Baby got back...acne
November 23, 2022 9:08 AM   Subscribe

I have back acne, how do I get rid of it?

I had a fairly significant hormonal shift a few months ago that I've resolved but it set off some significant cystic back acne. I haven't had back acne since I was teenager and I'm struggling to get rid of it. Things that have worked to reduce inflammation and irritation include washing twice a day, sleeping topless and using this sulfur spot treatment from Kate Somerville. I'd love something that has more long-term effects and can make it permanently go away instead of just reducing irritation and inflammation. Over the counter/something I can get at Sephora is preferred. Open to pretty much anything though -scrubs, soaps, sprays, masks....
posted by Toddles to Health & Fitness (18 answers total) 1 user marked this as a favorite
Best answer: I have struggled with mild hormonal body acne though it’s much more settled now. (And moderate face acne)

1) Paula’s choice 2%BHA body lotion is one people like. I tried it and it wasn’t my fav but I think it did work.

2) I have now switched face products after years of trying tons of things for my recent hormonal acne to Azelaic Acid acid on my face. I find it works really well when used after lotion and is gentle and doesn’t over dry or over irritate like other acids I’ve tried. The ordinary has a cheap one. Paula’s Choice has a more expensive one. I use the cheap one and have also used it on my body.

3) other acids or topicals include glycolic acid (the ordinary and Paula’s choice and others have this. It comes in different strengths and is more like an astringent), other salicylic products, and benzoyl products but benzoyl can bleach clothing.

4) as an aide, I love this Kiehls wash and I use it on my face and chest and shoulders. Really improved my skin without over drying. (After dozens of others)

5) the thing that really kicked the body acnes ass was Retin A Micro which is an RX retinol. It was relatively inexpensive with insurance. My face HATED it but it cleared the body acne with little problem and was much less severe after.

6) hormone management has also been key for me, so if you feel you have yours handled it can take a while for skin to adjust so some may just be time.
posted by Crystalinne at 9:20 AM on November 23, 2022 [1 favorite]

I know you say you prefer OTC solutions, but this is a dermatologist situation. You'll spend more time and money on a lot of things that may or may not work vs. a visit to the doctor.
posted by XtineHutch at 9:20 AM on November 23, 2022 [5 favorites]

Prescription Accutane is the nuclear option and has some significant side effects, but it works. Even a three month course might resolve the problem long term. I second the suggestion to see a dermatologist (acknowledging that it's not your preference). I had terrible acne for years and over the counter products and modifying personal habits (soap, diet, clothing) did nothing for me.
posted by emd3737 at 9:37 AM on November 23, 2022 [2 favorites]

I have an alt health book here from a long-time practitioner. Sometimes it's wrong/dated but it gets quite a lot right. Here's what it says on external treatments for acne (there is a much longer section on addressing internal causes).
Apply lemon juice; wash with castille or other pure soaps that contain no detergents [e.g., dr. bronner's]; apply bentonite, green, or any other clays moistened with apple cider vinegar as the only fluid -- leave on at least one half-hour, then wash off with water.
posted by aniola at 9:38 AM on November 23, 2022

Your case may be different but for La Phanx the only thing that finally worked was roaccutane (isotretinoin), which you can only get from a doctor.
posted by Phanx at 9:47 AM on November 23, 2022 [1 favorite]

Any chance you have a textile allergy? I get horrific back acne when wearing artificial fibers. It clears up when I only wear cotton.
posted by Jacqueline at 10:08 AM on November 23, 2022

Hibicleanse can be purchased at most drug stores and really helped me
posted by evilmonk at 10:19 AM on November 23, 2022 [2 favorites]

I have long, frizzy hair that requires a to of conditioning & product. When I started rinsing my back and making sure that zero conditioner/leave-in hair treatments were making contact with my back skin, all my back acne cleared up. Just in case this might be a factor.
posted by knotty knots at 10:39 AM on November 23, 2022

Best answer: I use Neutrogena Clear Pore Cleanser/Mask, which is 2.5 or 3.5% benzoyl peroxide cleanser. When I had bad acne, I would use it before/during showering, letting it sit for five minutes before rinsing off, then washing with my regular soap. I found this cut down on the bleaching effect, but even so, I would only do it before going to bed or my shirts will have bleached collars. Moisturize after showering.

As my acne got better, I reduced the time spent with it on my skin. Eventually I switched to salicylic acid rinse and only occasionally (1/mo?) need the benzoyl peroxide cleanser.
posted by flimflam at 10:44 AM on November 23, 2022

My long hair gets conditioner on my back. I keep a claw clip in the shower, so after conditioning and rinsing I can clip up my wet hair, and carefully wash my back with soap. Then I don't let my wet conditioner-y hair touch my back - I either get dressed or drape a towel over my shoulders - until my hair is totally dry.

That said, serious acne mostly comes from inside so external products aren't going to work as well as an inside solution - fixing hormones is the right start but then you might need accutane to really nuke it away.
posted by nouvelle-personne at 10:59 AM on November 23, 2022

My dad is a dermatologist, so I've tried a million things over the years, including antibiotics, Accutane, retinol, and more. The thing that has finally worked is using a back scrubber brush every single time I shower, with CereVe Acne Foaming Cleanser on it. I keep the scrubber outside the shower - otherwise, it gets moldy fast. I used to do this occasionally and be disappointed with the results - the trick is to actually do it daily. Good luck!
posted by equipoise at 11:08 AM on November 23, 2022

Don't forget to wash your sheets and pillowcases. I've found that I need to stay on top of weekly sheet changes or I'll break out on the back/neck area, and my acne is definitely caused by hormonal changes in the form of HRT.
posted by daikaisho at 11:51 AM on November 23, 2022 [1 favorite]

My doctor prescribed this for me (Canada): TactuPump

The active ingredients are adapalene and benzoyl peroxide, so if you want to try to DIY, you can try other products that have those. The important thing is to use it as a preventative measure, rather than to spot-treat a zit that is already forming. After about a month of regular (nightly) use, the incidence of acne lowered, and I kept using it for maybe a year? Now it has probably been ~6 months since I stopped using it, and I haven't had a recurrence.

It makes your skin quite sensitive, so when I use it on my face, I have to use it very sparingly.

It also discoloured a lot of our bedsheets and some towels (I sleep shirtless, so my back touches the sheet and the formula rubs off overnight). Totally worth it, though!

PS - I also had terrible face acne in my teens and early twenties, and I did 6 months of Accutane then. My usage of Tactupump is in my 30s, so quite far removed from the Accutane.
posted by tinydancer at 12:32 PM on November 23, 2022

Best answer: I have not used it, but I know a lot of people who swear by this Tower 28 spray
posted by dizziest at 12:40 PM on November 23, 2022 [1 favorite]

Retinol was a total game changer for my skin, and you can now get Differin over the counter if you're in the US.
posted by In Your Shell Like at 1:16 PM on November 23, 2022

If it's cystic you might look into a spironolactone prescription. Retinol works well for me on non-cystic acne but only the nuclear options have worked on those big deep bad bois.
posted by We put our faith in Blast Hardcheese at 2:26 PM on November 23, 2022 [1 favorite]

One thing that will help somewhat (not a complete solution, but part of the puzzle) is to avoid wearing any synthetic tops at all - stick to cotton and bamboo only. Nylon and other synthetics traps sweat and also irritates the skin.

Source: multiple dermatologists who I have seen.
posted by chariot pulled by cassowaries at 4:34 PM on November 23, 2022 [1 favorite]

Long shot but do you drink cow's milk? My bacne went away went I stopped drinking milk.
posted by yawper at 7:46 AM on November 24, 2022

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