We Ask a Derm: How Do I Clear Up Bacne and Back Acne Scars?
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Dealing with a case of back acne or bacne? You’re not alone. “More than 50 percent of people with facial acne also have acne on their back, shoulders and chest, so it is a fairly common issue,” assures Dr. Caroline Robinson, a board-certified medical and cosmetic dermatologist in Chicago.

Luckily, there are a number of ways to treat the breakouts, which Dr. Robinson and Dr. Lily Talakoub, a board-certified dermatologist and founder of McLean Dermatology and Derm to Door share tips for ahead.

What are the main causes of bacne? 

Acne, whether on the face or the trunk of your body (i.e., the chest, shoulders and back) is caused by a combination of oil, bacteria and dead skin clogging the pores. Back acne is sometimes worsened by sweat as well,” explains Robinson.

What are things we can do to treat bacne at home?

There is no one-size-fits-all solution, as everyone is different. In general, wearing loose-fitting workout clothes made of cotton or sweat-wicking fabric may help by reducing the excess sweat exposure on your skin, as well as washing your workout clothes after each wear,” recommends Robinson. “Changing your bedsheets and pillowcases weekly can also help by lessening the amount dead skin cells and bacteria coming in contact with your skin.”

Robinson adds, “It is also important to cleanse and treat your skin regularly and gently, as being too abrasive with your routine (think: excessive exfoliation) can worsen acne.”

Timing is important, too, says Talakoub. “When you wash up, make sure to shower right after workouts, so the sweat doesn’t sit for too long on your skin.”

And, last but not least, both derms agree that it is important to always protect your skin from the sun with a non-comedogenic (meaning it won’t clog pores) sunscreen when heading outdoors.

What products work for treating bacne?

Benzoyl peroxide, which is both anti-microbial and anti-inflammatory is a great option to address occasional breakouts on the body. This can be found over the counter as a body wash or leave-on product,” advises Robinson.

Talakoub seconds the benzoyl peroxide and also recommends applying a leave-on treatment with salicylic acid after showering.

“For more moderate acne breakouts, the American Academy of Dermatology advises that benzoyl peroxide be used in conjunction with topical retinoids, which your dermatologist can prescribe,” she adds. “Prescription retinoids are helpful in treating active breakouts and preventing new ones from forming.”

Is there anything you should avoid when it comes to bacne? 

“Bacteria and oil clog the pores and cause acne, so avoid sitting in sweaty or dirty clothes for too long!” cautions Robinson. “You can also lessen irritation by avoiding anything that rubs against your back, such as body brushes, scratchy loofas or even a backpack. Lastly, avoid picking or popping acne, as this will only make acne worse and cause hyperpigmentation.”

At what point should you see a dermatologist for bacne? 

When over-the-counter products aren’t working out for you, it’s time to see a dermatologist, who can prescribe different treatments. Dr. Robinson is a fan of Aklief, which contains trifarotene (aka the first retinoid molecule to be approved by the FDA in over 20 years).

“Aklief is unique because it specifically targets the factors that cause acne. This selectivity means that the product is potent even at low doses, which means it is safe to use on larger surface areas, like the back,” she explains.  

How can you lighten up hyperpigmentation left behind from old breakouts? 

“I always try to educate patients on the many different factors that can contribute to hyperpigmentation, including inflammation, hormones, pollution, the sun and genetics,” says Robinson. “Because of this, there is no single solution that works for everyone, and patients will likely need to try many different treatments over an extended period of time to see results. That said, sunscreen should always be the first line of defense against hyperpigmentation,” she adds.

Beyond that, Talakoub recommends seeing your dermatologist for “a series of light chemical peels once every month or microdermabrasion” to lighten up leftover pigmentation.

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