I was pretty spotty as a teenager. When I got discouraged with yet another failed attempt to clear up my face, my dermatologist would try to comfort me saying “but your back and chest are always clear”. His heart was in the right place, if not his science.
Acne on the back ( aka bacne) and acne on the chest is more common in men and especially during adolesence. It appears where hair follicles ( which have oil glands) are either more numerous or more active. Its also harder to see what is going on below the neck and in the back, and thus harder to clear.
The Best Bacne Treatment
According Mount Sinai super derm Dr Gary Goldenberg, bacne signals the need for oral medication. He starts patients on either oral antibiotics or oral isotretinoin ( aka Accutane) to not only clear the skin but to prevent scarring as well .He also prescribes a benzoyl peroxide cleanser such as Pan Oxyl. Once or twice daily the back and chest should be washed with the BP cleanser using a soft sponge bath brush rather than a rough loofah. Twice a day application of benzoyl peroxide/clindimycin combo like Acanya or Duac should be part of your treatment plan. You’re going to need a “bacne buddy” to help you apply the medication over the entire affected area on the chest and back.
Oral antibiotics will be used for up to three months. Oral isotretinoin is used for 4-6 months depending on your weight and reaction to the drug. Isotretinoin makes the skin more sensitive to the skin, but with larger, harder to reach areas it makes it tricky to apply adequate amounts of sunscreen. To avoid problems always wear a shirt or tee shirt to protect the skin. Even a regular tee provides some protection, but sun protective clothing can give up to 50 USF. You can find great examples of sun protective tees, pants and hats from REI and Coolibar.
FYI– The original oral isotretinon was called Accutane. It is no longer available. Dr Goldenberg often presctibes Absorica, another oral isotretinoin that absorbs well without the need for a high fat meal.