Summer should mean tank tops, days at the beach and cute sundresses right? Showing a little bit of skin is part of the summer. Somehow wearing a long sleeve t-shirt isn’t quite right in 80 degree weather. Unfortunately, a lot of us are a bit reluctant to expose some areas, such as our backs.
Back acne, or bacne, isn’t just for teens. Lately it seems that breakouts are an epidemic among my friends! Because the breakouts can be linked with hormones, shifts around pregnancy, times of stress or even just that time of the month, many of us well beyond our teen years are experiencing these blemishes.
The first step in treating acne is knowing how it forms and what you can target with your treatments.
1. The process starts with a typical hair follicle or pore. You'll see that there's a small oil gland off to the side. Under normal conditions, the skin cells cycle themselves with new cells being created as old cells slough off.
2. On occasion, those cells will start to accumulate in the pore rather than sloughing off completely. As oil is produced, the cells stick together more and inflammation starts in the walls of the pore. The whole process starts to cycle, more cells accumulate, more oil is produced and the skin will become more inflammed.
3. As the inflammation gets worse, some of the inflammatory cells will move into the pore. Now that you have white cells in the mix, bacteria will also start to get into the mix. Typically this is p. acnes, which is usually just found on your skin. It loves to eat oil, so this environment is perfect for it to thrive.
4. As the process spirals more and more out of control, the pore will become swollen and it may rupture. This allows everything to infiltrate into the surrounding skin.
The skin on your back is definitely different from that on your face, but the basics of blemish formation are the same. The back is thicker than the face, and the pores here are often larger than on your face. So, they are more prone to clogging. "Back acne is often androgenetic, hereditary and hormonal, but may be worsened by stress, poor diet, sweat and irritating clothing," adds dermatologist Dr. Karen Stolman.
Obviously you are still showering, but are you doing it at the right times? Many of us try to skip a shower after working out, whether we're at home or at the gym. But you shouldn't make that mistake. Most of the dermatologists we talked to recommended a shower immediately after your work out, and if you can't find the time you should at least be wiping off. Dermatologist Dr. Debra Luftman recommends Simple Cleansing Wipes.
When choosing a cleanser for your bacne, you can use a gentle cleanser such as Cetaphil or step up to a medicated cleanser if your skin can handle it. Dr. Eric Schweiger recommends "a cleanser containing salicylic acid, benzoyl peroxide or tea tree oil."
Dr. David Bank has a few specific product recommendations. "Neutrogena makes a body wash with micro beads and salicylic acid to fight acne and get rid of dead skin. It’s also easily available at your local drugstore. Murad has an acne skin care line that includes body cleansers and an acne spray as well for hard to reach spots on your back."
Most of us just start lathering up in the shower, trying to get everything clean before we run out of hot water. But when you're dealing with an issue like back acne, you need to be mindful of what you're rinsing off and where that water is traveling. New York City esthetician Haley Kulow advises to "skip conditioner, or if you must use it, wash it off over your shoulder and not down your back." You should also be washing your back last to remove any product residue. If you have acne on your face this tip works there as well.
Exfoliating your face helps to keep your pores open and evens out your skin tone. The same can be true for your back. "Since back skin is thicker than the face, exfoliation will help us better access the pores and sebaceous glands," explains Dr. Stolman.
Luckily, many acne cleansers will exfoliate for you. "First exfoliate with an over-the-counter cleanser containing salicylic acid or another fruit acid like mandelic or glycolic. Let the cleanser sit on your back for an extra few minutes to be effective," says Dr. Stolman.
Dr. Debra Jaliman also recommends using a deep cleansing brush to help clean out pores. "The Clarisonic with the acne brush helps a lot."
Leave on treatments for acne will work for both your face and your back, and many have the same active ingredients as the cleansers already recommended. Dr. Fayne Frey recommends leave on gels with benzoyl peroxide or salicylic acid, while Dr. Schweiger prefers a salicylic acid pad. Dr. Debra Luftman loves sprays that reach the entire back and Dr. Debra Jaliman is a fan of Neutrogena's dual tasking Clear Pore Cleansing Mask.
What clothing you chose to wear can make a big difference with back acne, especially while working out. Dr. Schweiger suggests, "wearing breathable fabrics throughout the day, such as cotton or linen, so that the oils won’t become trapped against your skin."
With all of the benzoyl peroxide and salicylic acid that has already been recommended, remember that these ingredients will make your skin much more sensitive to the sun. "Avoid sun exposure as this may dry out the skin and induce inflammation, leading to more acne," points out Dr. Frey.
To protect your skin when you are in the sun, look for broad spectrum sunscreens that are labelled non-comedogenic. Wearing UPF clothing is another great way to avoid sun damage.
"Try managing stress with good sleep, exercise, and wear breathable clothing when hot or exercising," advises Dr. Stolman. "Avoid sugar and lactose-rich dairy and choose low glycemic foods in your diet. A high glycemic diet has been linked to worse acne on both face and body."
"Avoid certain medications that are known to increase the incidence of acne like androgens (male hormones), lithium, and prednisone," says Dr. Frey.
"When OTC treatments are not effective, or if the back acne becomes moderate to severe, seek medical attention. Dermatologists often prescribe oral antibiotics in combination with topical prescription Vitamin A derivatives that can decrease oil production and help minimize the development of acne lesions," says Dr. Frey.