Swimsuit season brings a new wave of embarrassment for those with bacne. No one wants back acne, but at least at other times of the year, you can hide it. But, in the heat of the summer, what do you do?
It’s time to treat it. And to treat it effectively, we need to first understand why it’s there.
How Back Acne Is Different
Back acne is more severe than acne in other areas. Usually, it has bigger inflammatory regions because there’s just more surface area on your back than in other places. And because back skin is so thick, breakouts go deep under the surface.
That means treatment for back acne demands a different approach. Because of the depth of inflammation, we treat back acne aggressively. Usually, the best back acne treatment requires oral antibiotics like Silvadene or Isotretinoin. With facial acne, we try less aggressive treatments first. But, since back acne can be difficult to treat and resolve, we recommend the oral antibiotics sooner.
What Causes Back Acne?
Although back acne looks more severe than acne on the face, it’s caused by the same factors. Adolescence, hormones, and skin imbalances trigger these breakouts.
Folliculitis
If the breakouts seem to be triggered by workouts or haven’t improved with treatment, you may not be dealing with acne. Your bumps could be folliculitis. Infected hair follicles can masquerade as acne but require an entirely different treatment. That’s why it’s always good to visit your dermatologist to make sure you’re treating the right skin condition.
Hormone Therapy
Hormone therapy also triggers back breakouts. People with bacne are often taking testosterone, which causes large cystic acne spots.
Acne
You also could be dealing with regular acne. If you’re not on hormones, and you notice back breakouts no matter the season or how much you work out, you probably have acne.
A dermatologist will help you find the real cause of your back acne. Then, with the right diagnosis, you can start an effective treatment.
Types of Back Acne
Several different types of acne can pop up on the back. Some are easy to treat and disappear quickly. Others can be deep, painful, and result in some long-lasting scars. These three types of acne can appear anywhere — including your back.
1. Comedones
These are blackheads and whiteheads that show up when pores get clogged. Blackheads pop up when the clogged pore is open. It’s black because you can see the skin cells and dried oil in the pore. Comedones have a whitehead because the pore is closed.
Related: The Dermatologist’s Guide to Getting Rid of Blackheads
2. Inflammatory Lesions
These are your red bumps and pus bumps. The pimples with pus are called pustules. The red bumps without pus are called papules.
3. Cysts
Cysts are deeper and larger than pustules, papules, and comedones. Plus, they’re much more difficult to treat. They’re usually around one centimeter (or bigger!) in diameter. And they pop up on the back more than any other area. Why? The skin is thicker.
These are the breakouts that cause scarring. Patients with cysts can even develop keloids, which can require steroid injections or radiation therapy to resolve.
How to Prevent Breakouts on Your Back
If you notice your breakouts get worse with the heat, you’re probably dealing with heat rash, not acne. So stay in a cool, dry environment. But if you work outside in the DFW heat, make sure to shower regularly and change shirts throughout the day to keep the yeast from multiplying.
The same rules apply to workouts. Change your clothes immediately after a high-sweat workout and shower as soon as you can to cleanse the skin.
If you think your hormone therapy is triggering the breakout, cut back on your medication. A lower dosage may make a big difference.
Acne Treatment for the Back and Shoulders
If you seem to have acne, a dermatologist can help get you on a routine and medication that will clear up your back. We usually recommend using a benzoyl peroxide wash on your back regularly.
Bacteria need to live in the pores without oxygen. They can’t grow in the presence of oxygen. Benzoyl peroxide puts oxygen into the air follicle to kill the bacteria. So, with regular washing, you reduce the bacteria that live in the pores.
Also, depending on the severity of your breakouts, we’ll prescribe both topical and oral antibiotics, and we may recommend using Retin-A to topically treat your back breakouts.
Oral antibiotics such as Silvadene or Isotretinoin provide the best solutions to these frustrating breakouts — especially if you need an effective cystic back acne treatment. Remember, it takes patience for the skin to heal and rejuvenate (about 3-4 months), but once the treatment takes effect, it provides long-lasting improvement.
But don’t wait too long to treat your back acne. Bacne can leave scars, and big cysts can leave large keloids (raised scars) long after the acne has cleared.
So, to avoid long-term consequences of a hopefully short-term problem, visit your dermatologist as soon as your back starts to break out. They’ll get you cleared up so you can put back acne behind you.
Dr. R. Todd Plott is a board-certified dermatologist in Coppell, Keller, and Saginaw, TX. His specialization and professional interests include treating patients suffering with acne, identifying and solving complex skin conditions such as psoriasis, rosacea, atopic dermatitis, and identifying and treating all types of skin cancers. In his spare time, Dr. Plott enjoys cycling, traveling with his wife, and spending time with his children and new grandson.
Learn more about Dr. Plott.