By Maryann Mikhail, MD
Summer is a time for tank tops and bathing suits. Unfortunately, it is also the worst time for people prone to back acne, a.k.a. “bacne.” Heat, humidity and sweat lead to occlusion and clogged pores, trapping skin surface bacteria and attracting inflammation. Pimples on the back are often cystic, which means they are not only unsightly, but can be painful and leave marks. Fortunately, bacne sufferers can take steps to minimize and treat breakouts.
Sweat that does not evaporate sits on the skin’s surface, clogs pores and attracts bacteria. The trapping and occlusion leads to inflammation and breakouts.
Whenever possible, make an effort to change out of sweaty clothing quickly. For exercise, choose clothing that is loose fitting and made from sweat wicking fabric. If you feel you sweat excessively, or have hyperhidrosis, consider seeing a dermatologist to learn about treatment options.
Personal care products can worsen, or even cause breakouts if they contain pore-blocking ingredients.
Look for body washes and moisturizers that are labeled “non-comedogenic” (meaning they shouldn’t cause black and white heads). Avoid products based in oils, petrolatum, and wax. This includes shampoos and conditioners, which inevitably end up sliding off the hair and onto the back.
Benzoyl peroxide (BPO) is an over the counter medication that is bactericidal, meaning it kills acne causing bacteria. When used with antibiotics, it can help prevent antibiotic resistance. In addition, it helps turn over and remove the oil and dead skin cells within clogged pores.
For the back, benzoyl peroxide based washes are preferable to leave on preparations, due to its potential for bleaching fabrics. Ideally choose a 10% wash and leave on the skin for 2 minutes before rinsing. Be sure to rinse thoroughly and dry with a white towel to prevent tie-dyeing. Typically, breakouts begin to respond to a topical regimen in 4-6 weeks.
If your breakouts are cystic, scarring, started suddenly, or do not respond to the above, you should see a dermatologist. Moderate to severe acne may require prescription medication. Also, there are types of folliculitis that mimic acne and require different treatment altogether.