What Causes Back Acne (Bacne)—And How Do You Get Rid Of It?

Medically reviewed by Brendan Camp, MD

Acne on your back (“bacne”) can be frustrating, but it’s not uncommon. Just like acne on your face, back acne develops when skin pores become clogged with oil, skin cells, bacteria, and sweat.

Fortunately, expert-recommended over-the-counter (OTC) prescription treatments and lifestyle tactics can help clear back acne, reduce scarring, and prevent new breakouts from forming.

What Is Back Acne?

Back acne is acne that develops on your back. It happens when hair follicles under your skin become clogged with oil, bacteria, and dead skin cells. Your back has a fair amount of these follicles, which is why back breakouts are relatively common.

In general, acne is the most common skin condition in the United States. As many as 50 million adults are affected by it every year. Back acne isn't usually discussed as much as facial acne, but experts estimate that about half of people who experience facial acne also have breakouts on the back and upper body.

Types

Different types of acne bumps can develop on the back. These include:

• Whiteheads: Bumps with a white center, which occur when clogged pores close

• Blackheads: Bumps with a black or dark center, which occur when clogged pores remain open

• Papules: Smaller, inflamed, hard bumps

• Pustules: Pus-filled bumps with a white or yellow-colored center (also called pimples)

• Nodules and cysts: Large, inflamed, deep blemishes

What Causes Back Acne?

The same triggers for facial acne also apply to the back. Oil, dead skin cells, and bacteria all play a role in bacne development. Other possible factors include:

• Sweating (for example, due to exercise or a hot and humid environment)

• Friction from clothing, backpacks, sports equipment, and other gear

• Stress, which can worsen acne

• Diet

Virtually anyone can experience back acne, but it may be more likely to develop in:

• Adolescents: During puberty, androgen hormones make sebaceous glands (your skin's oil glands) larger. Excess oil can clog pores and cause acne.

• People assigned male at birth: Some studies show they're slightly more affected by back and shoulder acne.
  

• People who menstruate: Fluctuating hormone levels during monthly menstruation cycles can contribute to acne.

• People with a family history of acne: Research suggests that genetics play a role in the sebaceous glands and inflammatory response functions.

How To Treat Back Acne

Dermatologists (doctors who specialize in skin, hair, and nails) typically treat acne. It might also be treated by other providers like family doctors or pediatricians.

A variety of over-the-counter (OTC) and prescription options can help clear back acne. Healthcare providers generally suggest trying to treat blemishes at home if you recently developed back acne or if you have a few mild to moderate bumps that aren't painful or deep.

You'll likely need to use most treatment products for at least 6-8 weeks before seeing results. In the meantime, you can reduce the risk of triggering more back breakouts. For example, try to refrain from:

• Scrubbing your skin with harsh products

• Using a sweaty towel on your back after a workout

• Switching bacne treatments frequently

OTC Treatment

The following over-the-counter acne products are recommended to help clear mild to moderate back acne:

• Benzoyl peroxide: This product helps kill acne-causing bacteria when used in foam body wash formula. Try using it daily, and leave a layer of the product on your back for 2-5 minutes so the ingredient has time to work. If you need a strong OTC option, look for a 10% benzoyl peroxide product. Some benzoyl peroxide products can bleach or stain fabric, so be sure to rinse off the product completely after use.

• Retinoid (adapalene): Using a product such as Differin Gel (adapalene) in addition to benzoyl peroxide wash can improve results. OTC retinoids can help unclog pores, allowing benzoyl peroxide to work better. Try applying one of these products daily before bedtime. Note: Retinoids can sometimes cause skin dryness and irritation. Start slowly and gradually increase the frequency of use as tolerated.

• Salicylic acid: Salicylic acid can be helpful in reducing whitehead and blackhead breakouts because it unclogs pores, exfoliates the skin, and reduces inflammation. Try incorporating a thin layer of this product into your morning routine.

• Azelaic acid: This natural compound has anti-inflammatory and antibacterial properties that might help improve acne on your face, chest, and back. It also helps prevent post-inflammatory hyperpigmentation (dark spots that can remain long after a breakout has cleared).
  

Not all OTC options need to be used together at once due to the risk of skin irritation and dryness.

Related: Say Goodbye to Breakouts With The Best Dermatologist-Approved Face Washes for Acne

Prescription Treatment

More severe or painful back breakouts often require medical treatment. A dermatologist may offer certain prescription treatment methods, including:

• Dapsone gel: This topical antibiotic has been shown to significantly improve back acne over the course of several months.

• Antibiotics: A shorter course of antibiotics like doxycycline can help reduce levels of acne-causing bacteria on your skin. Some antibiotics are prescribed to be taken by mouth, while others are topical treatments.

• Hormone therapy: Oral (taken by mouth) contraceptives or spironolactone, a high blood pressure medication, may be an effective option for some people.

• Isotretinoin: An oral medication known as isotretinoin (a strong formula of vitamin A) may be used for extremely severe cases of back acne. This drug can have significant side effects, so thoroughly discuss all risks and benefits with your healthcare provider before trying it.

Applying acne products on your own back may seem daunting, or even impossible. Dermatologists suggest investing in a long skincare applicator tool that can help with application for hard-to-reach spots.

How To Get Rid of Back Acne Scars

Back acne can cause postinflammatory hyperpigmentation (PIH), a condition that causes darker spots on affected skin. Back acne breakouts can also sometimes lead to scarring as they heal. Scarring and PIH may be more likely to develop due to:

• Inflammatory acne that causes swollen, painful, deep blemishes

• Delayed treatment

• Picking at or popping acne

• A family history of acne scarring

There are a variety of ways to help reduce PIH and scarring. The type of treatment depends on whether you have PIH or scarring and whether the scars are raised or indented.

At-Home Scar Treatment

Certain at-home remedies may be recommended for minimal or mild scarring, including:

• Scar creams or gels: To treat, flatten, and fade raised scars

• Silicone tape or bandages: To help hydrate skin and reduce scar size

• Azelaic acid: To help fade PIH and reduce the risk of new acne from forming

You will need to use OTC products routinely, as directed on the label, in order to see results.

Professional Scar Treatment

For stubborn or more severe cases, a healthcare provider may suggest in-office options such as:

• Laser skin resurfacing: A technique that uses a light therapy beam to help reduce discoloration and raised scars

• Chemical peels: Involves using skin-safe acids to deeply exfoliate your skin

• Microdermabrasion: Skin exfoliation using a special tool

• Microneedling: A technique that uses a tool with tiny needles to encourage your body to produce more collagen, a structural protein that's the main component of connective tissue in bones, tendons, ligaments, and skin

Most treatments can help fade acne scars, making them less noticeable over time. However, continuing acne skin care treatment even after they fade can help keep the skin on your back blemish-free.

How To Prevent Back Acne

You might not be able to fully prevent back acne, but you can reduce the risk of making it worse or causing additional breakouts. Recommendations include:

• Wear sweat-wicking or cotton workout clothing, and wash it after each workout session

• Shower and change your clothes immediately after working out or partaking in a sweaty activity

• Use oil-free body skincare products, which should be labeled as “non-comedogenic,” “non-acnegenic,” “won’t clog pores,” or “oil-free"

• Be mindful of using backpacks, purses, or other gear that rubs against your back and could cause acne to flare

• Resist the urge to pop or pick at back acne, which can worsen inflammation

• Prevent new blemishes from forming by applying a thin layer of an acne treatment product evenly across the back area

• Consider including more anti-inflammatory foods and fewer high-glycemic foods (like white bread, rice, and potatoes) to potentially help minimize breakouts
  

When to Contact a Healthcare Provider

Experiencing a blemish on your back every so often isn't usually a cause for concern. Reach out to a healthcare provider if you're regularly struggling with controlling bacne breakouts, or if you notice any of the following:

• Back acne hasn't improved with self-care steps and OTC treatment after 6-8 weeks

• New breakouts emerging after initially clearing

• Painful, deep, or irritated acne

• Acne that seems to be getting worse

• Acne that's affecting your emotional wellbeing

While acne itself usually isn't harmful, it can affect your self-esteem, especially if it's more severe. That alone can be reason enough to seek medical guidance.

A Quick Review

It's not uncommon to experience breakouts on your back, otherwise known as "bacne." This happens when pores become clogged with oil, dead skin cells, and bacteria. It can be further triggered by factors like sweaty workout clothing, backpacks or other gear rubbing against the area, fluctuating hormones, and diet.

Over-the-counter products, prescriptions, and resurfacing procedures can help clear existing back acne as well as the skin discoloration or scarring it causes.

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