Body acne: how to clear back and chest breakouts
Why back and chest acne happens, a shower routine that helps clear it, how to tell it from fungal acne, habits that help, and when to see a dermatologist.
Written by the Glowpedia team · not yet reviewed by our dermatologist
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Back and chest acne, often called "bacne", has the same root causes as acne on the face, plus a few extras such as sweat, friction and hair products. Body skin is usually tougher than facial skin, and a short, steady shower routine helps many people.
Quick answer: Wash your back and chest with a benzoyl peroxide wash, leave it on for two to five minutes, then rinse. The American Academy of Dermatology also suggests adapalene gel once a day. Shower soon after sweating, wear loose clothes, and avoid anything that rubs. Expect to wait six to eight weeks for a clear change, and see a dermatologist for deep, painful acne.
Why does body acne happen?
Acne starts when oil and dead skin cells clog a pore, and bacteria and inflammation turn it into a pimple. The chest, shoulders and upper back have many oil glands, which is why breakouts often show up there.
Common triggers include:
- Sweat and friction: sports bras, tight tops, backpack straps and gym gear can trap sweat and rub the skin.
- Hair and body products: rich conditioners, hair oils and heavy body butters can run down the back and clog pores.
- Hormones: breakouts can flare around periods or during times of stress.
- Some medicines and supplements: for example corticosteroids, and some bodybuilding supplements. Do not stop a prescribed medicine without talking to your doctor.
Our body breakouts page explains these triggers in more detail.
Is it acne or fungal acne?
Not every rash of bumps on the back is acne. "Fungal acne" is a common name for Malassezia folliculitis, where a yeast that normally lives on skin overgrows in the hair follicles. DermNet describes it as small, itchy, same-sized bumps, mainly on the upper back and chest, without blackheads or whiteheads.
| Acne | Fungal folliculitis | |
|---|---|---|
| Look | Mixed sizes, blackheads, whiteheads, red bumps | Small bumps that all look alike |
| Itch | Not usually | Often itchy |
| Triggers | Oil, clogged pores, hormones | Heat, humidity, sweating, heavy creams, recent antibiotics |
| What usually helps | Benzoyl peroxide, salicylic acid, adapalene | Anti-fungal washes such as selenium sulfide or ketoconazole |
Anti-dandruff shampoos with anti-fungal ingredients are sometimes used as a body wash for this, but a dermatologist should confirm the diagnosis, because other rashes can look similar.
A shower routine for back and chest acne
- Wash and condition your hair first. Clip it up, then rinse your back well so no conditioner is left on the skin.
- Use a benzoyl peroxide wash. Benzoyl peroxide kills acne bacteria. The AAD notes that a 5.3% wash is less likely to irritate, and 10% is the strongest you can buy without a prescription.
- Leave it on for two to five minutes, then rinse. The AAD says studies show it works best when left on the back for that long.
- Pat dry gently. Avoid scrubbing, loofahs and back brushes, which can make acne worse.
- Add adapalene if needed. The AAD suggests adapalene 0.1% gel, a retinoid sold without a prescription in some countries, once a day after showering or at bedtime.
- Moisturize lightly with an oil-free, non-comedogenic lotion (one that is less likely to clog pores).
Some people use a salicylic acid body wash on alternate days, especially for clogged pores. Choose a gentle body wash for the rest of the body.
Benzoyl peroxide bleaches fabrics. Rinse it off well and use white towels, sheets and pajamas.
Combining treatments safely
- Retinoids and benzoyl peroxide can be drying together. Use benzoyl peroxide as a rinse-off wash and the retinoid at a different time, such as at night.
- If your skin gets dry or irritated, use each product less often and add a light moisturizer.
- Retinoids, including adapalene, can make skin more sensitive, so use sunscreen every day on exposed areas.
- If you are pregnant or breastfeeding, ask your doctor before using retinoids, including adapalene.
Habits that help keep breakouts away
- Shower soon after sweating. If you cannot, the AAD suggests wiping skin with an oil-free cleansing wipe and changing clothes.
- Wear loose, breathable clothes made of cotton or sweat-wicking fabric for workouts.
- Avoid things that rub your back, such as backpack straps. Carry a handheld bag when you can.
- Wash sports bras, workout clothes and sheets often.
- Do not pick or pop pimples. It can lead to dark marks and scars.
- Protect your skin from the sun. The AAD notes that sun can darken acne marks and make them last longer. Use an oil-free body sunscreen on exposed areas.
Body acne on darker skin tones
On brown and Black skin, each pimple can leave a dark mark, called post-inflammatory hyperpigmentation, that may last much longer than the pimple itself. These marks are not scars and usually fade, but it can take many months.
To lower the risk:
- treat breakouts early, before they become deep and inflamed,
- choose gentle products and build up slowly, since irritation can also cause dark marks,
- avoid picking, squeezing and harsh scrubs, and
- use sunscreen on exposed areas.
If marks are a big concern, a dermatologist can suggest treatments for acne and for the marks at the same time.
How long until you see results
The AAD says that if a treatment works, you may see results in six to eight weeks, and complete clearing can take three or four months. Dark or red marks left after breakouts often take longer to fade, sometimes many months.
When to see a dermatologist
See a dermatologist if:
- you have deep, painful lumps or cysts,
- breakouts are leaving scars or dark marks,
- you see no difference after six to eight weeks of a good routine,
- the bumps are very itchy or all look the same, which may be fungal folliculitis, or
- acne started after a new medicine or supplement.
Dermatologists can prescribe stronger options, such as prescription retinoids, antibiotics, hormonal treatments or isotretinoin. These need a doctor's assessment and follow-up, so talk to your doctor about what suits you.
FAQ
Is body acne caused by being dirty?
No. Acne is not caused by poor hygiene, but sweat and product residue left on the skin can make it worse.
Can I use my face acne products on my back?
You can, but washes are usually more practical for large areas. Body skin may tolerate stronger products, but start gently.
Do sunbeds or tanning help body acne?
No. Tanning may hide spots for a short time, but it damages skin and can make acne marks darker and longer-lasting.
Does diet cause back acne?
Diet is not the main cause for most people. Some studies suggest certain foods may affect acne in some people, but the evidence is limited.
Sources
- Back acne: How to see clearer skin (American Academy of Dermatology)
- How to treat different types of acne (American Academy of Dermatology)
- Malassezia folliculitis (DermNet)
- Acne (DermNet)