Got pimples on your back and/or butt? With the warmer, more humid (sweaty!) weather approaching, these annoying spots can make an appearance.
If your breakouts are mild-moderate, you don’t also have facial acne, or you have just started a new workout regime that means you’re extra sweaty (or had a summer holiday to Tahiti, lucky you), the good news is that there are some simple at-home steps that can help with body breakouts.
BUT, if you have extensive breakouts, or your acne contains large, painful cysts or nodules, then seeing a doctor will be your best bet – DIY at home won’t cut it. There is a topical retinoid now available in Australia especially for body acne (Trifarotene, brand name: AKLEIF) and systemic treatments like antibiotics or isotretinoin are also a potential solution.
And remember, you will need to follow our acne-busting tips every day for at least 10-12 weeks to see an improvement. If you’re still not getting on top of breakouts after this, then it’s time to seek medical advice.
Firstly, is it even acne?
There are a few things that can lead to pimple-like breakouts on your back and butt but aren’t acne vulgaris. You might need to recruit a friend to take photos of what’s happening on your back (a good friend if it’s your butt!).
One of the most common causes of back/buttne is folliculitis – inflammation of the hair follicles caused by an infection with the microbes that normally hang out on your skin, usually the bacterium, Staphylococcus aureus. This presents as pus-filled pimples (‘pustules’) but without any blackheads. Luckily, the same tips for acne vulgaris will usually improve folliculitis as well.
If you’re shaving these areas and getting breakouts, you might also have something called folliculitis/pseudofolliculitis barbae (shaving rash). Our Clinical Director, Dr Scott Ellis, wrote more about this, HERE.
And finally, if the bumps all look like exactly the same tiny, red, itchy spots, this could be a form of folliculitis that results from overgrowth of a normal skin yeast called Malassezia within the hair follicle. See a doctor or pharmacist for this one as an over-the-counter topical anti-fungal like ketoconazole is the treatment of choice.
Our best back/buttne busting tips
- Benzoyl Peroxide (BPO)
BPO is an antibacterial (especially useful for Staph and Cutibacterium acnes), anti-inflammatory and pore-unblocking agent that is an evidence-based over-the-counter treatment for mild-moderate body acne. It’s available in both leave-on and wash-off versions. Leave-on BPO cream/gel will bleach clothing, towels or bed linen if it comes in contact with them, so try a wash-off version (like the Benzac 5% Wash), and leave it in contact with the acne-prone areas of your skin for 5 minutes before rinsing off. You can use an applicator like THIS one to apply the wash (don’t forget to let the sponge dry between uses, and replace regularly to avoid it becoming a breeding ground for more bacteria).
If you’re outside Australia (or want to risk buying on Amazon!), you can buy higher strength BPO cleansers, but always try the lower strength first – higher strengths also come with the potential for more irritation.
2. Lifestyle Measures
The trick with back/buttne is to minimise warm, damp conditions under which bacteria can proliferate:
- Remove sweaty clothing (especially gym gear) as soon as possible
- Rinse the acne-prone areas with water as soon as possible – if you can’t shower, a gentle fragrance-free wipe will do in emergencies (THESE ones are great)
- Wash sweaty clothing between wears, and don’t re-wear bras or sports crops repeatedly
- If you’re sweating up a storm overnight, change your sheets regularly too
- Opt for clothing that stays cool and dry – fabrics like silk and cotton are great, as is sweat-wicking workout gear
What NOT to do!
Exfoliate! We will say it again – you cannot scrub acne away, not matter how much you scrub. All scrubbing does is to further inflame already inflamed skin.
Pick at your skin – we know this is hard.
Sunbathe – no sunlight does not make acne better. In fact, UV exposure makes acne scars darker, and stick around for longer.
- Yang, Z, Zhang Y, et al. 2020. Topical benzoyl peroxide for acne. Cochrane Database Systematic Review. PMID: 32175593.
- Drake L, Reyes-Hadsall S, et al. 2022. New Developments in Topical Acne Therapy. Am J Clin Dermatol. PMID: 35041198.
- Eichenfield DZ, Sprague J, Eichenfield LF. 2021. Management of Acne Vulgaris: A Review. JAMA. PMID: 34812859.
- Luelmo-Aguilar J, Santandreu MS. 2004. Folliculitis: recognition and management. Am J Clin Dermatol. PMID: 15554731.
- Eiland G, Ridley D. Dermatological problems in the athlete. 1996. J Orthop Sports Phys Ther. PMID: 8727020.
- Fakhouri T, Yentzer BA, Feldman SR. 2009. Advancement in benzoyl peroxide-based acne treatment: methods to increase both efficacy and tolerability. J Drugs Dermatol. PMID: 19588642.
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