Even with so much information on acne available, there are still a lot of questions about the most common skin condition in the U.S. Specifically, how does acne on our bodies differ than the acne on our faces? Also, why do people get back acne, or “bacne,” how can you reduce it, and how do you treat an area you can’t even reach? Here, skin-care experts explain how to tackle it and the back acne scars left behind.
How Back Acne Scars Form
Back acne scars, often referred to as “bacne” scars, are the result of the body’s natural healing process following the inflammation and damage caused by back acne.
“Bacne” is usually a condition that happens alongside normal acne, explains Omaha, NE dermatologist Joel Schlessinger, MD. Genetics and diet can factor in, but “bacne” is typically the result of an accumulation of dead skin cells and oil in pores, combined with an overgrowth of a common skin bacteria. “There are, however, many situations where it can occur without accompanying acne,” he adds. “In my patients, I often find that milk and milk products, such as cheese or yogurt, can cause acne to flare due to the hormones that are inside of milk. I ask my patients to switch to almond or oat milk as they have none of the hormones and all the ‘good stuff’ that can help build bones and maintain health.”
“Nourishing yourself through whole food sources, choosing organic fruits, vegetables, and protein sources free of hormones and antibiotics, as well as limiting or avoiding processed foods and refined sugars can be very helpful for ‘bacne’,” adds New York dermatologist Libby Rhee, MD. “Drinking plenty of water and avoiding alcohol, flavored sodas (even diet), and juices from concentrate are also nutritional choices that can be helpful when combating truncal acne.”
Types of Back Acne Scars
There are primarily two types of acne scars that can form on the back. Hypertrophic or keloid scars and atrophic scars. Hypertrophic or keloid scars occur when there is an overproduction of collagen during the healing process. They result in raised, thickened areas of skin that can be more noticeable than the surrounding skin. Atrophic Scars are the more common type of acne scars. Atrophic scars are formed when there is a loss of tissue during the healing process, leaving depressions or indentations in the skin. There are three subtypes of atrophic scars: ice pick, boxcar, and rolling scars.
Preventing Back Acne Scars
The best way to prevent back acne scars is to manage and treat acne promptly. Avoid picking or squeezing acne lesions, as this can worsen scarring. Additionally, using proper skin-care routines and seeking dermatological advice for severe cases of back acne can help minimize the risk of scarring.
The best way to prevent back acne scars from forming is to frequently cleanse the skin to prevent and treat active pimples and to decrease inflammation, says Beverly Hills, CA oculoplastic Surgeon Christopher Zoumalan, MD. “Body cleansers with ingredients such as salicylic acid can help unclog pores and reduce swelling. It is important to moisturize the skin after cleansing with an oil-free body lotion that will balance the skin but not clog pores.”
Our experts also recommend using a loofah or exfoliating gloves with a gentle exfoliating cleanser in the shower. “Make sure not to scrub the skin too aggressively, which can compromise the skin’s moisture barrier and lead to irritation and potentially even more acne down the road,” shares Dr. Rhee.
“Showering after a workout, wearing sweat-wicking clothing, keeping your hair tied up and off your back, and exfoliating with a alphahydroxy or betahydroxy acid regularly can help prevent back acne,” adds New York dermatologist Jody A. Levine, MD. “Washing your back with a benzoyl peroxide cleanser daily is effective as well.“
“One of our favorites to add to a regiment is Cetaphil Gentle Skin Cleansing Cloths ($5) to keep in your gym bag and after exercise or sweating,” recommends Fort Lauderdale, FL dermatologist Dr. Matthew Elias. “Use the wipe to cleanse your body and your back, particularly if you don’t have access to a shower after working out.”
Do This, Not That
The experts say it’s crucial to not pick at or try to pop any pimples on your back, as this will damage skin and make scars more likely. “Salicylic acid, retinoids, alpha hydroxy acids (AHAs), and lactic acid may help the appearance of ‘bacne’ scars and improve the texture of the skin,” adds Dr. Zoumalan.
Choose an exfoliating body cream as they are able to target scarring and textural concerns as they moisturize. “There are a few such as ISDIN’s Uradin Lotion 10 ($39) and CeraVe SA Lotion for Rough & Bumpy Skin ($19) with salicylic acid,” says Dr. Rhee. “Since the skin on your back doesn’t produce as much oil as the skin on your face, I recommend applying the topical retinoid a few times a week at night, mixed in with your body moisturizer for better spreadability. I love RoDerm’s CustomRx tretinoin-based creams because they are super effective and feel good. Take a pea-sized amount of your topical retinoid, up to a dime-size depending on how much surface area there is, mix it right into your body lotion and then apply to your back before bed. You can increase to a nightly application as tolerated.”
Back Acne Scar Treatment
New York dermatologist Orit Markowitz, MD says scars need tender loving care, but most importantly need to be prevented. “The best treatment is managing future scars but once that is completed there are many topical scar creams. Keeping the scars moist and covered in sunscreen is important for healing.”
The thicker, more raised hypertrophic scars are the most common type of scars caused by “bacne.” “If they become pitted or thickened over time or have a purple or reddish pigmentation, specially formulated scar creams, like Skinuva Scar Cream ($75), may be beneficial in improving the appearance of the scarring,” Dr. Zoumalan explains. “Carefully applying it over the acne scar twice a day can help flatten and reduce the hyperpigmentation associated with acne scars. It has been specially formulated to tolerate all skin types and skin tones with its unique clinically studied and published formulation consisting of synthetic growth factors, hyaluronic acid, vitamin C, centella asiatica and aloe vera.”
Serious Solutions
According to Dr. Schlessinger, you’d have better luck ensuring you don’t get a scar in the first place than treating an existing one, but if nothing else works there are in-office solutions that can help. “We often inject a mild steroid into these areas,” he says. “Many acne scars are still ‘active’ and the treatment of the acne can lead to resolution of the ‘scar’.”
“Chemical peels and lasers can prevent acne or enhance healing of acne and reduce the pigmentation and discoloration caused by acne, as well as improve skin tone and texture,” adds Dr. Levine. “Microdermabrasion can decongest pores and small comedones. Extractions or acne surgery is also a good treatment.”
New Laser Options
According to Dr. Markowitz, steriods and lasers will also help improve the look of bacne scars. “I like the Prima Laser for managing active acne,” she says. “If it’s cystic, we have the new Aviclear acne laser and will use that alongside prescription topicals or orals to help clear the ‘bacne.'”
“If you experience recurring cases, it is important to speak with your dermatologist to address the potential cause of your ‘bacne’ and identify the best active treatment for you to prevent future scarring,” adds Dr. Zoumalan.
