Acne is one of the biggest skin complaints that drives people to see a medical professional. The American Academy of Dermatology Association estimates that over 50 million people in the United States alone see dermatologists to treat this condition yearly.
Acne can occur anywhere on the body and may take a multi-prong approach with lifestyle modifications and topical medications to address it. However, it can be especially tricky to treat in hard to reach places like the back, a condition commonly referred to as "bacne."
"Bacne" is often treated the same way that facial acne is treated, but Cybele Fishman, M.D, assistant clinical professor of dermatology at Mount Sinai Hospital in New York recently told SELF, "Back acne often requires acne medication to be treated effectively. This may be because the skin is thicker on the back than the face, so topical medications may not penetrate as well."
Back acne can also be affected by more external factors like friction from clothing, backpacks, excessive oil production, and sweat building up—all of which can trigger breakouts and slow down the healing process. There are also several types of back acne that can present that may require a different approach to clear up. Luckily, once you know what you are dealing with, you can help your clients customize a treatment approach specifically for their concerns, and perhaps even help stop breakouts before they begin.
What Is Acne?
All acne, including acne on the back, develops when sweat, oil, dead skin cells, and bacteria get trapped and clog the skin’s pores. Acne is a sign of overactive sebaceous glands, which produce an oily substance known as sebum that helps keep the skin healthy. However, when the glands are overactive, too much sebum can lead to an accumulation of dead skin cells and bacterial growth that can block the pores of the skin leading to various types of acne.
As we stated above, acne on the back is oftentimes called "bacne" and it can be quite painful, embarrassing, and harder to treat than facial acne. It can present with red, inflamed bumps, blackheads, whiteheads, back pain, or tenderness, and can lead to acne scars.
What Causes Acne On The Back?
Similar to the face and the chest, the back has a high density of sebaceous glands that produce sebum and are attached to either pores or hair follicles. As we explained above, if there is an overproduction of sebum, a blockage can occur resulting in an overload of bacteria that can lead to ace lesions.
Another possibility is Malassezia, a type of yeast that overgrows in sweaty, humid conditions, and looks like acne. If the yeast gets into the hair follicles, it can lead to a skin condition known as pityrosporum folliculitis. If antibacterial treatments have not worked for your clients, it may in fact be this condition. A dermatologist can help determine what kind of acne your clients have and what the best course of treatment is including hormone therapy, oral antibiotics, prescribed topicals, or a deep peel, for example.
The Different Types Of Back Acne
There are several types of acne that can occur on the back. Knowing what kind of acne your clients have will be helpful when determining the best course of action to treat the condition. Below is a breakdown.
- Whiteheads: Whiteheads, also known as closed comedones, occur when the pores become clogged with excess sebum, bacteria, and dead skin cells and present as a closed pore with a raised, white, or flesh colored tip.
- Blackheads: Like all acne, blackheads are caused by an excess of sebum, bacteria, and dead skin cells. However, they present with an opening that exposes these materials to air causing the contents to oxidize and darken in color.
- Papules: Papules are cystic or solid and manifest in the skin as small firm bumps and can be red, brown, or other colors.
- Pustules: Pustules are similar to papules, but are larger in size and contain a fluid that is white or yellow in color with a centralized pus-bump in the skin.
- Nodules: Nodules are highly inflamed acne lesions with firm bumps deep in the skin that may be tender. They tend to be larger than papules and pustules and often require medical attention to address.
- Cysts: Cystic acne presents with large, painful bumps in the skin that are filled with pus caused by deep-rooted inflammation, which makes them softer to the touch when compared to nodules. Cystic acne is often red and will either drain or have an overlying crust and can cause scarring when it heals.
- Acne Conglobata: Acne conglobata is a rare, but severe skin condition that presents with deep, cystic nodules that are often interconnected with one another and contain a foul-smelling discharge. The formation of acne scars is very common with this type of acne, so it is best for your clients to work with a dermatologist before seeking other treatment types.
Over-The-Counter Treatments For Back Acne
Over-the-counter topical medications may offer some relief to those who suffer from mild to moderate back acne, especially when used in conjunction with acne-friendly skincare. These include benzoyl peroxide that helps to kill the bacteria that causes acne and reduce flare ups. When benzoyl peroxide is used with retinoids, which help with skin cell turnover and unclogging pores, the benefits to the skin can be compounded.
Lifestyle Suggestions For Your Clients Who Have Bacne
Like other forms of acne, back acne can benefit from small lifestyle adjustments including the following that you can suggest to your clients:
- Avoid triggers like pore-clogging products, stress, or certain medications
- Eat a balanced diet and engage in regular exercise
- Shower shortly after activities that cause sweating
- Avoid clothing that causes friction against the skin in addition to not wearing non breathable activewear that traps sweat against the skin
- Protect the skin with a full-spectrum sunscreen (especially when acne scars are present)
- When prescription retinoids (or other topicals that are strong) are applied topically, make sure to have your clients use gentle cleansers, such as Cetaphil to not further irritate the skin
Specialized Treatments You Can Offer Your Clients
With technological advances, there are several specialized treatments you could offer your clients to help them reduce their bacne lesions and minimize scarring (if it occurred) including the below.
Light Therapy For Bacne:
- To treat pimples, but not whiteheads, blackheads, cysts, or nodules, you can use red, blue, or infrared light
- To unclog pores, treat whiteheads and blackheads, photopneumatic therapy can help
- For severe acne, photodynamic light therapy can help, but it can cost more when compared to other light wavelengths
Plason: While it has not been FDA tested for bacne, Plason, is a clinically validated, non-invasive device that is the first platform available in the United States to offer two different treatments based on the concepts of atmospheric plasma and ultrasonic technologies. Plason’s handpiece showers the skin with positive and negative ion streams, plasma, actively charged molecules, and plasma to eliminate bacteria on all skin types. The device’s PlasmaClear treatment modality was designed to help individuals who have severe acne breakouts since it targets the bacteria that causes acne, reduces sebum, and improves the skin’s overall texture and tone.
Lian Mack, MD FAAD has been using Plason to treat her patients who suffer from acne with great success. You can see the impressive results of the treatments for yourself on her Instagram page where she shares a compelling before and after picture of her patient who she treated for bacne.
For scarring, microneedling may be used in addition to chemical peels, and lasers. Lasers can also help to minimize acne breakouts on the back and elsewhere, but it rarely clears the acne up completely. However, there is no doubt that lasers can be a great tool added to an acne treatment plan. Make sure you check your state licensing laws about who is allowed within their legal scope to perform these types of procedures.
When To Send Your Clients To A Dermatologist (If they aren’t already)
Treating acne (or bacne) and determining what your client’s triggers are takes time. If the current treatment plan works, results can be seen in a few weeks. Complete clearing can take months or longer depending on the damage to the skin. If your clients don’t see any significant changes in their acne on their back in six to eight weeks, they should be seen by a dermatologist to see if there are any underlying medical issues and to help determine the appropriate treatment plan.
Takeaway
When the sebaceous pores on the back get clogged with dead skin cells, bacteria, and sebum, back acne (aka. Bacne) can result. Over-the-counter products may offer some relief in mild to moderate cases. But if your clients’ bacne doesn’t clear up in six to eight weeks or is severe, you should suggest that they see a dermatologist to make sure that there isn’t an underlying medical condition or medication that is causing the skin condition.
Bacne can be both painful and embarrassing. Furthermore, it can lead to scarring, which is a painful reminder. As a beauty business owner, you can play an essential role in helping your clients manage and reduce back acne with both traditional services as well as specialized treatments that utilize various energy-based technologies.
