Breakouts & Pores
Back Acne
Back acne, sometimes called “bacne”, is acne on the back, shoulders and upper chest. It is the same condition as facial acne, but thicker skin, sweat, friction and hard-to-reach areas change how you treat it. It is common, often undertreated, and can leave scars.
- Back acne is true acne on the trunk, and studies suggest about half of people with facial acne also have it.
- A benzoyl peroxide wash left on for two to five minutes, a retinoid and less sweat and friction form the AAD’s at-home plan.
- Deep, painful or scarring back acne, or acne that has not improved after six to eight weeks, needs a dermatologist.
Overview
What is back acne?
Back acne forms the same way as facial acne: oil, dead skin cells and acne bacteria clog hair follicles and cause inflammation. The result can be blackheads, whiteheads, red bumps, pustules and, in more severe cases, deep, painful lumps. A 2022 review in the Journal of Clinical Medicine estimates that about 48 to 52 percent of people with facial acne also have acne on the trunk.
The same review notes that truncal acne is often neglected by both patients and clinicians. That matters because back acne can scar over large areas, and the scars are often raised (hypertrophic).
Common signs and patterns
What it can look or feel like
These features give context but do not confirm a diagnosis on their own.
Mixed spots
A mix of blackheads, whiteheads, red bumps and pus-filled spots of different sizes, often with facial acne too.
Deep, painful lumps
Larger, tender lumps under the skin suggest more severe acne that is more likely to scar.
Flares with sweat or gear
Breakouts that worsen where backpacks, straps, sports pads or tight clothing rub, or after sweaty workouts.
Marks left behind
Flat dark or red marks, or raised or sunken scars, where earlier spots healed.
Causes and contributors
Acne biology, plus sweat and friction, drives back breakouts.
The trunk has many oil glands, so it is a natural site for acne. Hormones and genetics play the same role as they do on the face. On top of that, the AAD notes that anything rubbing against your back, such as backpack straps or tight clothing, can irritate the skin and make back acne flare. Sweat left sitting on the skin is another common aggravator.
Some medicines and supplements can also cause acne-like breakouts on the trunk, including steroids. A 2022 review highlights anabolic steroid use by bodybuilders as a cause worth considering.
What it may be confused with
Similar-looking concerns need different decisions
Several conditions on the back look like acne but need a different plan.
Fungal acne
Itchy, uniform small bumps with no blackheads. Antibiotics can make it worse, and it responds to antifungals instead.
Folliculitis
Inflamed hair follicles, often from bacteria, hot tubs or friction. Bumps form around hair follicles and can come with itching or a red ring.
Steroid or drug-induced acne
Uniform breakouts that start after a new medicine or supplement, especially steroids. Tell your doctor about anything you take.
Bottom line
The bottom line: treat it consistently, reduce friction and do not wait if it scars.
Mild to moderate back acne often improves with a benzoyl peroxide wash, a retinoid and simple changes to clothing and post-workout habits. Results take time: the AAD says to expect six to eight weeks to see a difference and three to four months for clearer skin.
Back acne that is deep, painful or already scarring deserves earlier professional care. A dermatologist can offer prescription topicals and, when needed, oral medicines, and can also check whether the breakout is actually acne.
Evidence-supported options
Choose the option that matches the cause and severity
This is general education, not a personal treatment plan. Product strengths, permitted uses and prescription status vary by country.
Benzoyl peroxide wash
Kills acne bacteria. The AAD says it works best left on the back for two to five minutes before rinsing, and lower strengths are less likely to irritate. See how to use benzoyl peroxide.
Limit: It can dry the skin and bleaches towels, sheets and clothing.
Topical retinoid
A retinoid such as adapalene unclogs pores, and the AAD notes that using it with benzoyl peroxide can improve results.
Limit: Can cause dryness and irritation at first, and is not used in pregnancy without medical advice.
Sweat and friction control
Showering and changing soon after sweating, loose cotton or sweat-wicking clothing, and swapping a backpack for a handheld bag reduce flares.
Limit: Helps prevent flares but will not clear established acne alone.
Dermatologist-prescribed treatment
Prescription topicals, oral antibiotics, hormonal therapy or isotretinoin may be used for moderate to severe or scarring acne.
Limit: Requires medical supervision because of side effects and, for some options, pregnancy restrictions.
Supportive skincare
A simple routine while it is being managed
Consistency matters more than strength, so keep the routine easy to follow.
Daily
- Benzoyl peroxide washIn the shower, apply the wash to your back, leave it on for two to five minutes, then rinse well.
- Retinoid at nightAfter showering or at bedtime, apply a thin layer of retinoid to affected areas, as directed.
- Sun protectionUse a non-comedogenic, broad-spectrum SPF 30 sunscreen on any back skin that is exposed to the sun.
After sweating
- Shower soonShower as soon as you can after a workout or anything that makes you sweat.
- Change clothesSwap sweaty clothes for clean, loose ones made of cotton or sweat-wicking fabric.
- Mind the gearWash sports kit and towels regularly, and limit pressure from straps, pads and backpacks.
Common mistakes
What can make it harder to manage
- Rinsing a benzoyl peroxide wash off straight away, which gives it little time to work.
- Scrubbing the back hard with brushes or rough loofahs, which adds friction and irritation.
- Picking or squeezing spots, which raises the risk of marks and scars.
- Staying in sweaty clothes, or wearing tight gear that rubs for hours.
- Giving up before six to eight weeks, the time the AAD says it takes to see a difference.
When professional help makes sense
See a dermatologist when back acne is deep, scarring or not improving
- Deep, painful lumps or cysts under the skin.
- New scars or dark marks forming as spots heal.
- No improvement after six to eight weeks of consistent at-home treatment.
- Itchy, uniform bumps that may be fungal acne or folliculitis instead.
- Breakouts that started after a new medicine, supplement or steroid use.
Related reading
Continue with the next useful question
Editorial record
What this page knows, and what remains uncertain
Evidence summary
This page follows AAD self-care guidance for back acne and a 2022 peer-reviewed review of truncal acne, with DermNet and StatPearls for look-alikes.
Important limitations
Most acne trials study the face, and the review notes that evidence specific to truncal acne is limited.
Financial transparency
No paid product placement or affiliate ranking is included on this foundation page.
Recommendation logic
Options move from at-home treatment and prevention to prescription care for more severe acne.
Editorial Record
- Editorial status
- reviewed
- Medical reviewer
- Dr. Abdurrahman Efem
- Practical reviewer
- Merve Akkaya
- Last reviewed
- November 13, 2026
Frequently asked questions
Short answers to common questions
How do you get rid of back acne?
Start with a benzoyl peroxide wash left on for two to five minutes, consider adding a topical retinoid, and shower and change soon after sweating. If there is no improvement after six to eight weeks, see a dermatologist.
How long should I leave benzoyl peroxide wash on my back?
The AAD says studies show it works best when left on the back for two to five minutes before rinsing. Rinse well, since it bleaches fabrics.
Why do I get acne on my back?
The back has many oil glands, so acne forms there just as on the face. Sweat and friction from clothing, backpacks or sports gear can make it worse.
Is it back acne or fungal acne?
Fungal acne is very itchy, has no blackheads and produces small bumps that look alike. Back acne has a mix of blackheads, whiteheads and spots of different sizes. A dermatologist can confirm which one you have.
Does back acne leave scars?
It can. A 2022 review notes that truncal acne often scars, mostly with raised scars. The AAD says deep, painful acne and picking increase the risk, so early treatment helps.
Can I treat back acne during pregnancy?
Some acne treatments, including oral isotretinoin and topical retinoids, are generally avoided during pregnancy. Ask your doctor or dermatologist which options are suitable.
Compare and go deeper
Side-by-side comparisons and practical guides
Sources reviewed
Guidance behind this page
- American Academy of Dermatology: Back acne: How to see clearer skin.
- American Academy of Dermatology: Acne scars: Overview.
- Woo YR, Kim HS. Truncal acne: an overview. Journal of Clinical Medicine, 2022.
- DermNet: Malassezia folliculitis.
- Winters RD, Mitchell M. Folliculitis. StatPearls Publishing, 2023.
- Chien AL, et al. Treatment of acne in pregnancy. Journal of the American Board of Family Medicine, 2016.
Sources support general editorial guidance. They do not replace regional product labels, prescribing information or personal medical assessment.