Back Acne Basics: How to Get Rid of Back Acne

Back acne affects about 50 million American adults annually. Research shows half of those battling facial acne also get breakouts on their backs and upper bodies. Understanding what causes back acne and how to effectively treat it is the first step toward clearer skin.

Back acne doesn’t just affect teenagers; it can appear well into adulthood. Many adults experience flare-ups during stressful periods, hormonal shifts, or after increased sweating and friction from workouts. While frustrating, most cases are manageable with the right care routine and professional support.

What Is Back Acne?

Back acne, or “bacne,” affects around 85% of people between ages 12 and 24. It presents unique challenges compared to facial acne. Back acne starts when oil, dead skin cells and bacteria clog hair follicles on your back. Because your back contains more sebaceous glands than other body areas, and the skin is thicker than on your face, different acne treatment approaches may be required.

Many patients notice that their back acne tends to worsen in hot, humid weather or after exercise. This is because thicker skin and more active oil glands on the back trap sweat and oil more easily. If you’ve wondered “why am I getting acne only on my back,” it’s often due to this combination of excess oil, sweat, and friction.

Types of Back Acne

Back acne can manifest in different forms and a person can have more than one type simultaneously. Additionally, back acne can vary in severity.

Whiteheads

Whiteheads show up as closed comedones with white centers when plugged follicles remain under your skin. Dead skin cells and oil get trapped below the skin’s surface to create these spots.

Blackheads

Blackheads form when clogged follicles open at the skin’s surface and turn dark due to the sebum reacting with air. These open comedones are common on the back and require consistent cleansing to prevent further buildup.

Papules

Papules are small pink bumps without clear heads. These sensitive spots develop when hair follicles become clogged and inflamed. The inflammation leads to pustules (or pimples), which are white or yellow pus-filled bumps with red bases. Papules form when white blood cells fight the follicle’s inflammation.

Nodules and Cysts

Nodules and cysts are more serious forms of acne. Bacteria trapped in hair follicles create nodules, which are hard, painful lumps deep under the skin that can damage tissue. Cysts are the most severe type, and they are large, pus-filled lesions that go deep into the skin and often leave permanent scars.

Some people also develop post-inflammatory hyperpigmentation – dark marks that linger after acne clears. Others may notice rough texture or scarring that requires dermatologic procedures like chemical peels or laser therapy to smooth and even out the skin. Treating both active acne and scarring early helps reduce long-term discoloration and discomfort.

Why Do I Have Back Acne?

Back acne, often called “bacne”, is caused by the same factors that lead to facial acne: clogged pores, excess oil production, and bacteria. Genetics, hormones, and friction from clothing or activities can also contribute to back acne breakouts.

Common Back Acne Causes

Back acne breakouts happen due to several factors working together. We produce sebum through our sebaceous glands – an oily substance that protects the skin. But these glands can become overactive, and excess sebum mixes with dead skin cells, which leads to clogged pores.

Hormone Levels

Your hormone levels substantially influence the development of acne. Due to hormonal fluctuations, sebum production increases during puberty or pregnancy. This extra oil creates perfect conditions for bacteria to thrive and cause breakouts.

Both men and women experience hormone-related breakouts. In males, testosterone increases oil production, leading to deeper and more persistent acne. In females, hormonal changes during the menstrual cycle or pregnancy can trigger new flare-ups. For anyone asking “what causes back acne in females and males,” the answer is often linked to these hormonal fluctuations combined with daily lifestyle habits.

Stress also impacts hormones by increasing cortisol – a hormone that stimulates oil production. Managing stress through exercise, hydration, and sleep can help keep flare-ups under control.

Physical Factors and Sweat

Physical factors make back acne worse. The clothes you wear, backpacks and sports equipment create friction against sweaty skin. Sweat gets trapped between your skin and clothing and clogs pores, which becomes worse for people with excessive sweating (hyperhidrosis).

If you exercise regularly, showering right after workouts is one of the best ways to prevent back acne. Leaving sweat on the skin allows bacteria to multiply and can lead to larger, inflamed bumps. Wear breathable fabrics and wash gym clothes often to minimize irritation.

Yeast Infection

Malassezia, a type of yeast, thrives in humid, sweaty environments and can complicate back acne. This microorganism enters hair follicles and causes a condition called pityrosporum folliculitis, which resembles traditional acne. This poses a unique challenge for treatment, as standard acne remedies may not effectively address yeast-based infections. Although this condition can occur on the face or body, the back’s larger sebaceous glands and increased sweating make it particularly vulnerable.

A dermatologist can help distinguish yeast-related breakouts from bacterial acne and prescribe antifungal medications when necessary. If your back acne doesn’t respond to regular treatments, this may be the cause.

Other Triggers

These triggers can cause or worsen back acne:

Genetic Predisposition: Your family’s history increases acne risk.
Medication Effects: Certain drugs, particularly corticosteroids, can trigger breakouts.
Stress Response: High anxiety levels boost cortisol production and increase sebum output.
Skincare Products: Some lotions and body creams can block pores.

Environmental factors like humidity and pollution can also worsen clogged pores. Even something as simple as not rinsing conditioner thoroughly can leave residue that leads to flare-ups across the upper back.

Is Back Acne Caused by Testosterone?

Yes, elevated testosterone levels can contribute to back acne. Testosterone increases sebum (oil) production, and when excess sebum mixes with dead skin cells and bacteria, it can clog pores and lead to acne, including on the back.

Here’s why and how testosterone is linked to acne on the back:

Sebum Production: Testosterone, an androgen, stimulates the sebaceous glands in the skin to produce more sebum, an oily substance.
Clogged Pores: When there’s an overproduction of sebum, it can mix with dead skin cells and bacteria, leading to clogged pores (hair follicles) on the skin.
Bacterial Growth: Clogged pores provide an environment where bacteria, like Propionibacterium acnes, can thrive, causing inflammation and pimples.
Back Acne: The skin on the back, particularly the shoulders and upper back, is rich in sebaceous glands, making it a common area for acne, especially when testosterone levels are high.
Hormonal Fluctuations: Fluctuations in testosterone levels, such as during puberty or with testosterone replacement therapy, can trigger acne outbreaks.
Other Factors: While testosterone plays a significant role, other factors like genetics, skin care habits, and lifestyle choices also influence acne development.

Those managing hormonal acne may also benefit from dermatology-prescribed medications that balance hormone levels. For some patients, oral contraceptives or medications like spironolactone can regulate oil production and reduce breakouts.

How to Get Rid of Back Acne

Getting rid of back acne needs both good skincare and lifestyle changes. Consistency is key – acne on the back can take longer to heal because the skin is thicker and has more oil glands than the face. Gentle, steady care over several weeks usually brings the best results.

Adopt a Back-Friendly Skincare Routine

A consistent and gentle skincare routine can significantly reduce back acne. Here’s what to include:

Cleanse Regularly: Use a mild, non-comedogenic body wash with salicylic acid or benzoyl peroxide to unclog pores and reduce inflammation.
Exfoliate Weekly: Opt for a gentle exfoliating scrub with ingredients like glycolic acid to remove dead skin cells. Avoid harsh scrubs that can irritate the skin.
Moisturize: Acne-prone skin needs hydration. Choose lightweight, oil-free moisturizers designed for acne-prone skin.

You can also incorporate topical retinoids (like adapalene) to promote faster cell turnover and prevent clogged pores. If you’re looking for the best back acne treatment, combining active ingredients with dermatologist guidance often provides faster, more lasting results.

Wear Breathable Clothing

Tight-fitting clothing can trap sweat and oil against your skin, worsening breakouts. Wear loose, breathable fabrics, especially during workouts. Avoid backpacks or straps that cause friction.

If your acne flares after exercise, look for workout wear made of moisture-wicking materials and avoid sitting in damp clothing. Simple changes like these can help reduce friction and bacteria that lead to new breakouts.

Use Over-the-Counter Treatments

Topical treatments containing active ingredients like salicylic acid, benzoyl peroxide, or sulfur can effectively target acne. Apply these products after showering and ensure they dry before dressing.

If OTC options don’t help, ask a dermatologist about prescription treatments like retinoids or antibiotics. In-office treatments such as chemical peels or laser therapy can also target stubborn acne and scarring.

Maintain a Healthy Diet

Certain foods, particularly those high in sugar or dairy, may trigger acne. Incorporate a diet rich in fruits, vegetables, whole grains and lean proteins. Stay hydrated to support skin health.

Balanced nutrition supports clearer skin from the inside out. Omega-3 fatty acids, zinc, and antioxidants all play a role in reducing inflammation and oil buildup.

Consult a Dermatologist for Persistent Acne

If over-the-counter treatments don’t provide relief, consult a dermatology specialist for professional help. They may recommend:

Prescription Medications: Topical retinoids, antibiotics or oral medications like isotretinoin for severe cases.
Chemical Peels: Dermatologists and dermatology specialists can apply salicylic acid or glycolic acid peels to exfoliate and clear acne.
Laser Therapy: Laser treatments can target acne-causing bacteria and reduce inflammation.
Corticosteroid Injections: For large, painful cysts, injections can reduce swelling and speed up healing.

If scarring or dark spots have developed, professional treatments can also fade hyperpigmentation and smooth uneven skin texture. Microneedling and fractional laser therapy are particularly effective for acne scars on the back.

When to Seek Back Acne Treatment

Persistent, severe or back acne with scarring requires expert care. Seek treatment if:

Over-the-counter products are ineffective after 8 to 12 weeks of consistent use.
Acne causes significant pain or discomfort.
Breakouts lead to emotional distress or low self-esteem.
Acne scars begin forming.

Back Acne Treatment at Schweiger Dermatology Group

At Schweiger Dermatology Group, we’re here to help you achieve healthier, clearer skin. Schedule a consultation with any of our providers to explore treatment options. To make an appointment, book online or call 844-DERM-DOC.

Frequently Asked Questions About Back Acne

What causes back acne in females?

Back acne in females is often linked to hormonal fluctuations that increase oil production, such as during menstrual cycles, pregnancy, or times of stress. Lifestyle factors, like tight clothing, certain hair or skincare products, and sweating can worsen these flare-ups. A dermatologist can help identify whether hormonal or external triggers are contributing and recommend personalized treatment.

What causes back acne in males?

Back acne in males is typically caused by elevated testosterone levels that increase oil production in the skin. This excess oil, combined with sweat and friction from sports equipment or clothing, leads to clogged pores and inflammation. Men who are physically active or wear tight-fitting gear may experience more frequent or severe breakouts.

What are the best skincare products for treating back acne scars?

The best skincare products for back acne scars include those with ingredients that support cell renewal and brighten skin tone. Look for glycolic acid, lactic acid, or retinoids to smooth texture, and choose niacinamide or vitamin C for fading dark spots. Sunscreen is essential every day to prevent scars from darkening, and for more visible scars, dermatology procedures like laser resurfacing or chemical peels are highly effective.

What are natural way to get rid of acne scars?

A natural way to get rid of acne scars includes consistent exfoliation and the use of soothing, restorative ingredients. Aloe vera, rosehip oil, and honey can help reduce discoloration and support the healing process over time. While these natural options can gently improve skin tone, professional treatments deliver faster and more dramatic results when scars are more pronounced.

Can lifestyle changes help reduce back acne and scars?

Yes. Simple lifestyle changes can make a noticeable difference in preventing back acne and minimizing scars. Shower right after workouts, avoid tight or sweaty clothing, and keep bedding and towels clean. Maintaining a balanced diet, staying hydrated, and managing stress can also reduce hormonal flare-ups and promote faster skin healing.

Why am I getting acne only on my back?

The back contains more sebaceous (oil) glands than most areas of the body, which makes it prone to clogged pores. Sweat, friction from clothing or backpacks, and thicker skin combine to create an ideal environment for breakouts. Even if your face remains clear, these unique conditions make back acne more common in this area.

How long does it typically take to see results from back acne scar treatments?

Results vary depending on the type of treatment and severity of scarring. Mild dark spots can fade within several weeks with consistent topical use, while deeper scars may take two to three months or more of professional care. Most patients notice smoother texture and more even tone after a few treatment sessions with a dermatologist.

This blog was originally posted on 02/20/2025 and has since been updated.