Back acne and facial acne is essentially the same thing, however, back and body acne can be more challenging to control since the skin on the body is tougher and thicker, has larger pores, and more sweat glands, making it easier for pores to become clogged.
Treatment options vary, depending on the severity of the acne which can range from clear skin to severe acne. We can identify the severity of the acne in the following way:
Clear – no evidence of blemishes or lesions
Almost clear – few blackheads or whiteheads, perhaps the occasional papule or pustule (pimple or zit)
Mild – some blackheads and whiteheads and a few papules or pustules, but no evidence of nodules or cysts
Moderate – lots of blackheads and/or whiteheads, more evidence of papules and pustules (pimples) and only a few nodules or cysts.
Severe– mostly inflammatory acne, papules, pustules, nodules and cysts
Over-the-Counter Treatment Options for Mild Back Acne
Body Wash – For mild back acne, or for the occasional breakout of back acne, over-the-counter body washes containing benzoyl peroxide or salicylic acid may help contain the infection and prevent further breakouts. Remember to use a soft cloth, sponge or gentle brush on the back – do not scrub the skin since this may worsen the condition.
Creams or Gels – medicated creams or gels with benzoyl peroxide or salicylic acid can be applied twice daily after a shower. Allow enough time for the product to dry on the skin before dressing since these creams and gels can bleach the fabric of your clothing.
Professional Treatment for Moderate to Severe Back Acne
The treatment for moderate to severe back acne – those types of acne made up of a combination of papules, pustules, nodules, and cysts – should begin as soon as possible to reduce the risk of scarring. This is especially important if you have a history of scarring easily. Nodules and cysts are larger and more serious than pustules (pimples). They affect deeper layers of the skin and can be painful. The blemishes themselves can become large – some may measure up to several centimeters across.
Severe back acne breakouts can damage and destroy healthy skin tissue. Picking at the skin, harsh scrubbing in the shower or trying to pop cysts or nodules should be avoided at all costs. Doing so can greatly damage the skin, lead to scarring, and worsen acne. Aggressively treating this form of acne, under the care of a medical doctor, can help limit the severity of scarring and spread of the condition.
Antibiotics – Topical antibiotics such as erythromycin and clindamycin can control the spread of back acne while reducing inflammation of pustules (pimples). These medications should be used exactly as prescribed to avoid encouraging bacterial resistance. When used in conjunction with benzoyl peroxide, the effectiveness of topical antibiotics can be significantly boosted. Oral antibiotics can also offer control of breakouts as they reduce the amount of bacteria on the skin and inflammation. These are usually prescribed in conjunction with topical medications.
Retinoids – Topical retinoid, a derivative of Vitamin A, is often the treatment of choice for patients with moderate to moderately severe acne pustules. Not only do the prescribed forms of this medication clear pores, but they prevent the formation of pustules and other acne lesions. Known for being harsh on the skin, retinoids are now available in gentler formulas that offer the same effective results. They do increase sun sensitivity, however, so take appropriate sun protection precautions when using topical retinoids.
Isotretinoin – commonly referred to as Accutane – this is a powerful medication used to treat severe acne. It is an oral medication that is taken once or twice daily. Isotretinoin works by shrinking the oil, or sebaceous glands in the skin. By controlling the oil, breakouts are also controlled. Unlike most acne medications, you don’t have to continuously use Isotretinoin to keep breakouts at bay. Most people only need one (16 to 20 week) course of treatment to get good results. After treatment is finished, pimples rarely come back.
Oral contraceptives for women – Oral contraceptives, also known as birth control pills, can effectively treat acne in some women. For years doctors have used oral contraceptives off-label as acne treatments. Today, a handful of oral contraceptives are also FDA approved as acne treatments. Oral contraceptives are not used as a first line of defense against acne, they are often prescribed after other treatment options have been tried, or if a woman needs a form of birth control anyway. For best results, oral contraceptives are used in conjunction with other acne treatments, such as topical retinoids, or benzoyl peroxide.
Surgical excision and drainage – For large, pus filled cysts surgical removal may be required. A doctor makes a small incision in the skin and extracts the infected material.
Intralesional corticosteroid injections – For large lesions that are difficult to treat or that are unresponsive to treatment, a doctor can inject medication directly into the lesion to reduce inflammation and shrink the blemish.
Treating severe cases of back acne can be difficult. In some cases those with severe acne may end up with some degree of scarring. If you have acne scars, find out what options there are to diminish the signs of moderate to severe acne scars.