How To Get Rid Of Chest Acne and Bacne

When it comes to acne, it is always about facial, what about chest and back acne (bacne)? The acne on your chest, shoulders, or back, also deserves the light of the day. These types of body acne are called Truncal acne, they appear on your back, chest or shoulders and it is often ignored by those suffering from it.

The cause of chest acne and bacne is almost similar to facial acne but the characteristics of the skin on the body and face are quite different. Both chest acne and bacne deserve more attention as the scars they leave behind are large and it affects the quality of life of those suffering from it.

It is important to treat chest acne and bacne early to prevent the formation of scars. If you are dark-skinned like me, you are more likely to form thickened scars called a keloid or hyperpigmentation. Treating the acne early can help keep that from happening.

In this post, how to get rid of chest acne and bacne but first, let’s get to know and understand what causes chest and back acne.

Understanding Chest Acne and Bacne

Chest and back acne are common but often are overlooked by both patients and clinicians. Clinically, chest acne and bacne fall under the category of truncal acne. Research shows that 48–52% of people with facial acne also have acne on the chest or back​. It may not get as much attention as facial acne, but it certainly deserves it. Acne on the trunk (chest, back, and shoulders) can often be more stubborn and prone to scarring if not treated properly​, and if you are dark skinned, this may lead to more hyperpigmentation or keloids.

Regarding sex, men (54%) are more likely to have chest and bacne than females (43%) and it is more prevalent in adults than in children.

The causes of chest acne and bacne are similar to facial acne: clogged pores, excess oil production, and bacterial overgrowth​. However, several factors make truncal acne unique. The skin on the back and chest tends to be thicker and exposed to friction from clothing, which can worsen breakouts. Understanding these differences is key to effectively treating and preventing acne in these areas.

What Causes Chest Acne and Bacne?

Chest and back acne share several triggers with facial acne, but there are some key differences. Let’s break it down:

1. Clogged pores

Like facial acne, truncal acne occurs when the hair follicles (pores) become clogged with oil, dead skin cells, and bacteria. The sebaceous glands in the chest and back areas produce oil (sebum), which can mix with dead skin cells and clog the pores. When bacteria, particularly Cutibacterium acnes (C. acnes), get trapped, it leads to inflammation and breakouts​.

2. Sweat and friction

Physical activity, especially intense workouts, causes sweating, which can exacerbate acne. Tight clothing, backpacks, or even sports equipment rubbing against the skin creates friction, leading to irritation and acne flare-ups. This is why it’s common to see breakouts in areas that experience more pressure, like the upper back, chest, and shoulders​

.3. Hormonal fluctuations

Just like facial acne, hormones play a significant role in the development of chest and back acne. Androgens, the hormones responsible for increased oil production, often surge during puberty, menstruation, pregnancy, or stress, leading to breakouts. In some cases, hormonal imbalances such as polycystic ovary syndrome (PCOS) can also trigger truncal acne​.

4. Genetics

Your genes play a big role in whether you’ll experience acne on your chest and back. If one or both of your parents had severe acne, there’s a higher chance you’ll develop it too​. Studies suggest that people with a family history of acne tend to have more widespread acne, including on the trunk​.

5. Occlusion from skincare and hair products

Some body lotions, sunscreens, or hair products contain ingredients that can block pores, triggering what’s known as “pomade acne.” If you’re noticing acne flare-ups in areas where these products are applied, they could be to blame​.

5. Lifestyle factors

Poor hygiene, diet, and stress can also contribute to acne. Not showering immediately after sweating or staying in tight, sweaty clothes can make truncal acne worse

How to Prevent Chest and Back Acne

While treating existing acne is important, prevention is key. By implementing the following tips into your routine, you can reduce the likelihood of future breakouts:

1. Shower after sweating

One of the simplest yet most effective prevention methods is to shower immediately after any physical activity. Sweat, when left on the skin, traps bacteria and oil, increasing the risk of clogged pores​.

2. Wear loose, breathable clothing

Tight clothing can increase friction, which irritates the skin and worsens acne. Opt for breathable fabrics like cotton or moisture-wicking materials during workouts to allow your skin to breathe

3. Use non-comedogenic products

Make sure the lotions, sunscreens, and body washes you use are labelled as non-comedogenic, meaning they won’t clog your pores​

4. Exfoliate regularly but gently

Gently exfoliating your skin helps remove dead skin cells that can clog pores. Use a mild body scrub or a salicylic acid body wash 1-2 times a week to keep your skin smooth without causing irritation.

5. Avoid heavy backpacks

Carrying a heavy backpack can cause friction on the back, leading to or worsening existing bacne. Opt for lighter bags or wear your backpack loosely

How to Get Rid Of Chest Acne and Bacne

Treating chest and back acne requires a tailored approach because the skin in these areas is thicker than on the face. Here’s a well-rounded treatment plan:

1. Use a benzoyl peroxide wash

Benzoyl peroxide is a go-to treatment for both facial and truncal acne due to its antibacterial properties​. It helps reduce the presence of C. acnes bacteria that cause breakouts. A benzoyl peroxide wash (5% or 10%) is ideal for treating larger areas like the back and chest. Simply apply the wash to the affected areas during a shower, leaving it on for a few minutes before rinsing off. Be cautious, though—BPO can bleach fabrics, so use white towels and linens after application.

Try these benzoyl peroxide wash

2. Salicylic acid for exfoliation

Salicylic acid is a beta-hydroxy acid (BHA) that exfoliates the skin, unclogs pores, and reduces inflammation. When used in body washes or treatments, it can help break down the debris inside the pores, preventing new acne from forming. It’s especially useful for people with both inflammatory and non-inflammatory acne (blackheads and whiteheads)​. Salicylic acid can be found in body washes, toners, and spot treatments. For truncal acne, use a salicylic acid body wash that you can incorporate into your daily shower routine​.

Try these salicylic acid body wash

3. Topical retinoids

Retinoids, such as tretinoin or trifarotene, are often prescribed for more stubborn cases of acne. They work by increasing cell turnover, which prevents pores from becoming clogged with dead skin cells. Studies have shown that topical retinoids are effective in treating both facial and truncal acne​.

Trifarotene, in particular, has been recently developed to specifically target truncal acne. It selectively binds to the retinoic acid receptor gamma (RARγ), which is highly expressed in the skin on the chest and back​.

4. Oral antibiotics

For moderate to severe truncal acne, dermatologists may prescribe oral antibiotics. These work by reducing inflammation and bacterial growth. The most commonly prescribed antibiotics for acne include tetracyclines like doxycycline or minocycline​. Oral antibiotics are usually used in combination with topical treatments for maximum efficacy.

However, antibiotics should be used for the shortest duration possible—ideally no more than 3-4 months—to avoid antibiotic resistance​.

5. Hormonal treatments

For women, hormonal treatments like birth control pills or spironolactone can be highly effective in managing acne, especially if it’s hormonally driven. These medications work by regulating hormone levels and reducing the overproduction of sebum that leads to acne​.

6. Isotretinoin (Accutane)

For severe cases of truncal acne that don’t respond to other treatments, isotretinoin (commonly known as Accutane) may be recommended. Isotretinoin is a potent oral medication that targets all of the major causes of acne—reducing sebum production, unclogging pores, and preventing inflammation​. However, due to its potential side effects, isotretinoin is typically reserved for severe acne that is resistant to other forms of treatment.

Procedures for Truncal Acne and Scarring

In some cases, topical and oral treatments might not be enough to fully clear truncal acne or prevent scarring. That’s where professional in-office treatments come into play:

1. Chemical peels

Chemical peels involve applying a chemical solution (such as salicylic acid or glycolic acid) to the skin, which exfoliates the top layer and stimulates skin renewal. This can help unclog pores and reduce acne, as well as improve the appearance of post-acne scars​.

2. Laser and light therapies

Lasers and light-based treatments can also be used to reduce acne and treat scars. Photodynamic therapy (PDT) using topical 5% 5-aminolevulinic acid has shown effectiveness in reducing inflammatory lesions on the trunk​. Other laser treatments can target deeper layers of the skin to smooth out scars and reduce hyperpigmentation.

3. Intralesional injections

For painful, inflamed nodules or cystic acne, dermatologists may recommend intralesional corticosteroid injections. These injections help reduce inflammation and speed up the healing process, preventing the formation of scars​(jcm-11-03660).

Psychological Impact of Truncal Acne

Acne, particularly when it affects large areas of the body like the chest and back, can have a significant impact on your self-esteem and mental health. Studies show that patients with both facial and truncal acne experience lower self-esteem and body image issues compared to those with only facial acne​. Truncal acne can also interfere with social activities, sports, and even clothing choices, making it important to address not just the physical symptoms but the emotional ones as well.

Final Thoughts

Dealing with chest and back acne requires patience, consistency, and a multifaceted approach. By incorporating effective treatments, adjusting your daily habits, and seeking professional help when needed, you can significantly reduce or even eliminate truncal acne. Remember, skin healing is a journey—it takes time, but with the right strategy, your skin will thank you.