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Bacne

Written by: Becki Murray

Last Updated: 1 February 2024

What is bacne?

As its name suggests, bacne is acne that appears on your back rather than on other parts of the body. Like facial acne, bacne manifests itself as pimples, blackheads, whiteheads, and cysts:

  • These are red, inflamed bumps caused by your pores getting clogged, bacteria building up in the pores, and inflammation developing. Pimples may have white pus at their tips. Technically, pimples that contain pus are pustules, whereas pimples that don’t contain pus are papules.
  • A blackhead develops when one of your pores gets clogged by sebum (natural oil), bacteria, and dead skin cells. The top of the pore stays open, allowing the pore-clogging material to come into contact with the air, oxidise, and darken, giving the blackhead its dark head. Technically, a blackhead is a comedo, a type of acne lesion. The plural of ‘comedo’ is ‘comedones’, and there are two kinds of comedones: open comedones, which are blackheads; and closed comedones, which are whiteheads.
  • As with a blackhead, a whitehead develops when a pore gets clogged by sebum, bacteria, and dead cells; but in a whitehead, the top of the pore closes, making a small, round, white bump on your skin.
  • A cyst is a large inflamed lesion nestled deep in the skin and filled with pus. Cysts can be painful and can lead to scarring, so it is best to consult a dermatologist if you suffer them.

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What causes bacne?

Like facial acne, bacne can be caused by various factors, either alone or in combination. Typical factors include the following:

  • Hormonal changes. Fluctuations in your hormone levels, especially the levels of testosterone and other androgens, may cause your body to produce more oil. This can encourage or exacerbate acne or bacne.
  • Genetic differences mean that some people are more likely to get bacne (and acne in other areas of the body) than other people. You may be unlucky in this respect.
  • A wide range of medications can either cause acne or make existing acne worse. These medications include both topical corticosteroids and systemic corticosteroids, birth-control pills, hormone-replacement treatments, testosterone replacement medications, immunosuppressants, antidepressants, and antibiotics. So if you have bacne, make sure your doctor is aware of it when prescribing medications for you.
  • Lifestyle factors. Various lifestyle factors can contribute to acne and bacne. These factors include the following:

 

    • Poor hygiene that lets your pores get clogged.
    • Over-washing or scrubbing that irritates your skin and upsets its balance.
    • Eating a poor diet, especially eating a lot of sugar or dairy products.
    • Overindulging in alcohol.
    • Not getting enough sleep.
    • Wearing tight clothing that irritates your skin.

Bacne

Why does my back get acne when other parts of my body don’t get acne?

Your back is prone to getting acne because it contains many sebaceous glands — glands that produce sebum, the oil that helps to lubricate your skin, protect your skin from wind and other environmental factors, and hydrate your skin by trapping moisture in it. If you suffer from acne, sebum appears to be a menace, but it plays a vital role in keeping your skin healthy and flexible.

You have sebaceous glands all over your body, but your face, your scalp, your back, and your upper chest have greater concentrations of these glands. As a result, these areas of your body are where acne tends to occur or to be worst.

If you get bacne but not acne on your face, it may be simply because you are cleansing your face more frequently than your back.

How can I get rid of bacne?

You can reduce and treat bacne by using the same methods as for facial acne. There are three main types of treatment: topical creams, oral medications, and lifestyle changes. The following three sections explain these approaches.

For mild to moderate acne, you would typically start with topical creams and lifestyle changes. For persistent or more severe acne, a dermatologist may prescribe oral medications.

What topical creams can I use for treating bacne?

Various topical creams for treating acne are available, some over the counter and others on prescription. The creams typically contain one or more of the following ingredients:

  • Benzoyl peroxide. Widely used in over-the-counter treatments, this compound performs double duty, not only killing acne bacteria but also helping exfoliate the top layer of skin to unclog your pores and reduce inflammation.
  • Alpha Hydroxy Acids (AHAs). Alpha Hydroxy Acids include glycolic acid, lactic acid, and citric acid. These acids are soluble in water. You can apply an AHA to your skin to gently exfoliate the top layer of the epidermis, revealing smoother skin beneath and encouraging the growth of new skin cells. Many skin products containing AHAs are available over the counter.
  • Salicylic acid. Salicylic acid is a Beta Hydroxy Acid (BHA) widely used for exfoliation. Beta Hydroxy Acids are soluble in oil, which enables the acid to penetrate deeply into your skin’s pores and exfoliate them. Many over-the-counter acne treatments include salicylic acid.
  • Retinoids are vitamin A derivatives. You can get either over-the-counter retinoids, such as retinol, or prescription-only retinoids, such as tretinoin or adapalene. Retinoids can irritate and dry out your skin, so for over-the-counter products, you should start with a low-strength retinoid, apply it sparingly, and allow two to three days for the results to appear. If you need to move up to prescription-strength retinoids, consult a dermatologist who can prescribe a suitable product and tell you how to use it.
  • Tea tree oil. This natural oil has antibacterial properties that can attack acne bacteria.
  • This yellow element can remove dead skin cells, opening up clogged pores, and can absorb excess oil in your skin.

What oral medications can I use for treating bacne?

Dermatologists prescribe five main types of oral medications for treating acne and bacne:

  • To treat moderate to severe acne, a dermatologist may prescribe a short course of an oral antibiotic such as tetracycline, minocycline, or erythromycin. Antibiotics kill bacteria and reduce inflammation, but long-term use can cause antibiotic resistance.
  • Oral contraceptives. Some oral contraceptives can help control acne in women by regulating the hormones that contribute to acne.
  • Also known as Roaccutane in the U.K. and Accutane in the U.S., isotretinoin is used to treat cystic acne and other severe acne that doesn’t respond to other treatment. The effect of isotretinoin is to reduce the amount of oil your sebaceous glands release. Because isotretinoin can have serious side effects, your doctor will need to monitor you closely while you take it.
  • Anti-androgen agents. Androgens are male hormones. Anti-androgen agents, such as spironolactone or cyproterone acetate, can help acne, especially in women, by blocking the effects of androgens. These also require close monitoring.
  • Your doctor may prescribe a short course of oral corticosteroids, such as prednisone or prednisolone, to treat severe acne. For these drugs, too, the doctor will monitor your response.

What lifestyle changes should I consider for treating bacne?

The following list shows five lifestyle changes you can try for reducing acne. These changes work to a different extent on different people, so you will need to experiment to determine which changes are most effective for you.

  • Avoid trigger foods. Various foods seem to worsen acne in some people, although the link is not definitively established. Suspects include dairy products and foods that contain a lot of sugar. Also, certain types of fats — such as saturated fats, trans fats, and omega-6 fatty acids — appear to contribute to acne, whereas others — such as monounsaturated fats and omega-3 fatty acids — appear to be beneficial against acne.
  • Cleanse your skin soon after sweating. When you sweat a lot, such as when you work out in high heat or humidity, the sweat and skin debris may clog your pores; tight or non-breathable workout clothes can make the problem worse, especially on your back. Cleanse your skin soon after sweating to avoid this problem.
  • Reduce your stress levels. Stress can make your body produce more cortisol, which can stimulate the production of sebum, which may in turn lead to acne and bacne. Wherever possible, minimise your stress levels, though this is usually easier said than done.
  • Avoid tight clothing. Tight clothing can trap sweat and oil on your skin, especially if the clothing isn’t breathable. If the clothing causes friction against your skin, even worse.
  • Don’t carry a backpack. A backpack that rubs against the skin of your back causes similar problems to those of tight clothing. If the backpack is putting weight on existing bacne, it will make the bacne worse.

How can I get rid of bacne scars?

Bacne can result in scars that take the form of deep pits, angular indentations, or wave-like rolling scars.

You can tackle bacne scars — and acne scars on other parts of your body — in three main ways:

  • By using home remedies
  • By using topical treatments
  • By having tweakments

The following sections take you through each of these approaches in turn.

Which approach suits you best will depend on how severe your bacne scars are and whether you want to get rid of the scars entirely or reduce their visibility significantly.

What home remedies can I use to address bacne scars?

If your bacne scars are relatively mild, you may be able to improve them by using the following home remedies:

  • Aloe vera. Aloe vera is soothing for scarred skin and can also promote healing.
  • Vitamin E. Vitamin E oil can help moisturise your skin and neutralise free radicals that contribute to inflammation and aging in your body. Vitamin E may promote the regeneration of new skin cells, although studies have not yet proven this beyond doubt.
  • Honey can act as a natural moisturiser. It may help with scar healing, but this is not yet known for certain.

What topical treatments can I use to address bacne scars?

There are four main types of topical treatment you can use to reduce the visibility of bacne scars and reduce differences in texture between the scars and the surrounding skin:

  • Retinoids, vitamin A derivatives mentioned earlier on this page, can make scars less visible. Start with over-the-counter retinoids, such as retinol, to gauge their effectiveness on your skin. If necessary, consult a dermatologist for a prescription-strength retinoid.
  • Skin peels with Alpha Hydroxy Acids (AHAs). As discussed earlier on this page, AHAs such as glycolic acid and lactic acid are widely used for exfoliation.
  • Skin peels with salicylic acid. As mentioned earlier, salicylic acid is an effective exfoliant. Various skin products containing salicylic acid are available over the counter.

Hydroquinone. Hydroquinone is a skin-lightening cream used to fade darker scars. Hydroquinone is not available over the counter, so you would need to consult a dermatologist who could prescribe it

What tweakments can I have to reduce bacne scars?

Here are four types of tweakments you can have to reduce bacne scars:

  • In dermabrasion, the practitioner uses a rapidly rotating device to “sand down” the outer layers of skin and stimulate a natural healing response in the body. Dermabrasion is especially effective for raised scars and scars with uneven textures. The practitioner adjusts the treatment depth to suit the type and severity of scar.
  • Laser therapy. A practitioner can use a laser to remove or resurface the outer layer of the skin or to stimulate the growth of new skin cells underneath the scar.
  • Skin peels by a dermatologist. If skin peels using over-the-counter strengths of chemicals don’t give the results you need, you can have a skin peel performed by a dermatologist using heavier-duty chemicals. Such peels remove more layers of skin than home-strength peels, so you will typically need more downtime to recover afterward.
  • Microneedling uses very short, sharp needles to make tiny holes in your skin, provoking a healing response that produces more collagen and elastin. This response can gradually improve the surface of a scar.
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