Back Acne

What is back acne?

Back acne (or “bacne”) is acne that develops on your back. It causes pimples that appear as red bumps, whiteheads or blackheads. These zits can be unsightly, annoying and painful.

Acne happens when oil, dirt, dead skin cells and bacteria clog your skin’s pores. Back acne usually results when sweat gets trapped under a shirt or athletic gear during exercise or strenuous activity. Clothing rubs against your sweaty skin, which leads to zits or makes them worse.

Several over-the-counter and prescription treatments can clear up back acne. But it may take a few months for skin to clear.

Who might get back acne?

Anyone can get back acne. It can appear at any age and in people of all sexes. But it’s more common in teenagers and young adults assigned male at birth (AMAB).

How common is back acne?

Acne is the most common skin condition in the United States. Around 50 million people in the U.S. have acne. It can develop anywhere on your body. Most often, acne appears on your face. But it’s also common on your back, shoulders, chest, neck and bottom.

What causes back acne?

Back acne develops like other types of zits. Your skin’s pores (tiny holes) get clogged with dirt, dead skin cells, sweat and an oil called sebum. Your body makes sebum to keep your skin and hair from getting too dry.

If your body makes too much sebum or you don’t clean your skin properly, you can get clogged pores. This can result from:

• Family history: You’re more likely to develop pimples if you have a family history of acne.
• Friction: Shirts, backpacks, sporting equipment and other clothing that rubs against sweaty skin can cause or worsen back acne.
• Hormones: People who are pregnant and young people going through adolescent development (puberty) are more likely to get acne breakouts as hormone levels change.
• Medications: Some drugs, including corticosteroids, can cause back acne or make it worse.
• Poor hygiene: People with unclean hair can get back acne when oils from their hair rub against their back. Back acne can also result from dirty sheets, towels or clothing.
• Skin care products: Certain lotions and creams can clog pores and lead to acne.
• Stress and anxiety: When you have a lot of anxiety or stress, your body makes more of the hormone cortisol. As cortisol levels rise, your body produces more sebum.
• Trapped sweat: Sweat can get trapped between your skin and your clothing. When it does, your pores can get clogged. People who have excessive sweating (hyperhidrosis) have a higher chance of developing back acne.

What are the symptoms of back acne?

You may have pimples only along your shoulders and upper back. Or they may develop all over your back and torso down to your waist. These zits can be painful and may develop in clusters. You might have one type of pimple or a combination of:

• Blackheads.
• Cysts, which result from a type of acne called cystic acne. The cysts form bumps deep below your skin’s surface.
• Nodules, which result from a severe type of acne called nodular acne. Acne nodules form hard lumps under your skin.
• Red bumps that don’t have a “head.”
• Whiteheads.

How is back acne diagnosed?

You can usually recognize signs of back acne on your own. If you have a lot of pimples on your back or they keep coming back, see your healthcare provider. They’ll examine your skin. They may recommend seeing a dermatologist (a provider who specializes in caring for skin).

How can I treat back acne?

You can treat mild back acne at home. You should:

• Avoid popping or squeezing the pimples: You can damage your skin by popping zits. Squeezing or popping them can also lead to acne scars, which can be severe. Picking at a zit can also lead to an infected pimple.
• Keep your skin clean: Use an oil-free body wash that’s “noncomedogenic,” which means it won’t clog your pores. Shower and change into clean clothes after exercise. Resist the urge to scrub your skin with harsh cleansers. Scrubbing can make acne worse.
• Try topical creams, gels and cleansers: Benzoyl peroxide products can clear up back acne. When using a benzoyl peroxide cleanser, allow the medicine to stay on the pimples for up to five minutes before rinsing it off. You may also try a retinoid gel or an acne sticker that releases salicylic acid medication into the zit over several hours.
• Use clean linens: It’s important to use clean towels, sheets and pillowcases so bacteria don’t build up. Try to wash your sheets and towels at least once a week.

If back acne lingers or keeps coming back, see your dermatologist. They may recommend other prescription skin care products to treat severe acne. Or you may need antibiotics or other oral medications.

How can I prevent back acne?

You may not be able to prevent back acne. But ask your healthcare provider if any medications you take (such as corticosteroids) may be causing back acne. You can also lower your risk of getting back acne by:

• Changing your clothes after you sweat.
• Keeping your skin clean.
• Limiting the use of sports equipment (like football pads) and heavy backpacks.
• Managing stress levels.
• Remembering to use sunscreen.
• Using noncomedogenic products.
• Wearing loose-fitting, sweat-wicking or cotton shirts.

What can I expect if I have back acne?

Most of the time, back acne gets better with at-home treatments. If these pimples don’t respond to over-the-counter products, dermatologists can treat severe back acne with prescription medications.

Depending on how many zits you have on your back, you may need to try different types of treatments. It might take several weeks for them to clear up. Your healthcare provider may recommend a combination of medications to get the results you want.

When should I see my healthcare provider about back acne?

See your healthcare provider if:

• Back acne is severe, or if it goes away and comes back.
• You feel hard or painful nodules or have pimples deep under your skin.
• You have severe pain or inflammation.
• You have signs of an infection, such as a fever.

A note from Cleveland Clinic

Back acne can range from mildly annoying to very painful. These back zits can take time to treat, especially if you play a sport that requires you to wear heavy equipment or padding on your back. To prevent back acne, always clean your skin after you sweat and change into a clean, dry shirt after a workout. Also, try to limit the friction and pressure on your back by avoiding equipment that rubs against your skin. If back pimples are painful or they keep returning, see your healthcare provider.