WORDS HANNAH MAY-LEE WONG

It’s certainly no fun when it seems only pimples have got your back. Want to get rid of them? Take the advice of a dermatologist.

Having acne can really ruin one’s confidence and having them on your back is no less embarrassing. Back acne or ‘bacne’ is particularly frustrating as they appear in places that are hard to reach. Thankfully, according to consultant dermatologist Dr Ch’ng Chin Chwen, there are things you can do to alleviate back acne. In this article, Dr Ch’ng debunks some common myths about back acne and gives us helpful dermatologist-approved tips on how to get rid of them the right way.

What causes back acne and why do only some of us get them?
Acne, no matter which part of the body it appears in, is mostly triggered by genetic and hormonal factors. There is some recent evidence pointing to high sugar foods and milk/dairy products as key contributing factors to acne breakouts as well.

A variety of medications are known to be associated with acne breakouts. These include oral corticosteroids, hormones (such as anabolic steroids, certain contraceptive pills, and testosterone), certain antiepileptic medications, antibiotics or antidepressants, and some chemotherapeutic medications.

Why is the skin on our back particularly prone to acne?
This area has more sebaceous glands. The formation of acne on our skin involves sebaceous glands, which are more abundant over our face, upper chest and back. Areas without sebaceous glands don’t develop acne (for example, the palms).

What worsens back acne?

• Using harsh skin care items like antibacterial soaps, astringents and abrasive scrubs can disrupt the skin’s natural protection layer, irritate the skin, and worsen acne. Hence, excessive washing, scrubbing or use of drying skin care products can also exacerbate back acne.
• Use of oily/thick textured skin care products that clog the pores can worsen back acne. For people with acne-prone skin, it’s best to stick to oil-free or non-comedogenic skin care products.
• Back acne may be more common in our country because of our hot and humid weather. Sweating, wearing thick or tight clothing, or working in an oily environment can clog pores and worsen back acne.
• Stress has long been known to be a contributing factor to acne breakouts.

What should we do to get clear skin on our backs? Any medication or topical treatment options available?

• Avoid trigger factors as mentioned earlier in this article.
• Practice good skin care habits: no excessive washing/ cleansing, diligently use sun protection, avoid hot and humid places, shower immediately after sweating, wear loose and airy clothing made of cotton, and regularly moisturize your skin.
• Topical acne medicines (similar to those that treat facial acne) are available in most pharmacies. Perhaps look for products that can cover large surface areas easily, such as products specifically formulated for body acne or spray-on products.
• Your dermatologist may prescribe oral medicines such as antibiotics, spironolactone, and isotretinoin to treat your acne.
• Light and laser treatments provided by your dermatologist may also help treat back acne. Do you recommend those with back acne to use a loofah/ back scrubber? Gentle scrubs can help clear clogged pores, but harsh scrubs can disrupt skin barrier and cause more inflammation—the balance may be difficult to strike. If you want to use loofah, use it softly, and remember to wash and dry the loofah properly after each use for hygiene reasons.

It’s easier to opt for a chemical exfoliator rather than physical scrubs for a gentler effect. Use products with AHA (alpha hydroxy acid), BHA (beta hydroxy acid) or salicylic acid. Note that salicylic acid is stronger and may not be suitable for those with dry skin to use regularly.

Are those ‘special acne body wash’ the best option for those with back acne?
Yes. Body washes that contain AHA, BHA or salicylic acid may help with back acne.

When should we see a dermatologist?
If you have tried changing your diet, lifestyle, skin care products, and have regularly used over-the-counter acne gels but still have uncontrolled acne, you should see your dermatologist.

It’s hard to care for our backs as some areas are hard to reach. Are there any products that can help us solve this problem?
Some products come in a spray form for difficult-to-reach areas. HT