One of the vastly seen skin disease in adolescents is acne. It affects about 80-90% adolescents attaining pubertal age. Some of this acne also continues into adulthood leaving some kind of psychological and social impact. Acne, also called as acne vulgaris is a chronic skin condition that results from dead skin cells and sebum from the sebaceous glands.

Overview

Acne presents itself in the form of pimples, blackheads, whiteheads, and scarring. Acne are common in body parts which consists of higher density of sebaceous glands – especially on the face, back and chest. Some of these inflammatory acne lesions can cause permanent scarring.

Causes

The causes of acne are many. Genetic make-up of a person is one of the factors that determines the susceptibility to developing acne. Other factors include :

  • Acne are commonly seen in adolescents as sebum production from the sebaceous gland is at its peak during puberty due to a drastic shift in hormone levels and metabolism. During puberty, there is a surge in some hormone levels like androgen, which causes the sebaceous gland to enlarge and produce more sebum
  • Acne are also usually seen is women attaining menses and women with hormonal imbalances like polycystic ovarian syndrome (PCOS); increased levels of male sex hormone – androgen
  • Bacterial infections like Cutibacterium acnes can cause development of acne. Increased growth of this organism on the skin can cause acne
  • Increased humidity and polluted air can cause acnes
  • Diet also influences the occurrence of these acnes. Consumption of large amounts of dairy products like milk, cheese, butter, cottage cheese can lead to development of acne as these products increase mucous production in the body which acts as a trigger for clogging the pores. Also, a diet that is high in fat and refined sugars is a cause for acnes. Research has shown that diet containing milk and milk products stimulate the release of insulin and insulin like growth factor -1 (IGF-1), which further increase the production of androgen hormones, sebum and thereby, acne.
  • Cosmetic products like a greasy moisturizer, other make-up and skin care products can cause the pores to clog and increase the occurrence of acnes
  • Stress can also trigger acne breakouts. This could be due to increase in the levels of hormones which lead to excess sebum production and thus, acne

Back acne 

Back acne or bacne, can be disturbing. The good part is, it is completely preventable and also treatable. One of the reasons for bacne is something known as ‘acne mechania’, which is a result of friction or rubbing into the pores of the back area. It is more common on the back because of things like back packs, chairs, gym tools, which rub against the back causing friction between the skin pores and sweat. Acne mechanica can slow the body’s natural way of exfoliating, causing skin debris to sit on the back for longer, causing acne.

Treatments for back acne 

Nowadays, many treatment options are available for acne. They include home remedies and lifestyle changes, while some require medical management. Below mentioned are some tips for getting rid of the acne on the back :

  • Exfoliate : As acne are caused due to buildup of skin debris and sebum in the skin, some kind of exfoliation, containing salicylic acid, helps in eliminating dirt and oil from the skin. This can unclog pores and thereby reduce acne breakouts and clear existing ones. People prone to back acne should replace cream based shower gels with the ones that contain salicylic acid or Alpha Hydroxy Acid (AHA). AHA helps in striping off the dead skin cells and excess sebum on the back and clears acne breakouts effectively without drying the skin
  • Post workout shower : Workouts and exercise cause sweating which is a good way to eliminating body toxins. But if this sweat is allowed to sit on the body for long, it can lead to back acne breakouts. Also, the acne causing bacteria thrive on a sweaty skin. Therefore, it is important to take a shower after an exercise session
  • Tea tree oil : Tea tree oil has gained a lot of popularity in recent times, for its acne fighting properties. Research has shown that 5% tea tree oil solution helps in reducing the amount and overall severity of acne. The antiseptic and antibacterial properties of tea tree oil can reduce oiliness on the skin which can lead to reduction in acne breakouts. The antimicrobial function of the oil is due to its capacity to damage the cell wall structure of bacteria
  • Wearing comfortable clothes : Tight – fitting and body hugging clothes can trap the dirt and sweat on the skin and irritate the skin pores. It is advisable to wear loose-fitting or comfortable clothes, especially doing workouts or exertion to avoid clogging of pores and acne breakouts
  • Topical applicants : For mild to moderate acne, topical creams containing benzoyl peroxide or salicylic acid help in treating acne by killing the organism that is known to cause acne and also by removing the accumulated sebum and unclogging pores. Retinoid containing creams also work by unclogging pores and deliver better results when used in combination with benzoyl peroxide
  • Sunscreen : Exposing bare back to the sun can cause skin damage and result in acne breakouts. Along with applying sunscreen, it is also essential to opt for a water based or gel based sunscreen, which do not clog pores and feel light on the skin
  • Hair care : This part of treatment is often overlooked, but is equally important. People with long hair touching the back, should wash hair frequently, tie them during exercise sessions as the sweat can harbour on the back and increase acne. Besides this, it is also important to note that while washing hair, the conditioner or the shampoo should not be allowed to pour down the back as they contain compounds that can cause clogged pores and result in acne. Switching to a zinc based anti-dandruff shampoo can arrest the growth of acne causing bacteria on the back and lead to acne prevention
  • Aloe vera : Aloe vera is an age-old plant based remedy for many skin conditions. The leaves of the plant contain a gel like substance that can be used directly to apply on the affected areas on the skin. It is a potent anti-inflammatory, which helps in the reduction of acne. It helps in healing the acne and improves skin texture
  • Choosing the right skincare products : Skincare products that are known to clog pores, should be avoided and non-comedogenic products, which do not clog pores and give a feeling of weightlessness should be used
  • Diet : As we know incorrect dietary habits can trigger acne breakout, it is essential to pay attention to eating habits and alter them for better. Reducing dairy consumption, including plant based foods, raw foods, fruits and vegetables, and limiting sugar, processed foods can help to improve skin health and reduce acne

Conclusion

Back acne can be treated. Many people are able to combat back acne using simple home remedies and natural alternatives. However, if it is very severe and do not go away with any skincare routine, it needs to be treated by an expert, who can offer aggressive and more effective treatment options like antibiotics, hormone therapy, skin extractions, synthetic peels, or laser treatment.

References

  1. https://www.sciencedirect.com/science/article/pii/S2352647517300862
  2. https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962019000100011&lng=en&tlng=en
  3. https://www.ncbi.nlm.nih.gov/books/NBK459173/

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Skin Care,

Last Update: May 13, 2020