best back acne treatment in Singapore

What Causes Back Acne?

There are many factors that contribute to what causes back acne. Genetics, hormones and stress are just a few. Occlusion due to clothing that clogs up the pores often worsens the condition.

Environmental heat and humidity increases the amount of sweat and sebum produced, further exacerbating the condition. 

Back acne is driven by hormones and it is more common in young adolescent males. Hormonal imbalances in females with a condition known as Polycystic Ovarian Syndrome often present with acne as well.

Back acne or truncal acne despite being relatively common, is underreported and undertreated. Back acne can cause scarring and keloid scars.Therefore, prompt and early treatment helps to reduce further scarring.

Why do I get Back Acne?

Where is one of the first areas to produce sweat during a workout? The back of course! Back acne is common as the oil glands are larger and more concentrated over these areas.

Bacne, Back acne or Truncal Acne is a common form of acne that affects the back, shoulders and chest. It is seen in up to 50% of individuals that come to the clinic with facial acne.

Bacne tends to be more common in young males, individuals with severe acne and hormonal acne. Left untreated, back acne can progress to cystic acne, red marks, blemishes (post-inflammatory hyperpigmentation), keloids and permanent scars.

Truncal skin is more vulnerable to oil, sweat, friction and occlusion than facial skin. What causes back acne from one person can greatly differ from another. Therefore, it is important to try to uncover what may trigger your acne in the first place. 

post-inflammatory hyerpigmentation caused by back acne
Post-inflammatory Hyperpigmentation

What does Back Acne look like?

back acne
Moderate Back Acne
back acne keloid
Back Acne with Keloids

The appearance of back acne can range from comedomes to inflammatory papules, pustules, nodules and cysts on the back and chest.

The most frequent areas affected are the upper back, chest and lower back. Shoulder and upper arm involvement can occur in some cases. Scarring, especially hypertrophic and keloid scarring often accompanies back acne.

The severity of back acne is dependent on certain factors that include:

  • Area affected
  • Number of inflammatory papules and pustules
  • Presence of cysts and nodules
  • Scarring
  • Impact of quality of life
treatment for bacne in Singapore

3 Ways to Get Rid of Back Acne

  1. Washout after a Workout. A sweat soaked shirt that blocks and clogs the pores is a common culprit of acne. We advise washing immediately after a workout and changing into fresh breathable cotton attire.
  2. No Excuses Just because you Can’t See It. We frequently ignore our backs until someone points it out to us. We advise washing the back with a benzoyl peroxide or salicylic acid based wash to remove skin debris and keep skin healthy.
  3. Eat Healthy. A well-balanced diet that is low in sugar content and dairy products may lead to an improvement in your acne.

What Treatment Options are there for Back Acne?

First, we need to uncover the factors that relate to what causes back acne. The treatment of back acne depends on the severity of your acne, your medical history, allergies, skin type and skin sensitivity. Often, combining treatments are more effective at targeting the different processes of acne to give an optimum outcome.

  • Topical Acne Creams 

Prescription Acne creams containing a combination of a retinoid and benzoyl peroxide have anti-bacterial, anti-inflammatory and anti-comedomal properties to provide a multi-prong approach to acne. Azelaic acid 20% cream used twice daily resulted in significant improvement after 12 weeks of back acne treatment. Topical acne treatments would be suitable for mild to moderate truncal acne.

  • Oral Antibiotics 

Antibiotics are a mainstay of treatment for moderate to severe inflammatory back acne vulgaris, and work by reducing bacterial load and inflammation. Antibiotics have proven to be safe and effective in many studies to treat acne. A course of treatment may last at least 3-4 months. However, there is an increasing trend of antibiotic-resistant acne worldwide.

  • Oral Retinoids

Oral retinoids is a Vitamin A derived medication that works extremely well in acne and are currently the most effective treatment for severe recalcitrant acne. It reduces oil secretion by 90% within 6 weeks of treatment, reduces whiteheads and blackheads by 90% within 3 months and has an anti-inflammatory effect. 

A consultation is necessary to discuss about the side effects, suitability and precautions before starting oral retinoids. 

  • Hormonal Therapies

Oral contraceptive pills and oral spironolactone for females work by suppressing the effect of androgen on the sebaceous glands and have benefited individuals who may be not suitable for other therapies.

  • Anti-inflammatory Injections 

If you develop a painful acne cyst on your back, the anti-inflammatory injection treatment can rapidly improve your symptoms in 1-2 days.

Bacne keloid scarring can also be treated with anti-inflammatory injections, spaced 4 to 6 weeks apart to reduce the scar thickness and volume.


How can I improve my acne scars?

Acne scarring is an unfortunate consequence of acne. It often results from acne that has been left untreated and resultant damage done to the dermal layer of the skin. Severe forms of acne such as cystic acne have a much higher risk of scarring.

There are many forms of Acne Scars, and Acne scar revision will depend on the type or types of acne scar you have.

Our clinic uses various techniques including chemical resurfacing, subcision, lasers, surgery and fillers to resurface and correct acne scarring.

Dr Moses Ng dermatologist

Back acne or truncal acne can be equally debilitating compared to facial acne. Often, patients who see me for facial acne may not realise the extent of their back acne. Treating back acne early will lead to less scarring and healthier looking skin.

Dr Moses Ng

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More Information:

  • Acne – American Academy of Dermatology.
  • Acne – British Association of Dermatologists.
  1. Lee JW, Yoo KH, Park KY, Han TY, Li K, Seo SJ, et al. Effectiveness of Conventional, Low-dose and Intermittent Oral Isotretinoin in the Treatment of Acne: A Randomized, Controlled Comparative study. Br J Dermatol. 2010 Nov 29.
  2. Collier CN, Harper JC, Cafardi JA, Cantrell WC, Wang W, Foster KW, et al. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008 Jan. 58(1):56-9.
  3. Woo YR, Kim HS. Truncal Acne: An Overview. Journal of Clinical Medicine. 2022 Jun 24;11(13):3660.