There is no denying that baring your back and shoulders is a major trend come summertime. But what does it mean for those of us who are battling bacne and back acne scars? While we say bare your skin without giving breakouts a second thought, we know from experience that that’s not always the easiest thing to do.
Be it cystic acne or tiny red bumps, blemishes on the back and shoulders can be extremely infuriating, not to mention stubborn. So, we reached out to a few skincare experts for their thoughts on how to get rid of back acne and back acne scars once and for all.
Keep reading for the dermatologist-recommended ways to fight back acne.
What Is Back Acne?
k acne—or bacne for short—is, simply put, a breakout on your back. Like the skin on the face, the back is home to a number of sebaceous glands that excrete oil known as sebum. When bacteria, dead cells, and sebum build up, they can inflame the pores, leading to a breakout.
Because the back is home to a dense collection of sweat and oil glands, it's more susceptible to breakouts—plus, the area is almost always covered by clothing, which can cause further damage to the skin (more on that, below).
Causes of Back Acne
• Excess oil and hormones: “It largely stems from changes of hormones within the body,” says Sally Penford, education manager at the International Dermal Institute. “This can lead to increased oil production in the skin, and the oil, coupled with dead skin cells and bacteria, then promotes congestion and pimples.”
• Friction from clothing and accessories: If you’ve noticed spots are more prominent on one shoulder, the breakout could be caused by friction from your bag strap. Take a look at your laundry detergent too, recommends dermatologist Gary Goldfaden, MD. Spots that come on suddenly could be cropping up because you’ve recently changed the way you wash your clothes.
• Failure to wash the skin frequently: Exercise gets a lot of flak as far as acne is concerned, but before you blame your spin class for your breakouts, look at your post-sweat skincare routine. “It’s best to get out of gym clothes post-workout quickly,” says Howard Murad, MD, board-certified dermatologist and founder of Murad skincare. “Then hop in the shower right away to blast away the sweat and bacteria before it clogs up the pores. Make sure you wash your gym gear regularly, too.”
• Genetics: And then there’s the most frustrating one of all. “Genetics,” says Murad. “Don’t hate your parents for the possibility that you’ve inherited acne. Some people naturally produce more oil and spot-causing bacteria than others.”
How to Prevent Back Acne
According to Rachel Nazarian, MD, a board-certified dermatologist and assistant clinical professor at Mount Sinai Hospital Department of Dermatology, the causes of back acne are similar to those of acne elsewhere—skin cells and oil clog up pores, and bacteria on your skin adds to the inflammation. "Because the back has a high density of sweat and oil glands, and is generally covered with clothing, it’s prone to heat-trapping, occlusion, and pressure," Nazarian explains. All of these factors increase the chances of back acne formation and scarring.
• Avoid backpacks: Rubbing and friction can cause a type of acne on the back called acne mechanica, and it can inflame acne making scars more likely.
• Use an acne-medicated body wash: Washing with an acne-specific body cleanser will help to decrease acne pimples and inflammation quickly. Look for ingredients like salicylic acid that break up blocked, clogged pores and decrease back acne inflammation.
• Wear breathable clothing: To avoid trapping sweat and heat, wear fabrics such as cotton rather than polyblend fabrics.
• Don’t pick: Even though some of our back acne pimples may be within our reach, picking only increases injury to the skin and makes it even more likely scars will form.
• Don’t sunbathe: Although it may be tempting to camouflage acne pimples with a tan, this will increase redness and the pigment that acne leaves behind, leaving those scars around longer and preventing them from fading.
Cleanse With the Appropriate pH
Put the body scrubs away. According to Penford, exfoliators and loofahs stimulate oil glands, causing more congestion (aka more blemishes).
Soap can also encourage spots, as it is quite alkaline, which may lead to bacteria growth. A cleanser with the appropriate potential Hydrogen (pH, for short) level, which refers to the amount of acid in a substance, is what you should clean your back with. The pH scale ranges from one to 14, and, according to Penford, you should “look for a soap which has a pH in line with your skin, around 5.5.” The lower numbers are acidic, while the upper levels are considered alkaline, or non-acidic.
A wash like Sebamed is a good option, as it creates a mild lather that will cleanse without stripping the skin. For even further penetration, keep the cleanser on your back for at least five minutes, almost like you would with a mask for your face.
Look for Breakout-Busting Ingredients
Sebamed not for you? The good news is, many blemish-blitzing face washes can double as body wash, provided you rinse the skin with tepid water and blot-dry (don’t rub) with a towel. Reach for cleansers dosed with benzoyl peroxide, tea tree oil, sulfur, or salicylic acid, as these solutions will mop up oil and dissolve the bacteria that block your pores. Paula's Choice Skincare's Extra Strength Daily Skin Clearing Treatment, which teams benzoyl peroxide with plant extracts to calm irritation, is a great option for those with sore, cystic spots that tend to crop up on shoulders. Be warned, however, that benzoyl peroxide can bleach sheets and clothing—but it's an ideal choice for hard-to-reach, deep pimples, like those so often found on the back.
Retinoids are another all-star ingredient. "These vitamin A derivatives have been shown to improve collagen formation and improve acne scars," Nazarian says. You might need help to apply to your entire back, but a small amount can be used for a large surface area. According to Nazarian, scars will show improvement in eight to 12 weeks.
Body cream is needed to balance your skin after using a deep-cleansing wash, particularly if you're utilizing products with harsh ingredients like those mentioned above. And while it may sound counterintuitive, acne-prone skin needs moisture so cells can continue to turn over rather than dry out and clog pores.
Look for oil-free lotions with a mild hydroxy acid, Penford recommends, as they will “gently offer ongoing exfoliation to prevent buildup of pore-clogging cells.” Try a moisturizer like Ameliorate's lotion, which plies spots with resurfacing lactic acid and is also great for treating keratosis pilaris.
Stay Out of the Sun
There’s a bit of a rumor going around that sunbathing reduces blemishes on the back, and Penford is here to set the record straight: UV rays aren’t the reason your bacne clears on vacation. She says, “It may actually be the relaxation of being away that is the key factor. If stress levels are reduced, testosterone levels lower and so, too, will your acne.”
Be wary of getting sweaty, though, as all that warm weather can stimulate sebum production, resulting in—you guessed it—another body breakout. Keep SPF topped up as well with an oil-free lotion; UV rays can darken acne scars in the same way they make your skin look tanned. For an option that will be kind to your skin, we recommend La Roche-Posay’s spray, which harnesses high protection in a very light spray that won’t feel greasy.
Take Your Vitamins
Pretty much every beauty woe in the book requires some internal TLC, and breakouts on your body are no different. Murad recommends foods that are rich in vitamin A, like sweet potatoes and apricots, as these help your pores rid themselves of dulling dead skin cells. Other acne-reducing food recommendations from Murad include “avocado, salmon, black cod, and walnuts, which contain beneficial oils that prevent your skin from drying out as well as breaking out.”
A skin-clearing supplement, like Murad’s Pure Skin, feeds pores the right nutrients for preventing acne. Containing plenty of vitamin A, which is great for regulating the many functions of skin naturally, these supplements help your cells slough away dead skin and oil buildup, thus reducing the amount of clogged, oily pores.
Zinc is an essential mineral that has anti-inflammatory and antibacterial properties. It prevents acne, diminishes signs of aging, and protects from UV damage.
Undergo Laser or Light Therapy
Medical spas and dermatologists offer a slew of laser and light treatments geared specifically at clearing the skin. Though it takes time to see results and multiple treatments are usually needed, infrared lights and blue and red light devices remove excess oil and treat pimples at the source. Even better, they can target scars in addition to current and future breakouts. "Your board-certified dermatologist can help you find the right laser for the type of scars you have on your back," says Nazarian. Red scars, black scars, or bumpy scars are all treated differently.
Other treatments, such as those utilizing LED lights, can work to banish breakouts and improve the overall texture of the skin. "LED red light is an anti-inflammatory light that improves circulation and collagen formation, and may improve the appearance of acne scars with continued use," suggests Nazarian. These are most effective when used for red acne scars and marks.
Try Topical Chemical Peels
Either as a wipe-on pad or a medicated body wash in the shower—which is an easy way to apply to the whole back—topical chemical peels are helpful in treating back acne. Usually containing a potent ingredient, such as an alpha or beta hydroxy acid, they work by sloughing off dead surface cells, increasing cell turnover, and revealing fresh skin. "Look for ingredients like glycolic acid," recommends Nazarian, "as it helps to remove surface skin cells and diminish acne scars with time."
It's important to note that peels often lead to overly sensitive skin, so those who undergo a treatment on their back should take special care to cover their skin from the sun and slather on the sunscreen.
Turn to Micro-Needling or Dermarolling
Micro-needling is a straightforward treatment: Tiny needles roll over the skin, creating micro-injuries and stimulating the body to create more collagen. "The needles penetrate to varying levels of the skin and stimulate wound healing," Nazarian says. The result is plumper, more even skin.
If you're dermarolling at home, you’ll need help for the hard-to-reach areas, and with micro-needling, you’ll need to see your dermatologist. If you are using a derma-roller at home, make sure to follow the directions carefully and keep it clean to avoid further damage.