The great war on acne may never be won but the most hidden type can often be bacne, or back acne. A blessing and a curse, generally hidden from view but harder to treat, we’re seeing it’s rise as the weather warms up and we return to our gyms and exercise routines out of isolation. And while it’s not written all over our face, back acne can cause feelings of embarrassment, disgust and anxiety.
“The skin on our back is thicker and more sebaceous which means it has more oil-producing glands than other areas of the body,” explains dermatologist and All About Acne member, Dr Mei Tam. “Stating the obvious, it’s also difficult to reach”.
Dr Tam admits there can be many reasons for back acne and most of them are the same as acne anywhere else on the body. “Family history, acne can run in families; hormones; environmental factors such as humidity and clothing; severe stress; certain medications can be a trigger; steroid use; and specific diseases such as PCOS can also cause back acne”, she says.
“Why we see an increase in back acne when going back to the gym is due to sweating. It’s a combination of clothing that retains sweat and doesn’t allow your skin to breathe plus the added difficulty of washing the back properly, simply a reach factor”.
Considering the large surface area of skin and how difficult it is to reach, Dr Tam suggests that some topical medicines may not be appropriate. “Try to unblock pores with salicylic acid and benzoyl peroxide washes and gentle exfoliation, no harsh scrubbing!” she says. Medication such as topical or oral antibiotics as well as hormonal treatments such as the oral contraceptive pill are also options. And, as with facial acne, if back acne is severe then isotretinoin should be discussed with your dermatologist.
We should also consider showering as soon as possible after a workout and putting sweaty workout clothes immediately in the wash – this also includes our own gym towels which have become a COVID-19 necessity. Loose clothing should be chosen where possible and tie hair up off your back and neck. Consider adding the odd yoga or meditation session to your routine to keep any stress at bay but importantly, know when it’s time to see a specialist.
“Give over the counter products enough time to work, which is at least four weeks to see some improvement,” Dr Tam explains. “However, if you’re unresponsive or have severe or inflammatory acne, you’re at greater risk of scarring where seeking early treatment by a dermatologist is crucial”.
Dr Mei Tam is member of All About Acne and Melbourne Skin Clinic, and consultant dermatologist at Skin Health Institute and St Vincent’s Hospital (Melbourne).