How to stop back acne

Why does back acne happen?

Acne develops when hair follicles become blocked with oil and dead skin cells. Bacteria can grow inside the blockage and trigger inflammation. The result can be blackheads, whiteheads, inflamed pimples or deeper lumps. Hormone changes, family tendency and certain medicines can contribute, so washing alone does not address every cause. Heavy sweating, humidity, rubbing and greasy skin or hair products can also trigger breakouts.234

Can you treat back acne at home?

Home treatment is reasonable for a few recent blemishes, or a mixture of blackheads, whiteheads and pimples without deep pain. Benzoyl peroxide reduces bacteria and helps with spots and blocked pores. Salicylic acid preparations are another option for loosening blocked follicles. Treatment depends on severity: widespread, persistent or deep acne can require prescription medicines, and severe acne needs a dermatologist.1356

How to start a back acne routine

1. 1Choose a benzoyl peroxide product labelled for use on the back. Some products are only for the face. Start with the lowest available strength and follow the packet directions.
2. 2Before first use, apply a small amount to one or two small affected areas for three days. If there is no reaction or discomfort, proceed as directed.
3. 3Clean your back gently. Wash once or twice daily, including after exercise, without scrubbing or repeatedly washing the same area.
4. 4For a benzoyl peroxide wash, wet the skin, use the directed amount, then rinse thoroughly and pat dry. Follow the contact time for your particular product.
5. 5For a gel you leave on, gently clean and dry the skin first, then apply a thin layer. Treat the affected area rather than only individual pimples.
6. 6Start benzoyl peroxide once daily to check tolerance. Wash your hands after applying it, and do not increase the amount or frequency beyond the directions.

Contact times differ by formulation. Benzoyl peroxide emollient foam washes used for back acne can be left on for two to five minutes; common gel washes have directions of one to two minutes. Do not substitute one timing for the other. A 5.3% foaming wash is less likely to cause dryness and irritation than a stronger option; choosing the lowest strength is a sensible starting point.15

An applicator designed for the back can help you reach the treatment area, a rare bathroom accessory with an actual job description. Apply medicine gently rather than using the applicator to scrub.1

Should you add adapalene?

Adapalene is a retinoid, a type of acne medicine that helps unclog pores. Adapalene 0.1% gel used with benzoyl peroxide can improve back acne treatment; it is applied daily after showering or before bed. Availability without a prescription depends on the country. Check with a pharmacist or doctor before combining acne medicines, because combinations can increase dryness and irritation. If you already use prescription treatment, ask before adding another active product.156

What to change after exercise

• Wear loose, breathable clothes, including cotton or fabric that draws sweat away from the skin.
• Shower and change out of sweaty clothes as soon as possible. If a shower is unavailable, gently use an oil free cleansing wipe and change clothes.
• Workout clothes belong in the wash after each use, even if their marketing calls them technical.
• Reduce rubbing from backpacks and straps. A handheld bag avoids pressure against the back.

Use gentle, fragrance free skin care and avoid loofahs, back brushes, abrasive scrubs and harsh antibacterial soaps. Choose oil free or noncomedogenic products, meaning formulas designed not to clog pores. Picking or squeezing spots can worsen acne, slow healing and cause scars. Protect exposed skin outdoors with an oil free, broad spectrum, water resistant sunscreen with SPF 30 or higher. Tanning is not an acne treatment.14

How long does back acne take to clear?

Benzoyl peroxide usually starts working within about four weeks. Visible improvement in back acne can take six to eight weeks, and complete clearing can take three to four months. Continue treatment as directed rather than increasing the dose to hurry it along. If there is no improvement by six to eight weeks, arrange a medical review; worsening acne deserves an earlier appointment. If you miss a dose, skip it when the next one is nearly due instead of doubling up.157

What if treatment makes your skin sore?

Dryness and peeling are common early in topical acne treatment, particularly during the first two to four weeks. Benzoyl peroxide can also cause warmth, tingling or slight stinging. Using it less often can reduce common side effects. An oil free moisturizer can help if the skin is peeling, but check your medicine's directions before layering products over the treated area. Stop the product if irritation is severe and seek advice.567

Burning, blistering, a rash or swelling of the treated area needs prompt medical attention. Stop benzoyl peroxide and get emergency help for throat tightness, difficulty breathing, faintness or swelling of the face, lips or tongue. Do not use benzoyl peroxide on cuts, grazes or infected skin, and keep it away from your eyes, nose and mouth.57

Pregnancy, breastfeeding and other precautions

Benzoyl peroxide can usually be used during pregnancy, but check with a doctor before starting and tell them if you become pregnant during treatment. Check before using it while breastfeeding, and avoid applying it to the breasts. Children under 12 need medical advice before use. Tell your pharmacist about allergies and other medicines. Benzoyl peroxide can bleach hair and coloured fabrics and increases sensitivity to sunlight, so protect exposed skin and avoid sunbeds.57

Will changing your diet stop back acne?

Diet is not a dependable substitute for acne treatment. Diets high in refined sugars or dairy have been linked with acne in some people, but the connection remains uncertain. Evidence that reducing these foods improves acne is weak. Extra vitamins and minerals have not been proved to help. Skin treatment and reducing irritation are more practical starting points than imposing a long list of food bans.46

When does back acne need a doctor?

Book an appointment for deep or painful lumps, lots of spots, developing scars, worsening acne or acne affecting your mental health. Hot, swollen skin also needs assessment for infection. Depending on severity, treatment can include prescription creams, oral antibiotics or hormone treatments. Antibiotic creams are generally combined with benzoyl peroxide or azelaic acid to reduce antibiotic resistance. Persistent or severe acne can require isotretinoin under specialist supervision; isotretinoin must not be taken during pregnancy because it causes severe birth defects.2346