Why does back acne happen?

Why does acne happen?

Oil glands normally release sebum, the oil that helps stop skin drying out, through hair follicles onto the skin surface. Acne develops when oil and skin cells stick together inside a follicle instead of leaving it. Bacteria that normally live on skin can then grow in the blockage. Back acne follows the same process as facial acne, even if "bacne" sounds like a separate product category. If the blocked follicle's wall breaks, its contents spill into nearby skin. The immune system responds, producing swelling, pus and tenderness. That is why back acne can include both small surface bumps and deeper, painful spots.24

What makes back breakouts more likely?

• Hormonal changes can increase oil production. During puberty, androgens are hormones that enlarge oil glands. Hormonal changes during pregnancy can also contribute to acne.
• Family history matters. Having a parent or close blood relative with severe acne increases your risk of severe acne.
• Certain medicines can cause acne, including corticosteroids, lithium and medicines containing hormones.
• Oily skincare and hair products can worsen breakouts. Products applied to skin can add oil to the material blocking follicles.
• Sweat and rubbing can aggravate back acne. Tight clothing and backpacks create pressure or friction, and reducing back sweat can help reduce flare ups.
• Stress, too little sleep and certain foods can worsen existing acne. The role of diet is still being studied; a breakout does not identify a particular food as its cause.

Why are some spots small and others painful?

Whiteheads and blackheads are comedones, meaning blocked follicles. They usually sit nearer the surface and are not swollen or tender. A whitehead stays covered by skin; a blackhead has an open surface, where exposure to air darkens its contents rather than dirt causing the colour. Inflammatory acne includes pus filled bumps, hard lumps called nodules and deeper fluid filled lumps called cysts. These can hurt and leave permanent scars. Picking or squeezing can damage follicles, worsen inflammation and cause more blemishes.246

What can you do about it?

1. 1Wash gently with a cleanser twice daily. Avoid scrubbing, abrasive back brushes and harsh products, which can irritate skin and worsen acne.
2. 2After sweating, shower and change clothes promptly. Wear loose, breathable tops and wash workout clothes after each use. Avoid bags that rub against your back.
3. 3Choose products labelled noncomedogenic, meaning formulated not to clog pores. Gentle, fragrance free skincare is preferable to harsh antibacterial soaps and astringents.
4. 4For mild back acne, ask a pharmacist about a topical treatment such as benzoyl peroxide or salicylic acid. A benzoyl peroxide emollient foam wash can be used daily; leave it on the back for two to five minutes before rinsing thoroughly. Benzoyl peroxide can cause irritation, dryness or peeling and bleach fabrics.

Asking someone to help apply treatment is another option.3

How long should you wait before getting help?

Back acne treatment can start showing results in six to eight weeks, with complete clearing taking three or four months. Seek medical help if there is no improvement after six to eight weeks, or sooner for deep, painful spots, scarring, widespread acne or an effect on your mental health. Hot, swollen skin with redness also needs medical assessment. A doctor can consider prescription treatment when topical products are not enough. Let your healthcare provider know if acne medicines cause side effects.1367