Updated 07/21/21. When I was a teenager, I suffered from terrible back breakouts. Sure, I would get the occasional breakout on my face and around my hairline (this would exacerbate in my 20s), but most of my breakouts appeared on my back. To make matters worse, it was primarily cystic—the hard, sore, underground bumps that take weeks to go away. I visited a dermatologist who gave me oral antibiotics and topical benzoyl peroxide to use on my back. The combination helped lessen the breakouts, but I was left with dry, itchy skin and bleached clothing from the peroxide.
Body acne, whether it be on the back, neck, or chest, can be frustrating to address. The good news is that we’ve come a long way from relying on antibiotics and harsh, drying topical creams. In this post, I’ll teach you how you can try to get it under control, sharing advice I wish I knew back when I was dealing with my own back breakouts.
What Exactly Is Body Acne?
Body acne is fundamentally the same as that which develops on the face, but it can be challenging to address since it often covers a larger surface area on the body (not to mention it’s often located in hard-to-reach spots). It occurs as a result of overactive oil glands combined with blocked pores caused by dead skin cells that aren’t being shed. These factors create an environment in which “bad” bacteria can thrive and cause those red, inflamed bumps we know all too well.
It normally develops on the back and chest, because the skin is thicker, and both areas have an abundance of sebaceous glands that produce oil. It can also sometimes be found on the arms, but it’s generally not found on the lower body. When it comes to back and chest breakouts specifically, you’ll likely see either larger pustules, which are inflamed red spots with a “whitehead,” or cysts, which are often painful bumps that form deep under the skin and never come to a head. It’s important to refrain from picking at cystic blemishes since the body usually reabsorbs them from within. Picking won’t make the blemish go away any faster and could result in long-lasting damage to the skin in the form of hyperpigmentation, also known as post-breakout scars.
What Are Possible Causes of Body Acne?
As is the case with most acne, the biggest trigger for body acne is hormones. Stress can also be a trigger since it encourages the production of androgens—a group of hormones that can stimulate oil production. Breakouts on the back and chest can also be caused by tight-fitting clothing, especially when that clothing is worn during sweaty workouts. The same goes for athletic equipment such as football pads (this is especially common in teens).
How Can I Get Rid of Body Acne?
Here are my tips for getting body breakouts under control.
Avoid Tight-Fitting Clothing
Body acne can’t always be completely avoided, but it’s still a good idea to break habits that could be contributing to it. Tight-fitting clothing, particularly tight-fitting workout gear, could be a trigger. Clothes that trap heat and moisture against the body for prolonged periods of time and/or create friction should be avoided. Opt for loose-fitting clothes instead. (On that note, learn more about how to care for your skin when working out).
Clean Your Bedsheets Weekly
When someone struggles with breakouts on their face, I usually tell them to be diligent about changing their pillowcases to avoid reintroducing oil, dirt, and bacteria to the skin. The same concept applies to the body. Regularly cleaning your sheets may minimize oil buildup.
Opt For Sun-Protective Clothing
Sunscreen is important, but it’s also tricky since so many formulas are notorious for exacerbating breakouts. This is especially true for waterproof formulas that are applied to the back and body. That’s why I recommend opting for sun-protective clothing if possible. This will protect sensitive areas, like your chest and back, from the sun. Be sure to choose clothing with a UPF rating (which is essentially SPF for clothing).
Check Your Hair Conditioner for Panthenol
Remember how I struggled with back breakouts as a teenager? Well, it took me a long time, but I eventually realized it was being caused by an ingredient in my conditioner called panthenol (vitamin B5). Someone has mentioned it to me, so I checked my conditioner, and I discovered that it was very high up in the ingredient list which means it had a lot of it in there. Since I was bleach blonde, I used a lot of conditioner after shampooing, and the residue that was left on my back was apparently causing a big issue for me. So, I found a conditioner that didn’t contain panthenol (which wasn’t easy to find, by the way) and my breakouts literally vanished. If I ever slept over at a friend’s house and didn’t have my panthenol-free conditioner and had to use one with this ingredient in it, I would get breakouts on my back within a day or two. Through the years I have suggested to people with back acne to avoid panthenol and have had a lot of feedback that it was the cause of theirs, too. While this certainly may not be the cause of everyone’s body acne, it’s worth considering.
This is my personal experience with panthenol (and anecdotal evidence is never one to be discounted!), however, some research has shown that it could actually benefit blemish-prone skin by helping to reduce acne lesions and scars. That’s why I recommend testing it out for yourself. If you struggle with back breakouts, try using a conditioner without panthenol to see if it has an effect. If it does you can assume it’s a trigger. If it doesn’t, then you can assume it’s not a trigger.
On that note, it’s important to know that panthenol should not cause breakouts when used in skincare products, since the percentage at which it’s included is so low. It’s an excellent moisturizing ingredient that I use in my own skincare product line, and I’ve never had an issue with using it. It only seems to become an issue for some people when it’s used in high concentrations in hair products (read all about how to read an ingredient list).
People who are prone to body acne are those who produce excessive oil, and generally speaking, those who have oily skin on their face will also have oily skin on their back and chests. Since oil is a breeding ground for bacteria, one of the ways to reduce breakouts is to shower often—as often as twice a day if it’s hot out. Trust me, keeping the skin clean can make a huge difference.
I also recommend showering as soon as possible after working out. While sweat doesn’t technically cause acne, it can disrupt the normal flow of oil within the pore. If you can’t shower immediately after working out, apply a cleanser to a damp washcloth and wipe it over the affected area.
Use a Pore-Clearing Cleanser
Every time you shower, I suggest using a pore-clearing cleanser to clean the skin, remove oils, and reduce the number of “bad” surface bacteria that are present. It can be difficult to find a body cleanser that fits the bill, so I actually prefer using a facial cleanser, instead. Look for one that’s formulated for blemish-prone skin types, is sulfate-free, and uses salicylic acid. The goal is to clean the skin and pores without drying them out.
Be Sure to Exfoliate
Dead skin cells can clog pores, so it’s crucial to gently remove buildup by exfoliating every time you shower. If back breakouts are your concern, it can be hard to reach certain areas. A simple solution is to apply your cleanser directly to a loofah or cloth. This physical exfoliation will help slough off dead skin cells that have been loosened by exfoliating acids. Just be sure to use light pressure to avoid causing unnecessary redness or sensitivity.
I also recommend applying a salicylic acid serum to the affected area. This can help reduce the appearance of new breakouts and address discoloration from old breakouts. Apply a salicylic acid serum twice a week, for best results.
Apply a Spot Treatment When Necessary
Body acne tends to be rooted deep in the skin and the infection often won’t come to the surface, so you’ll want to choose a spot treatment carefully. Look for something like Anti Bump Solution that doesn’t focus on drying a blemish out. If a blemish is not on the skin’s surface, drying it out will only make matters worse.
Applying a drying spot treatment can only be helpful if you have blemishes that come to a whitehead. If you aren’t having much luck with spot treatments, benzoyl peroxide could be worth a shot. Using it as a spot treatment will prevent unnecessary dryness.
Schedule a Back Facial
All of the suggestions I’ve given are great to do at home. However, if you’re struggling to see results, schedule an appointment with a professional. Many spas offer back facials, which are designed to clean out clogged pores. In addition to the back facial, an esthetician may offer expert advice based on what they observe with your condition.
Use Medication If Necessary
If you’ve been diligent about caring for your skin in all of the ways I’ve described, including seeking professional help, then it’s time to consult a dermatologist. They may suggest temporary antibiotics or a topical retinoid. There are also medications that can directly address hormonal imbalances that may be causing your body acne.
Celebrity Esthetician & Skincare Expert
As an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”