Body acne, or truncal acne refers to acne affecting the body, and is common in acne patients. For example, around 50% of those with facial acne have acne on the back and on the chest. In this article we will explain the causes of breakouts on your body, and discuss back acne treatment, back acne scars, and tips for prevention.
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What is back acne?
While you may be more familiar with acne on the face, acne can develop on your body too. Acne Vulgaris, one of the most common skin diseases, is a chronic inflammatory disease that occurs most commonly at areas of the skin with a high number of sebaceous (oil) glands. These areas include the face, chest and back. Additionally, while body acne is most commonly on the back and chest; the buttocks might also develop acne due to irritation from sweat, and ill-fitted clothing.
Back acne causes
The same factors causing facial acne, trigger the acne on your body. These factors are overproduction of sebum, excess of dead skin cells, skin microbiome disbalance due to the bacteria C acnes, and inflammation. One study conducted by Dagnelie et al showed that the inflammatory mechanisms in acne lesions on the back appear very similar to that of facial acne, as imbalance of the skin microbiome activates our innate immunity.
Moreover, similar to facial acne, other factors that play into back acne causes are genetics, nutrition and diet, clothing, climate, sweat. Another possible cause of body acne could be the circulating hormones in our bodies. Testosterone, present in both males and females, can lead to overproduction of sebum. Furthermore, when keratinocytes or skin cells don’t shed normally on the surface of the skin, it can lead to a buildup of oil and dead skin. This can lead to acne in the form of open (blackhead) or closed (whitehead) comedones on the body.
How to prevent back acne – body acne skincare routine
1. Develop good habits when working out
Wear loose-fitting clothing with sweat-wicking fabric or breathable textiles like cotton. Make sure to wash your workout clothes after each use. Furthermore, take a shower and change into clean clothes after exercising or any activity that causes you to sweat. However, if you cannot shower immediately, use the anti-inflammatory oil blotting linen to gently blot away oil from your skin. Additionally, try to change out of sweaty clothes when possible.
The Anti-inflammatory Oil Blotting Linen is made from the Cannabis Sativa Plant that stabilizes skin oils through its natural plant extract content. This helps to moistruize and hydrate your skin.
2. Try not to pick and pop acne
Doing so can worsen the acne on your chest and back.
3. Change your pillowcase and sheets frequently
An average person will spend 229,961 hours in their lifetime sleeping, given that an average person sleeps 8 hours every night. Clean sheets are essential for preventing body acne. After a week, there will be accumulation and build up for dead skin cells, oil and grime on your sheets. Dermatologists advise that the material in contact with your skin, especially your pillowcase, should also be non-irritating and breathable.
The Copper Pillow Case is made of copper nanoparticle impregnated fabric. Our CUIONS™ Fabric has been laboratory tested to kill Staphylococcus Aureus**, a common bacteria that can cause secondary skin infections in acne and worsening of eczema. **Laboratory studies show 99.9 percent reduction in Staphylocuccus Aureus upon contact with CUIONS™ copper fibre.
4. Protect your skin from the sun
The sun’s UV rays can darken acne, leading to the formation of scars from acne. Apply sunscreen on areas that are not covered by clothing, and help to protect your skin from oxidative damage caused by UV exposure.
The SunProtector is exquisitely formulated for humid climates. It is a broad-spectrum sunscreen that also regenerates and soothes sensitive skin.
5. Wear loose-fitting clothing to sleep
Tight-fitting clothing can cause unnecessary irritation and friction, potentially worsening the acne lesions on your body.
The Anti-ageing Kimono in CUIONS Gold features a nanoparticle integrated biofunctional textile¹ woven into a luxurious garment with minimal seams for ultimate skin comfort and breathability. The garments targets the skin microbiome and helps to treat body acne and eczema through its bactericidal properties.
Back acne scars
Individuals with acne sometimes find that acne scars occur more frequently on the body rather than the face. A reason for this is that when located on the body, individuals may be less bothered by the scars rather than those with scars on the face as they are less visible in daily life. Therefore, this reduced visibility can lead to a perceived lesser impact on social and daily activities, and thus individuals may not initiate treatment early enough.
Hypertrophic scars are the most common type of back acne scars. These are characterized by extra layers of scarring on top of the skin. Keloid scars are shiny and smooth, and are growths of scar tissues. Sometimes back acne can produce scars that are sunken in or resembles a puncture. These are atrophic scars.
Back acne treatment
It is important to implement a healthy cosmeceutical skincare routine to help maintain a healthy skin microbiome, preventing skin barrier dysfunction and thus, inflammation that can lead to back acne.
For back acne treatment, use a gentle cleanser. Harsh soaps with astringent ingredients can worsen acne. Traditional anti-acne ingredients such as salicylic acid, benzoyl peroxide can cause irritation to the skin. Instead, choose botanical antibacterial ingredients such as medical grade honey to gently cleanse areas of your body prone to acne.
Apply an anti-inflammatory pimple cream to your back and chest acne for treatment. Research has shown that lipid extracts from six chlorella species are effective in the inhibition of the lipase enzyme and ROS produced by P. acne. The same test was conducted to test for the inhibition of pro-inflammatory cytokines and chlorella was found to be effective against inflammation1. These anti-inflammatory properties of chlorella work together to help prevent acne breakouts, making it a potent bioactive ingredient for pimple cream.
If you have moderate to severe body acne, your dermatologist can help you start on a routine and medication that will help to clear up your back acne. There are a few types of oral medications that your skin specialist may prescribe. Firstly, antibiotics to kill bacteria and reduce inflammation. Sometimes, this is prescribed alongside a topical medication or cosmeceutical skincare products. Other oral medications include birth control pills that impact the hormones. These help to reduce oil production in the skin. Additionally, your dermatologist may also prescribe Isotretinoin if you have severe back acne.
Other skin procedures that your skin specialist may recommend to help treat your back acne, would be lasers and other light therapies, or chemical peels. Blue light therapy can help to reduce the levels of P.acnes on the skin. Chemical peel procedures in a dermatologist’s clinic that include glycolic acid, salicylic acid etc can be helpful in back acne scars treatment. According to a study, a single application of a chemical peel can improve a scar’s appearance by up to 90%.
When acne is not acne – Pityrosporum Folliculitis
Several skin diseases that occur on the body may be misdiagnosed or mistaken to be acne. Pityrosporum Folliculitis is a skin disease that appears as an eruption of papules and pustules on the face and the body. Hence, it is often confused with acne.
It results from the overgrowth of the yeast Malassezia in hair follicles and the skin’s microbiome. Like P.acnes, Malassezia has shown to induce skin cells to induce inflammation, which may explain the clinical similarity between Pityrosporum folliculitis and acne. Features that differentiate between the two are the absence of comedones and presence of lesions that cause itchiness.
When to see a dermatologist
If you are unsure if the spots on your back and chest are due to acne or Pityrosporum Folliculitis; or need to treat your back acne, visit a dermatologist to diagnose your condition.
Dr. Teo Wan Lin is an accredited dermatologist treating acne in Singapore who specialises in the diagnosis and treatment of skin diseases. She is also the founder of cosmeceutical skincare line Dr.TWL Dermaceuticals, which develops evidence-based cosmeceutical actives for the adjunct treatment of acne. She is also the author of Skincare Bible: Dermatologist’s Tips for Cosmeceutical Skincare, and Masking Up: A Dermatologist’s Guide to Maskne.