Back Acne (Bacne): What Causes It and How to Treat It

Medically Reviewed By Bukky Aremu, APRN
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Back acne, which people often refer to as “bacne,” is acne that typically occurs on the upper back. Acne is a skin condition that affects the pores. Pores have a hair follicle and an oil gland at the bottom and an opening at the top. The oil gland produces sebum, which flows to the skin’s surface to moisturize it. As it travels upward, it can carry dead skin cells and other debris to the pore’s opening. Acne occurs when the oil, debris, and bacteria become trapped in the pore, forming a plug.

The upper back has many oil glands, making it a common place for acne to develop. Other commonly affected sites include the face, neck, and chest.

Read on to learn more about what causes back acne and how to treat and prevent it.

What are the causes of back acne?

A woman with flowers on her back
Ivan Andrianov/Stocksy United

Back acne is the result of oil, dead skin cells, and bacteria collecting in pores and blocking them. Although the exact reasons for this process are unclear, experts believe that acne is likely due to a combination of genetics and other factors.

Hormonal changes may also play a role. Oil production and skin cell turnover increase when androgen levels rise during the teenage years. This may make the pores more prone to becoming clogged.

What are the treatments for back acne?

For mild or moderate back acne, over-the-counter (OTC) products may effectively control breakouts. The American Academy of Dermatology Association (AAD) recommends a benzoyl peroxide foaming wash. This product removes bacteria and is most effective when you use it every day.

As the skin on your back is thicker than the skin on your face, neck, and chest, you can let the wash stay on the skin for up to 5 minutes. Doing so will help the benzoyl peroxide penetrate better. Afterward, it is important to rinse the area thoroughly to prevent the product from bleaching your towels, sheets, or clothes.

The AAD recommends starting with a wash containing 5.3% benzoyl peroxide. This strength is the least likely to cause irritation and dryness. If it is not effective, you can try the higher 10% strength.

The AAD also recommends using an OTC retinoid called adapalene (Differin). It works as an exfoliant to unclog pores, and you can use it daily after you shower or before going to bed. Special lotion applicators for the back can help you apply the medication where you need it.

If back acne has not improved after 6–8 weeks, it is advisable to see a dermatologist. Prescription medications may be necessary to control severe acne. The options may include oral antibiotics in combination with topical treatments, such as prescription-strength retinoids.

What does back acne look like?

Back acne can appear as various types of blemishes:

  • Blackheads: These are clogged pores that remain open at the skin’s surface. The medical name for them is open comedones.
  • Whiteheads: These clogged pores are closed at the skin’s surface. They are also called closed comedones.
  • Papules: Papules are small, raised, and tender bumps.
  • Pustules: These pus-filled pimples can have a white or yellowish center.
  • Cysts: Also known as nodules, these deep-rooted blemishes typically do not have a distinct head. They can often be painful.

What are the risk factors for back acne?

Several factors may increase your risk of developing back acne, including:

  • Age: Although teenagers and young adults most commonly experience acne, it can affect anyone.
  • Medications: Some medications, including those containing hormones and lithium, may contribute to acne breakouts.
  • Diet: High carbohydrate or high glycemic diets may contribute to acne breakouts.
  • Heredity: If a parent has experienced back acne, you may be more likely to have this condition.
  • Skin environment: Possible contributors to back acne breakouts include greasy or oily skin care products, tight or occlusive clothing, and high humidity.
  • Stress: Stress can worsen breakouts in people who already have back acne.

Can you prevent back acne?

You may not be able to prevent all back acne breakouts. However, you can take certain steps to lower your risk of breakouts or keep breakouts from worsening. You can try:

  • cleaning your skin with lukewarm water and gentle cleansers rather than hot water and harsh cleansers, which can worsen breakouts
  • avoiding irritating skin care products, including antibacterial soaps, abrasive scrubs, and scrubbing tools
  • refraining from picking at the blemishes, as popping or squeezing pimples further irritates the skin and increases the risk of scarring
  • trying not to wear anything with straps that will rub your back, such as a backpack or a purse with shoulder straps
  • protecting your skin from the sun, which can irritate the skin and make acne worse
  • washing your sheets and pillowcases frequently with fragrance-free products and hot water to remove bacteria
  • wearing loose-fitting clothes
  • taking a shower right after working out or sweating and washing your workout clothes after each wear

If you are concerned about your risk of back acne, consider talking with a dermatologist. Early intervention can help minimize scarring and other complications.

What are some potential complications of back acne?

As with other forms of acne, back acne can cause complications. Some people, particularly those with dark skin, may also experience hyperpigmentation after a breakout.

The scars that develop from severe acne can be pitted or raised and thick. The treatment options for these scars include chemical peels, dermabrasion, and laser resurfacing. Learn more about acne scar treatments.

Back acne can sometimes also cause depression and anxiety. Some people with back acne may feel self-conscious about or embarrassed by their symptoms, which can lead to low self-esteem. If your acne is causing you emotional distress, contact a dermatologist. Effective treatment is available.

Frequently asked questions

Here are a few commonly asked questions about back acne. Bukky Aremu, APRN, has reviewed the answers.

Is back acne common?

Back acne is a common skin complaint. Your back has many oil glands, all of which can be prone to clogging up with oil, dead skin cells, and bacteria.

What soap is best for back acne?

The AAD recommends using a soap or body wash containing benzoyl peroxide. The association advises starting with a 5.3%-strength wash and switching to a 10%-strength wash if necessary.

Does back acne indicate high testosterone levels?

Back acne can result from higher levels of androgens, including testosterone. Androgens affect sebum production, which can, in turn, increase the likelihood of the pores becoming clogged.

Summary

Many people will deal with a back acne breakout during their lifetimes. For some people, it will be a mild problem. For others, it can be severe. You might be more likely to have a severe problem with back acne if one or both parents had a similar problem.

Mild to moderate back acne usually responds to OTC treatments, which include benzoyl peroxide washes and mild exfoliants. Severe cases, including nodular and cystic back acne, may require the care of a dermatologist and prescription medications.

Back acne can be more than a cosmetic problem. The breakouts and possible scarring can cause anxiety and self-esteem issues. Effectively treating back acne can help prevent these complications.

A dermatologist can offer advice on lowering your risk of developing back acne breakouts or treating existing breakouts.

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Medical Reviewer: Bukky Aremu, APRN
Last Review Date: 2022 Jul 25
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