Acne can be frustrating to deal with in itself, but back and shoulder acne are particularly irritating. This type of acne caused by bra straps, tight-fitted clothing, and more can seem impossible to avoid.
"Tight clothing mixed with friction and excess moisture, such as sweat, can lead to the development of acne," says Jeremy Fenton, MD, of Schweiger Dermatology Group in NYC. "The combination of friction, heat, and covered skin may result in the development of a form of acne called acne mechanica. The friction can irritate the skin and disrupt the surface, which can clog the pores with dead skin cells and lead to inflammation." That said, there's more than one cause in question, and as far as back and shoulder acne treatments go, it's all about knowing the root cause of your breakouts. If you're struggling with bacne, we're here to fill you in on everything from causes to prevention to treatment.
Below, dermatologists share their best tips for back and shoulder acne.
Types of Back Acne
- Pustules: A layer of skin covering pus that lives under the skin caused by the buildup of oils, dirt, and impurities.
- Papules: Similar to pustules, papules are a raised area of skin that does not have pus.
- Cystic acne: Breakouts that occur deep underneath the skin and are often red, swollen, and painful.
- Whiteheads: Pores that are clogged with a buildup of dirt, oils, and dead skin cells but are covered by a thin layer of skin.
- Blackheads: Clogged pores that are dark in color due to dirt, oils, and buildup coming into contact with the air.
Causes and Prevention of Back Acne
- Hormones: A common cause is puberty or any hormonal change or a familial genetic predisposition.
- Perspiration: Pressure on the back combined with excessive sweating, poor hygiene, and closed coverage of the skin without "breathing," can result in back acne.
- Bacteria: High growth levels of bacteria on the skin (cutibacterium acnes) can be a culprit, which can occur on the face or body.
- Steroids: Another force at work could be steroid usage. With increased androgen levels from steroids, the sebaceous glands on the skin secrete more oils. This is most common on the back and shoulders or chest than the face.
Cleanse and exfoliate regularly.
Sure, you probably know that cleansing and exfoliating your skin is an important part of avoiding breakouts, but doing so for your back and shoulder is easier said than done. "Cleansing, exfoliating, treating, and hydrating the area is key, which is more difficult to do alone and reach all the areas unless you work for Cirque du Soleil," says Ava Shamban, MD, cosmetic celebrity dermatologist and cofounder of Skin Five.
To help make cleansing your back easier, she recommends using a back cleansing tool, like a microfiber band or loofah with a long handle, so you can do your best to get to those areas and effectively cleanse and exfoliate regularly but gently. Her pick? Aquis' Exfoliating Back Scrubber, which is two-sided for cleansing and exfoliating in one tool. "It reaches corner to corner and helps get the entire surface area of the back."
Change your diet.
It's no secret that what you eat can affect your body and your skin. Shamban explains that lifestyle changes like reducing stress and improving your nutrition can help with shoulder and back acne, along with getting a proper night's rest. "Cutting out sugar and highly processed foods and eating a more plant-based diet are all good preventative measures," she says. Try eliminating overly processed snacks from your normal routine. Instead, check the ingredient label and try to find options with five ingredients or fewer. Or, even better, stick with whole foods, like a piece of fruit or nuts when you feel like munching.
Avoid sitting in gym clothes.
While it may be tempting to leave your workout gear on for the day (especially if you're working from home), it's good to take your gym clothes off immediately.
"The most important treatment is to avoid leaving moist clothing pressed against the skin for long periods of time and to promptly remove clothing and shower immediately after exercise," says Jessica Weiser, MD, of Weiser Skin MD.
Shamban agrees, adding that wearing natural fibers that breathe, like cotton and silk, and eliminating tight-fitting lycra and spandex on the area until it is clear helps too.
If you don't think you'll have the opportunity to change right away, you can help prevent the buildup of sweat by applying a baby powder, like Johnson's Baby Powder ($2), prior to working out. This will help absorb sweat as you produce it, rather than letting the moisture sit on your skin. You should also keep a no-rinse cleansing option with you to help remove sweat when you're in a pinch. Try ShowerPill's The Body Wipe ($10).
Don't overdo it.
Cleansing is important, but it's equally important to avoid over-cleansing, which can strip or dry the area. "This can exacerbate the sebaceous glands into overdrive and the cycle continues," Shamban explains. "Over-treating the area can cause irritation and inflammation."
While you should cleanse daily with a gentle cleansing option (Murad's Acne Body Wash, $44, is perfect since it's specifically formulated to treat body breakouts without over-drying your skin), exfoliation should be done less frequently. "Gently exfoliating the skin two to three times a week can help encourage skin turnover and decrease comedone [blemish] formation," says Weiser.
Use salicylic acid.
To effectively cleanse the area, Shamban recommends looking for options that are formulated with salicylic acid or benzoyl peroxide, which are both key ingredients for keeping acne at bay. Give her Acne Cleansing Foam a try, which contains time-released encapsulated salicylic acid and a natural herb blend. It works to both prevent acne and unclog pores. It's also easy to use: Simply squeeze the cleanser onto the actual scrubber to get your entire back. "I created this to be used as a body (or face) wash but specifically with this exact condition of bacne in mind. It is a common occurrence for my patients," Shamban explains. For a thorough cleanse, you can also use an exfoliating scrub formulated with either ingredient, like Peter Thomas Roth's Acne Face & Body Scrub ($24), which contains salicylic acid and a glycolic acid complex to help clear and prevent breakouts.
Turn to manuka honey.
You don't necessarily have to use a skincare product to treat your back and shoulder acne—there are natural, at-home alternatives that can work wonders as well, according to Shamban. Specifically, manuka honey. "Manuka honey is a bacne buddy. It has an antibacterial effect that can assist in cleaning and healing. It helps to balance the pH of the skin as it gently clarifies," she explains. What makes manuka honey different from traditional honey is those antibacterial properties. It also has anti-inflammatory and antioxidant benefits. "It has properties to gently and naturally exfoliate and slough off dead skin cells, which will keep skin and pores clean and clear." And if you are partial to skincare products, you can use one formulated with manuka honey to reap the benefits, like Shea Moisture's Manuka Honey & Mafura Oil Intensive Hydration Body Wash ($10).
Try treating breakouts with retinol.
We recommend this over-the-counter retinol treatment to hydrate your skin.
Retinol, a form of vitamin A, is a popular ingredient in the skincare world that's commonly known for its anti-aging abilities, but according to Shamban, it can also be a great treatment for back acne (not to mention acne in general). "You can get an over-the-counter retinol product, but I usually recommend having a tele-derm or in-office visit. Altreno's Retinoid Lotion for body is highly effective to treat the area," she says. Retinol encourages cell turnover, getting rid of dead skin cells so that younger skin cells can make their way to the surface. Oh, and that removal of dead skin cells? It prevents buildup that can result in clogged pores, which is why it's a great treatment option for acne. It also helps to improve skin texture and tone. That said, if you can't get to the dermatologist, we're fans of this option from Paula's Choice.
Cleveland Clinic. When should men see a dermatologist for adult acne? Updated November 2, 2018.
Samarghandian S, Farkhondeh T, Samini F. Honey and health: a review of recent clinical research. Pharmacognosy Res. 2017;9(2):121-127. doi:10.4103/0974-8490.204647