Which medicine helps body acne?

Can you treat body acne yourself?

Home treatment is reasonable for a few recent blemishes or a mixture of blackheads, whiteheads and pimples that are not deep or painful. Nodules are hard lumps under the skin; cysts are deeper, painful lumps containing fluid or pus. Both can leave scars, so get help early rather than trying progressively stronger washes. Acne commonly affects the chest, shoulders and upper back, where oil glands are concentrated.34

Which medicines do what?

Retinoids are medicines related to vitamin A. Apply them across the area affected by acne, not just individual pimples, because they also prevent new blockages. Several months of use can be needed before positive results appear. Salicylic acid is another option for clogged pores, but do not automatically add it to benzoyl peroxide: combining acne treatments needs a pharmacist's or doctor's advice.14

How to choose benzoyl peroxide

Check that the product is suitable for the area you want to treat: some benzoyl peroxide medicines are for the face only, while others cover the face, back and chest. Start with the lowest available strength to assess tolerance. Lower concentrations and wash formulations are less irritating than stronger products. For back acne, a 5.3% foaming wash is less likely to cause dryness, peeling or irritation than a stronger wash.134

Benzoyl peroxide comes in washes and products you leave on, which makes reading the label more useful than admiring the bottle.1

How to start treatment

1. 1Test benzoyl peroxide on one or two small affected areas for three days before broader use. If there is no reaction or discomfort, follow the package directions.
2. 2Start once daily to see how your skin reacts. Do not increase the amount or frequency beyond the label or prescription.
3. 3For a wash, wet the affected skin, apply the product gently, then rinse thoroughly and pat dry. Follow that product's contact time.
4. 4For a lotion, cream or gel left on the skin, gently wash and dry the affected area first, then apply a small amount and rub it in gently.
5. 5Wash your hands after applying the medicine. Keep benzoyl peroxide away from your eyes, nose and mouth.

Contact time depends on the wash. Back acne treatment with a benzoyl peroxide foam wash can involve leaving it on for two to five minutes before rinsing; some gel washes have instructions for one to two minutes. Use your own product's directions rather than borrowing the timing from another bottle.13

Adapalene 0.1% gel can improve back acne treatment when used with benzoyl peroxide. It is generally applied daily after showering or before bed. Ask a pharmacist or doctor whether that combination is suitable before adding it.13

An applicator can help get treatment onto your back, giving a bathroom gadget something useful to do.3

What helps the medicine work?

Sweat trapped under clothes and friction from backpacks or sports equipment can worsen body acne. Shower and change into clean clothes after exercise, and wear loose cotton or sweat wicking clothing. Choose an oil free body wash labelled noncomedogenic, meaning it is made not to clog pores. Scrubbing does not clear acne and can make it worse. Do not squeeze or pick spots: that can damage the skin, cause scars or lead to infection. Wash sheets and towels at least weekly.6

Use oil free, noncomedogenic, broad spectrum SPF 30 sunscreen on exposed skin outdoors. Sun exposure can worsen acne and darken marks. Benzoyl peroxide can bleach hair and coloured fabrics, so keep it away from towels, clothes and bedding.35

How long does body acne medicine take?

Benzoyl peroxide can start working in about four weeks. For back acne, visible improvement often begins within six to eight weeks, while complete clearing can take three to four months. Arrange a review if there is no difference after six to eight weeks, and seek help sooner if acne worsens. More medicine will not make benzoyl peroxide work faster. If you miss a dose, skip it when the next dose is nearly due; do not double up.135

What side effects mean you should stop?

Benzoyl peroxide can cause dryness, peeling, warmth or mild stinging. Using it less often can reduce common irritation; speak to a pharmacist or doctor if symptoms persist or bother you. Stop using it and get urgent medical advice for burning, blistering, rash or swelling. Get emergency help for throat tightness, breathing difficulty, faintness, hives or swelling of the face, lips or tongue. Do not apply benzoyl peroxide to infected or broken skin, cuts or grazes.15

What about pregnancy, breastfeeding and other medicines?

Benzoyl peroxide can usually be used during pregnancy, but check with a healthcare professional. During breastfeeding, ask first and avoid applying it to the breasts. Children under 12 need medical advice before use. Tell your clinician about other medicines and supplements, especially acne treatments that dry or irritate skin. If body acne began while taking corticosteroids, ask whether the medicine could be contributing.156

When are prescription medicines needed?

See a doctor for lots of spots, deep or painful acne, scarring, repeated flare ups or acne affecting your mental health. Hot, swollen skin or fever also needs assessment. Prescription choices include topical retinoids, topical antibiotics and oral antibiotics such as doxycycline or lymecycline. Isotretinoin is another option that reduces oiliness and inflammation. The choice depends on severity and the type of acne, not simply how much skin is affected.26

For hormonal acne, certain combined birth control pills or spironolactone can help when standard treatment is insufficient. Not every birth control pill treats acne. Spironolactone is not suitable during pregnancy because it can harm a developing fetus. Persistent acne alone does not diagnose a hormone disorder; a clinician can assess whether testing is needed.7