Acne is a common skin disease in adolescents and young adults, occurring mainly in areas rich in sebaceous glands such as the scalp, face, chest and back. It originates from enhanced sebum production, which leads to comedones and secondary inflammation of the hair follicles in sebaceous areas.
Skin on the back is as prone to acne as skin on the face. The occurrence of back acne, coined as bacne, has been significantly associated with insecurities of appearance for both men and women. Patients who are 20 years and above are significantly more likely to suffer from appearance-related distress compared to 16 -19 year-old patients. In this article, learn more about the causes, prevention and treatment options for back acne.
Causes of Back Acne
Fluctuations of sex hormones is a main contributing factor to bacne. Stress, illness, travel, disturbed sleep pattern, menstruation cycles and puberty can all alter the hormonal cycle and lead to breakouts. Specifically, the production of testosterone in both men and women, enlarges oil glands and causes them to produce an excess of oil. At the same time, dead skin cells that are not shed properly clog up the follicles. The combination of these processes leads to a build-up of oil and results in whiteheads and blackheads. Additionally, Cutibacterium acnes is present on everyone’s skin and it does not cause any problems for many. However, the buildup of oil on the skin of people prone to acne creates an optimal environment for the bacteria to multiply. This can lead to inflammation and the formation of blemishes, pimples and cysts. Back acne is actually a subset of acne vulgaris and you’ll most likely find that the individual has acne on their face too.
When Back Acne is not just Acne
A form of back acne is actually a fungal infection, termed as fungal acne, Malassezia folliculitis, also known as pityrosporum folliculitis. It is an infection of the hair follicle caused by Malassezia yeasts. This yeast overgrows in a humid, tropical, summer-like climate, being very common in Singapore. It is also common in individuals who tend to produce more oil. We can characterize it by multiple small bumps on the surface of the skin that actually look very similar to each other, and they may actually be itchy. This is different from traditional acne bumps.
Risk Factors Of Back Acne
First of all, it’s important to note that bacne in most cases is a combination and not just one of the two conditions. The reason is really because if you are acne prone, you already produce more oil than your peers. This puts you at a higher risk of the yeast colonizing your skin, which causes pityrosporum folliculitis. Genetic susceptibility is one key factor, which determines the content of the sebum the individual produces and consequently, affecting the microbiome of the skin. So this explains why certain individuals never develope acne despite having exposure to the same environmental triggers as another person.
Triggers that can cause Back Acne
Living in a humid, tropical climate, or individuals who get flare ups during the summer season is one key trigger. This is because when the weather is hot, individuals sweat more, changing the local skin microbiome. The fungal organisms, malassezia furfur, as well as bacteria that causes acne, known as C acnes, then proliferates. This will then increase your chances of developing bacne.
The local factors that’s caused by textile skin interactions are also relevant in this context. For example, if an individual exercises a lot and stay sweaty throughout the day without changing out of the wet clothing, this causes an accumulation of sweat mixture with dirt, grime and bacteria. All that will cause secondary infections in individuals who suffer from bacne. In particular, if one wears tight-fitting clothing especially from nonbreathable, synthetic or elastic material, this can occlude the surface of your skin and can cause your symptoms to get worse.
Preventing Back Acne
It is recommended to shower after sweating, avoid products that irritate your skin, avoid scrubbing the affected areas, not pick at spots as this may lead to them spreading and scarring. It is best to stay out of the sun and avoiding tanning beds because damaged skin is more prone to acne.
Breathable textiles with dry-fit textile technology usually help to actively cool the skin and not get saturated with sweat during intense exercise. These are recommended for sportswear to prevent backne. Traditionally, we consider cotton, linen and silk to be breathable textiles that help to regulate the skin microenvironment. However, the downside is that a lot of these materials when saturated with sweat such as in the case of sportswear, actually become very heavy.
Biofunctional Textile for Preventing and Treating Back Acne
In my practice, we are using a biofunctional textile – a kimono to be worn at night. The Anti-Ageing Kimono in CUIONS™ Gold features a nanoparticle integrated biofunctional textile woven into a luxurious garment with minimal seams for ultimate skin comfort. The garments targets the skin microbiome and helps to treat body acne and eczema through its bactericidal properties. It also creates a breathable skin microclimate by reducing the humidity around the skin, hence resulting in a healthier skin microbiome.Wearing the correct skin friendly fabrics will prevent recurrence of body acne and is an important part of treatment.
The unisex Anti-Aging Kimono in CUIONS™ Gold features a nanoparticle integrated biofunctional textile¹ woven into a luxurious garment with minimal seams for ultimate skin comfort and breathability.
The evolution of biofunctional textiles is also relevant in the treatment of disorders such as bacne, where there’s a large body surface area affected unlike individuals who only have acne on the face. When cream application may be difficult, it stands to be a promising mode of therapy. Topical antibiotics for the treatment of acne has been around for decades, but long term use is quite tricky because of the emergence of drug resistance. Biofunctional textiles essentially function as topical antibiotics but without the risk of bacterial resistance.
Design and Cut of Clothing
Additionally, the importance of clothing doesn’t just stop at the material, but also the design and the cut. The design should allow for adequate airflow and comfortable movement. For the junction between the skin and the garment, it’s important to reduce the chances of occlusion related dermatosis.
Treating Back Acne
Firstly, one can use an antibacterial body wash such as the Miel Honey™ Cleanser, a medical grade antibacterial, anti-fungal honey cleanser which naturally emulsifies and leaves a humectant layer on the skin. A prescription retinoid is also helpful in the adjunct treatment of bacne. It can help reduce the appearance of blackheads and whiteheads, which subsequently become inflamed when infected.
TheMiel Honey™ Cleanser is dermatologist-designed for thorough cleansing of skin with botanical emulsifiers leaving a clean yet moisturised feel. It contains Arnica Montana Extract that stabilizes skin and reduces flaking.
Natural Back Acne Treatment
Some of the topical medications besides retinoids that can be helpful in the treatment of bacne are in the realm of botanicals. Berberine, a derivative from Eastern medicine is an active ingredient which successfully suppress various acne pathways, including inflammation, scar formation, antioxidant properties, and also has minimal to zero irritation potential.
Schaunig C, Kopera D. Silk textile with antimicrobial AEM5772/5 (Dermasilk): a pilot study with positive influence on acne vulgaris on the back. Int J Dermatol. 2017;56(5):589-591. doi:10.1111/ijd.13541
Hassan J, Grogan S, Clark-Carter D, Richards H, Yates V. The individual health burden of acne. J Health Psychol. 2009;14(8):1105-1118. doi:10.1177/1359105309342470