Is back acne normal?

Why does acne happen on your back?

The upper back has many oil glands. Acne develops when excess oil and dead skin cells block hair follicles, the small openings where hairs grow. Bacteria can grow inside those blocked follicles and cause swelling and pus. Hormone changes can increase oil production, particularly during puberty. Tight clothing and oily skincare or hair products can also worsen breakouts. The face is only one common acne site, despite getting most of the publicity.123

Back acne is not a sign of poor hygiene, so the shower does not need to become an apology. Scrubbing or washing too often can irritate skin and make acne worse. Sweat can irritate existing acne, which is why showering after exercise helps with care rather than correcting a cleanliness problem.234

What should you do about mild back acne?

• Wash gently with a mild cleanser and lukewarm water, no more than twice daily. Shower as soon as possible after exercise.
• Wear loose, breathable clothing, especially during exercise or sweating.
• Choose products labelled noncomedogenic, meaning less likely to block pores. If your back feels dry, use a fragrance free, water based moisturizer.
• Leave spots alone. Picking or squeezing increases the risk of scars.
• Ask a pharmacist about treatment if you have a few blackheads, whiteheads or pimples.

How do you use benzoyl peroxide on your back?

Benzoyl peroxide reduces bacteria and treats spots and blocked pores. Choose a product labelled for the back: some are for the face only. Start with the lowest available strength. It is usually used once or twice daily; follow your product's directions.5

For a benzoyl peroxide wash:

1. 1Wash your hands and wet the affected skin.
2. 2Wash with a small amount for 1 to 2 minutes.
3. 3Rinse thoroughly, pat dry and wash your hands again.

A leave on gel instead goes in a thin layer on clean, dry skin. Benzoyl peroxide can bleach clothing, towels and hair. Avoid broken or infected skin and use sunscreen on exposed treated areas. Dryness or peeling can improve with less frequent use; ask a pharmacist or doctor about persistent irritation. Stop using it and seek emergency help for throat or tongue swelling or difficulty breathing.5

Benzoyl peroxide usually starts working within 4 weeks. Get advice if acne worsens or has not improved after 12 weeks. Check before combining it with other acne treatments. During pregnancy it can usually be used, but check with your doctor; breastfeeding also warrants checking first.5

When should you see a doctor?

Book an appointment for numerous spots, deep painful lumps, scars, hot swollen skin or acne affecting your mood. Deep lumps called nodules and cysts carry a greater scarring risk. Severe acne needs prescription treatment rather than repeated pharmacy purchases. Do not try to drain a cyst at home: infection is a significant risk.246

For women with stubborn chest or back acne, hormonal treatment is another option to discuss with a dermatologist. Options include certain birth control pills and spironolactone, with suitability based on medical history. Spironolactone requires pregnancy prevention because it can cause serious birth defects. These are prescribed treatments, not additions to make on your own.7

Is acne normal?

Yes. Acne is very common: an estimated 80% of people aged 11 to 30 experience at least mild acne. It can continue into adulthood, so it is not exclusively a teenage condition. Acne is not contagious, and treatment can help clear breakouts and prevent scarring.13