Back Acne and Body Acne: Causes and Treatments

May 7
Dealing with back acne and body acne can be a challenge. We discuss what causes this condition and what you can do to treat it. 
Unfortunately, acne isn’t limited to the face and neck areas. Lesions can also appear on the back, chest, and upper arms. 
We explain the causes of back and body acne. If you’re uncertain about how to treat this disorder, we share remedies and tips for mild to severe cases.
Causes of Body Acne and Back Acne 
Regardless of where on the body acne occurs or how bad it gets, there are common causes to be aware of. These include:
1. Overactive Sebaceous Glands
Sebaceous glands produce sebum, a substance that works to moisturize and protect your skin. These glands have a higher concentration on your upper body, particularly on the face and scalp.
When sebum production is too high, this natural oil can clog your hair follicles—the pores of your skin. As a consequence, these blockages can cause lesions.
2. Bacterial Proliferation 
The bacteria that live the surface of human skin are usually harmless, and some can be beneficial for skin health too. 
One strain known as Propionibacterium acnes tends to exist in high quantities in areas where there are lots of sebaceous glands. 
However, if bacteria penetrates your skin’s surface, they can cause inflammation. Clogged hair follicles are more vulnerable, as the pore is enlarged. 
3. Excess Surface Debris 
Sebum and bacteria are not the only compounds that can provoke lesions. Other types of debris can block hair follicles, including dead skin cells, heavy cosmetics, dirt, and sweat. 
4. Hormonal Fluxes
Hormones have an intricate relationship with your skin. That’s why life events such as puberty, pregnancy, and menopause are more likely to be associated with acne spikes.
Abnormal hormonal activity can also be the culprit. Certain diseases, such as hypothyroidism and polycystic ovary syndrome (PCOS), can also provoke back acne and body acne.
5. Friction
The acne on your back and body can be aggravated or caused by friction. This phenomenon is known as acne mechanica.
The friction can be from skin-against-skin, tight clothes, or habits such as resting your back against a pillow for long periods.
6. Some Medications 
Certain drugs can encourage acne as a side effect, such as high-dosage corticosteroids or anti-psychotic lithium. 
Medications that alter your hormones can do the same, such as hormonal birth control. However, every individual responds to medications differently. 
Treating Mild Back Acne and Body Acne
If your condition is mild, over the counter treatments for body acne and back acne might help. These are non-prescription acne remedies to try:
1. Avoiding Sweat Buildup and Friction 
It’s vital to keep your skin clean and avoid irritation. Aim to shower immediately after exercising or strenuous activities. 
Try to keep friction to a minimum on affected areas, e.g., don’t wear a heavy backpack if you have back acne.
2. Acne-Friendly Body Washes
Look for soaps and cleansers formulated to combat acne. Make sure you’re choosing a body wash, not a face wash—ingredient concentrations may differ.
Ingredients that are effective on acne prone skin include benzoyl peroxide, salicylic acne, retinoids, and antimicrobials. You want something that will exfoliate your skin without further inflaming your back acne or body acne. 
3. Medicated Lotions and Sprays
Regular body lotions can contain comedogenic substances that can worsen clogged pores. Opt for lotions with similar ingredients as we mentioned above to keep your skin hydrated without encouraging new lesions. 
4. Mixing Treatments
It’s usually safe to use multiple non-prescription acne treatments at once. For example, you can try a body wash and a lotion or spray. 
Treating Moderate to Severe Body Acne and Back Acne
If you’re dealing with large numbers of lesions or they’re severe (e.g., nodules or cysts), you’ll have to consider going to a professional to see improvement. Your dermatologist may prescribe:
1. Retinoids
Topical retinoids are available in higher concentrations by prescription only. They can clear out clogged pores, and have anti-inflammatory effects on lesions. 
2. Antibiotics 
Oral antibiotics might be necessary to control bacterial overgrowth. Doxycycline and tetracycline are frequently prescribed to target Propionibacterium acnes.
3. Corticosteroids 
If the lesions on your back and body are painful and highly inflamed, your doctor might recommend low-dosage corticosteroid injections to alleviate them.
4. Acne Medications 
There are other acne-specific medications available. Depending on the dermatologist’s assessment, you could receive a prescription for:
  • Spironolactone.
  • Isotretinoin.
  • Tazarotene. 
Commit to Your Routine
As with most skin disorders, there’s no quick fix solution for back acne and body acne. If your condition isn’t severe, you can experiment with non-prescription treatments such as body washes and lotions. 
Always monitor your skin for the telltale signs of an allergic reaction, such as redness, itching, or pain. Those of you with advanced back or body acne should set an appointment with your dermatologist to discuss prescription remedies. 
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Why pH of skincare products is important?
The pH is defined as the negative logarithm (base ten) of the concentration of free hydrogen ions in aqueous solution. The pH of skin surface ranges from 4.5 to 6 making it slightly acidic. The acidic nature of the whole skin surface was first claimed by Heuss in 1892; however, the first scientific study was carried out by Schade and Marchionini in 1928, who called it the acid mantle. The “acid mantle” protects the skin by inhibiting the growth of pathogenic organisms, regulating keratinization, desquamation and wound healing. Any disruption in the acid mantle disrupts the activity of enzymes involved in barrier function and anti-microbial protection. The skin pH and the buffering capacity of the skin surface are made up of the components of the stratum corneum as well as the secretions from sebaceous and sweat glands. Sweat is an important contributor towards skin acidity owing to its content of amino acid, lactic acid, and urea, which supplement skin NMF levels. The formation of stratum corneum barrier requires enzymes that are pH dependent. Two lipid-processing enzymes β-glucocerebrosidase and acidic sphingomyelinase require a pH of 5.6 and 4.5, respectively. An increased skin surface pH activates enzyme serine proteases, which causes degradation of corneodesmosomes and affects the skin barrier. pH also has a big impact on the skin microbiome. The bactericidal activity, because of dermicidin and nitrites in sweat, occurs optimally at pH 5.5. The resident bacterial flora changes as pH increases causing increase in population and activity of P. acnes and Staphylococcus aureus which are responsible for acne and eczema. All these result in contact dermatitis, atopic dermatitis, ichthyosis, acne vulgaris and Candida albicans infections. Products with high pH cause swelling of skin follicles affecting the permeability of the skin making it dry, sensitive, and susceptible. Most of the skincare products are formulated within the pH range of normal healthy skin except the exfoliating products that contain alpha-hydroxy acids (AHA’s), Vitamin C products and chemical peel which work at low pH. Facial oils, cleansing oils, balms are not pH dependent.
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