Back and Body Acne: Causes and Treatments

Mid adult woman wrapped in towel looking at bathroom mirror
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Blackheads and pimples don't only appear on the face. There are plenty of other places those breakouts can pop up. The chest, neck, shoulders and upper arms, and even the butt are all common places to get pimples. Back acne is so common it even has its own name: bacne.

If you're dealing with back and body acne, know that it's completely normal and you've got plenty of company. Body acne can happen to anyone, both teens and adults (but it's a shade more common in males than females.)

Causes

Body acne is caused by the same factors that trigger facial acne, namely overactive oil glands, excess dead skin cells, and a proliferation of acne-causing bacteria.

Here's how acne pimples develop: When oil and dead skin cells become trapped within the follicle, or what we commonly call the pore, it can create a blockage. This blockage becomes a blackhead and can progress to an inflamed pimple if bacteria invade.

Body acne is generally confined to the back and upper half of the body, as opposed to your legs. Like the face, these areas have more sebaceous glands per square inch than other areas of the body, so the follicles are more likely to become plugged with excess sebum and dead skin cells.

Acne Mechanica From Heat, Friction, and Sweat

Certain articles of clothing, sports equipment, and other gear may be triggering your body breakouts. Rubbing or pressure on the skin, combined with heat and/or sweat, can irritate and inflame follicles and cause a specific type of acne called acne mechanica.

If at all possible, try to avoid sources of friction while you're trying to heal body acne. These include tight-fitting clothing, too-snug collars, backpacks, purse straps, and athletic pads or gear. Students may want to carry their books in a handheld bag instead of wearing a heavy backpack.

Sweat can also irritate body acne.

To minimize irritation, shower as soon as possible after exercising. Don't aggressively scrub the skin, though. Remember, you want to avoid friction. A thorough, but gentle cleansing—preferably with a salicylic acid or benzoyl peroxide wash—is better than a vigorous scrubbing.

Embarrassed by Your Breakouts? That's Normal

If body acne doesn't bother you all that much, that's great. But if it does bother you, know you're not alone. Many people say they feel embarrassed or ashamed of their body acne, and take great pains to cover affected areas.

You may choose clothing that reveals as little of the breakouts as possible, avoiding tank tops or sleeveless shirts and deep necklines. You might even consider quitting recreational sports or not participate in certain activities because of breakout embarrassment. It's hard to enjoy yourself at the pool if you're feeling self-conscious about baring your skin in a swimsuit.

Body acne can be especially hard if you're a teen. Undressing in locker rooms or choosing a prom dress can be frustrating and can affect your self-confidence. But all of these feelings are completely normal. You're not being vain. Acknowledge these feelings; don't feel like you have to justify them or talk yourself out of them.

Then, start on a treatment for body acne to get those breakouts under control.

Treatment

You've got plenty of options for treating your body breakouts.

Treating Mild Body Acne

Mild body acne (meaning you just have small bumps and breakouts, or just a few pimples) often responds to good daily skin care and over-the-counter (OTC) treatments. Try a body wash containing salicylic acid or benzoyl peroxide. If you prefer, there are bars containing benzoyl peroxide. You can find these at any drug store. Use it every day. Try to shower as soon as possible after working out or sweating to minimize pore blockages.

If cleansers aren't doing the trick, add a medicated treatment lotion or spray to your treatment routine. Again, look for one that contains either salicylic acid or benzoyl peroxide. There are pros and cons for benzoyl peroxide vs. salicylic acid you might explore to decide which to use. Apply these once or twice a day, depending on the product directions. Sprays are great for those hard-to-reach places on your back.

Look for an OTC product that also contains an alpha hydroxy acid, such as glycolic or lactic acid. Alpha hydroxy acids help to speed cell turnover, rapidly exfoliating the skin and reducing the number of pore blockages.

When treating body acne, you typically can use several acne treatment products at once without causing excessive irritation (for example, a salicylic acid wash plus a benzoyl peroxide lotion). The skin on the back, chest, shoulders, and upper arms is tougher than facial skin, and can generally tolerate more powerful treatments.

But, the skin on the neck is fairly sensitive. Use treatment products slowly and carefully in this area. If you notice excessive irritation, dryness or peeling on any area of the body, scale back or discontinue use of the treatment product, and consult your doctor.

Treating Moderate to Severe Body Acne

Body acne is stubborn, so moderate to severe cases aren't going to get any better with the OTC options listed above. You'll need to bring in some stronger prescription treatments to get those breakouts under control.

Don't wait too long to see a physician for a prescription acne treatment, especially if your acne is severely inflamed. Body acne can also cause deep scarring. The greater the inflammation, the higher the chance of developing lasting scars.

Depending on your situation, your dermatologist may prescribe a topical treatment, oral medications, or both. Common treatments include:

Isotretinoin is used for very severe forms of acne, or after other treatment options have been exhausted, as it carries significant potential side effects.

As with facial acne, it takes time to control body acne. You will most likely have to try several treatment products or medications before finding the one that works best for you.

A Word From Verywell

Body breakouts can be frustrating. Finding a treatment that works can seem even more frustrating, especially after you've tried several with little improvement. But here's something to put your mind at ease: Nearly every case of acne can be successfully cleared, given time, patience, and the right treatment.

Good daily care for the skin on your body is a good backbone for your acne treatment routine. Unless your breakouts are very mild, you'll need a prescription treatment to get good clearing. While a trip to your doctor or dermatologist may seem like a hassle, in the long run, you'll save yourself time and money. You won't be buying OTC products that won't work for you and you'll be happier with the results you get.

Sources:

Acne. American Academy of Dermatology. https://www.aad.org/public/diseases/acne-and-rosacea/acne.

Questions and Answers About Acne. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health_info/Acne/.

Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, et. al. "Guidelines of Care for the Management of Acne Vulgaris." Journal of the American Academy of Dermatology. 2016; 945-73.

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