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What causes back acne and how to get rid of them?
Back acne, commonly known as bacne, is an acne breakout that primarily develops in the back. Similar to the face, the back has sebaceous glands that produce sebum, resulting in clogged pores and eventually, bacne. Blackheads and pimples on the back can cause significant discomfort, much like acne on different parts of the body. Acne on the shoulders, chest, and neck can even constrict the type of clothing one wears. As it is unsightly, it can also add a level of insecurity to the individual.
Acne or pimple is a relatively common problem that mainly affects the adolescent population in the world. However, it can also affect adults, with approximately 15 per cent of adult women worldwide, based on the statistics of the year 2014 (1) . Commonly, acne is a term that is often used to mean face acne, however, acne can occur on other parts of the human body as well. The back is a common region for acne to appear. Pimples can also appear on the buttocks, chest, neck, shoulders, and even upper arms. Body acne, much like facial acne, can affect all age groups.
Types of Back & Body Acne
Body and back acne can present in different forms, each of which can be equally distressing for those suffering from the condition. The type of pimple that develops on the body is similar to the facial acne types, which are mentioned below:
Whiteheads
These are white bumps that appear on the skin when a follicle below the skin has been clogged. They are also known as closed comedones and can arise from the use of comedogenic skin care products.Blackheads
Also commonly known as open comedones, and are basically the follow-up to a whitehead. A whitehead is below the surface meaning that the follicle isn’t open. When it rises to the surface and opens up, it is known as a blackhead. The contents of the clogged comedones, on exposure to air, darken and appear black in colour, hence the name, blackheads.Papules
These are pink bumps that occur around a hair follicle. They are small, hard, and superficial compared to cystic acne. The tenderness of these bumps is a feature that is shared by nodules, cystic acne and papules.Pustules
Pustules are actually what is being referred to when the word pimple is used, although people generally use pimple to describe all types of acne except comedones. A pustule is basically a pus-filled, infected, reddened papule meaning that it is a bump that arises from an infection of a hair follicle.
Nodules
Nodules are quite serious as they cause tissue damage as a result of swelling of the skin. These are also inflamed hair follicles, however, the inflammation begins way deeper into the skin and forms a bump under the skin. Unlike papules, the bump is much larger and often painful.Cysts
Cystic acne is a painful, pus-filled deep pimple that is infected by bacteria. The infection and inflammation are around a hair follicle, and it runs quite deep meaning that there is a higher likelihood of scarring from cystic acne. Cystic acne is the worst type of facial and body acne, as they cause discomfort and cosmetic issues like scarring both during their course and after they resolve.
Causes of Body Acne
There are many causes of body acne, and they are often the same as facial acne. The general triggers of facial acne and body acne overlap, as they arise from clogged pores, excessive dead skin cells and trapped bacteria. The skin of the regions affected by body acne, much like facial skin, has sebaceous glands that produce an oily and waxy substance called sebum that can clog the pores. Accumulation of sebum and dead skin cells causes both facial and body acne.
Common causes of acne:
1. Genetic predisposition
Acne often runs in families, indicating a genetic predisposition to this skin condition. If your parents or siblings have experienced facial, body, or back acne (commonly referred to as "bacne"), you are likely to develop acne yourself. This genetic link suggests that certain inherited factors, such as skin type, hormone levels, and the immune system's response to bacteria, play a significant role in acne development.
2. Hormonal imbalance
This is the main cause of acne for facial and body acne amongst teenagers. However, hormonal fluctuations during menstruation and menopause can also cause acne in young adult and adult women.
3. Medications
Certain medications have facial and body acne as their side effects. This is something that needs to be discussed with the primary care physician before initiating a medication if the person already suffers from acne.
4. Stress
While stress itself doesn't directly cause acne, it can lead to behaviors and physiological changes that contribute to its development. When you're stressed, your body releases hormones like cortisol, which can increase oil production in the skin, leading to clogged pores and breakouts. Additionally, stress can lead to poor lifestyle regime, such as inadequate sleep, unhealthy eating habits, and neglecting skincare routines, all of which can exacerbate acne.
5. Bad Dietary Practices
The content of carbohydrates, sugars, and dairy in the daily meals of a person can also determine the extent to which body acne will develop in the person’s body. Dairy and sugar are the common dietary culprits behind acne that doesn’t resolve even with a detailed skincare regimen.
6. Sweating and other hygienic practices
Sweat clogs the pores, especially when it is trapped in a region due to mechanical reasons such as tight clothing or after exercising. The type of acne that develops due to mechanical factors such as tight clothing, sports equipment, and so on is known as acne mechanica. It affects the body more than the face and is mostly due to the accumulation of sweat that has nowhere to escape. This type of acne is easier to prevent as it only requires an escaping mechanism for the accumulated sweat followed by proper cleansing of the area affected. Avoiding tight clothing and using an exfoliating cleanser can help prevent and manage acne mechanica.
How to Treat Back Acne?
Body and back acne is treated using the same mechanisms as those used for the treatment and management of facial acne. The first and foremost step is to wash the skin regularly with oil-free and non-comedogenic cleansers. These cleansers will clean the area without clogging the pores. Regular washing and other general hygienic practices help slough off dead cells and clear out sweat so neither of them can collect, causing acne.
It is important to note that regularly washing the body is not enough to treat body acne which has already developed deep into the skin. In fact, treating mild body and back acne may also require the use of over-the-counter topical agents. The use of these creams and lotions is especially recommended for those with mild to moderate back and body acne.
Topical Treatments for Back Acne
The topical agents that are chosen to target bacne and body acne should contain one of these as their key ingredients; benzoyl peroxide, sulphur, resorcinol, and salicylic acid. These ingredients are well known for their anti-acne effects and will not only erase the acne but also reduce new spots from appearing.
For moderate to severe bacne and body acne, the use of prescription medications and topical agents may be required. These medications can only be prescribed by a doctor, and some will have the same active ingredients, however, with increased potency.
Non Invasive Energy-Based Treatments for Back Acne
Body and back acne scars can also be treated with topical agents or procedures performed by an aesthetic medical practitioner, such as microneedling and laser therapy. Microneedling involves penetrating the skin with micro needles using radiofrequency (RF) technology, encouraging the skin to rejuvenate, from the inside. During this process, it also helps to repair the broken skin and stimulate collagen growth. The growth of new skin cells improves the overall texture of the skin and improve the appearance of scarring that occur as a result of back or body acne.
The effective way to minimize the appearance of acne scars is to treat them as early as possible. Resurfacing treatments such as ablative RF, RF microneedling, erbium lasers (Er. YAG) , picosecond laser and CO2 are effective ways to treat an atrophic acne scar. However, since CO2 lasers produce more heat during the laser treatment than erbium, the risk of PIH is also much higher, especially in Asian skin. Thus, erbium and picosecond lasers are the preferred treatment options for mild to moderate acne scarring. For optimal results, patients require multiple treatments spaced four to six weeks apart.
Non-ablative lasers such as Q-switched Nd:Yag nanosecond lasers and picosecond lasers, intense pulse lasers (IPL), are suitable for lightening pigmentation in those with post acne marks, also known as post-inflammatory hyperpigmentation (PIH).
In another type of laser therapy, the area of the body most prone to acne due to increased sebum or bacterial growth is targeted with a beam of laser light that clears away the triggers. This significantly reduces the likelihood of a breakout and is a great way to prevent acne.
Back Acne Takeaway
Body and back acne (bacne) are relatively common occurrence amongst all age groups. There are many causes of body acne but they all boil down to excessive dead skin cells, increased sebum production, and bacterial overgrowth in specific parts of the body.
Wearing tight clothes allows sweat to accumulate in one region, and this is one of the most common reasons for the development of body and back acne. Regular washing, exfoliators, and the use of over-the-counter acne treatments can only help with the management of mild body acne.
Prescription medications and procedures such as micro needling and laser therapy are required for the management, prevention, and reduction of acne scars in moderate and severe cases of body and bacne.
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