid are cysts. These are different from surface blackheads and whiteheads, and need more than a vigorous wash.4

How to prevent shoulder breakouts

Sweat mixed with bacteria and oils can clog pores. Blotting rather than wiping helps avoid the irritation that can trigger another breakout. Wash sweaty workout clothes and towels before using them again, even if the laundry basket has other ambitions. Loose, breathable clothing is particularly useful when exercising or sweating; tight clothing is an acne trigger.15

Check products used on your back and shoulders for noncomedogenic or oil free labeling. Greasy skin and hair products can contribute to acne, so include hair products when reviewing what reaches the area. Once inflammatory acne improves, keep a regular skincare routine: breakouts can return during or after treatment.145

How long does back acne take to clear?

Inflammatory acne often needs several months of skincare and treatment to become clearer. Retinoids also commonly take several months before positive results are noticeable. The aim is both to heal existing blemishes and stop new ones forming. If good skincare has not improved your acne after a few months, seek medical help rather than continuing the same routine indefinitely.24

When should you see a doctor?

• Seek help for lots of spots, deep or painful lumps, or acne that is leaving scars.
• Get medical advice if the skin becomes hot, swollen and red, which can indicate infection. Redness can be harder to see on brown and black skin.
• Book an appointment if home treatment is not helping, or acne is affecting your mental health.
• Have persistent or worsening itchy, tender bumps checked. Folliculitis, an infection of hair follicles, can look like pimples but needs to be distinguished from acne.

A doctor can offer prescription creams, gels or tablets, or refer you to a dermatologist. Options include retinoids, antibiotics, hormonal treatments and isotretinoin, chosen for the type and severity of acne. Topical antibiotics work better when combined with benzoyl peroxide. Oral antibiotics are used for moderate to severe acne; these are medical treatment choices, not a shopping list to start yourself.12

How to fade marks from body acne?

A flat brown mark and a dented scar are different problems, despite being filed under the same unhelpful word: marks. Dark patches after inflammation are called postinflammatory hyperpigmentation. They remain where the skin problem has healed and can range from light brown to black. They are more common, more intense and longer lasting in darker skin tones.16

Sunlight can darken these patches. Apply broad spectrum SPF 50 or higher daily when the marked area is exposed. Treatments used to lighten pigmentation include azelaic acid, vitamin C and tretinoin, although improvement differs between treatments and combinations are often needed. Peels, lasers and intense pulsed light can help some surface pigmentation, but can also worsen it by injuring the skin. Do not treat a change in skin texture as though it were only pigment: acne can leave permanent scars.46