From the Guidelines
The best treatment for back acne typically involves a combination of topical treatments, good hygiene practices, and sometimes oral medications, with benzoyl peroxide, topical retinoids, and oral doxycycline being strongly recommended 1. For mild to moderate back acne, start with benzoyl peroxide washes (5-10%) used daily in the shower, leaving it on for 2-3 minutes before rinsing. Topical retinoids like adapalene 0.1% gel applied nightly can also be effective. Some key points to consider when treating back acne include:
- Using spray formulations or asking someone to help apply treatments for harder-to-reach areas
- Salicylic acid (2%) products to help exfoliate and unclog pores
- Consulting a dermatologist if initial measures don't work after 4-6 weeks, who might prescribe stronger topical antibiotics like clindamycin or oral antibiotics such as doxycycline (100mg twice daily) for 8-12 weeks
- Considering isotretinoin (formerly known as Accutane) for severe or cystic back acne under close medical supervision 1 Additionally, wearing loose-fitting, breathable clothing, showering promptly after sweating, using non-comedogenic body products, and changing sheets weekly can help prevent back acne, which often develops due to the skin in this area having more oil glands and being subject to friction and sweat, creating an ideal environment for acne-causing bacteria to thrive 1.
From the FDA Drug Label
Purpose Acne treatment Directions Adults and children 12 years of age and older: use once daily clean the skin gently and pat dry before applying the product cover the entire affected area with a thin layer. For example, if your acne in on the face, apply the product to the entire face. The best treatment for back acne is to apply adapalene (TOP) to the entire affected area, in this case, the back, once daily, as directed for acne treatment 2 2.
- Clean the skin gently and pat dry before applying the product
- Cover the entire affected area with a thin layer
- Use once daily, do not use more than one time a day
From the Research
Treatment Options for Back Acne
The treatment for back acne, also known as acne vulgaris, can vary depending on the severity of the condition.
- For mild acne, topical treatments such as benzoyl peroxide, salicylic acid, and low-dose retinoids are effective 3.
- For moderate acne, combination therapy comprising topical benzoyl peroxide, antibiotics, and/or retinoids, as well as oral antibiotics in refractory cases and oral contraceptive pills for female acne patients, is recommended 3.
- For severe nodulocystic acne vulgaris, oral isotretinoin therapy is the most effective treatment option 3.
Combination Therapy
Combination therapy is often used to treat acne, as it addresses the multifactorial pathophysiology of the condition.
- The combination of clindamycin 1%-benzoyl peroxide 5% gel is efficacious and well-tolerated 4.
- Adapalene 0.3%/benzoyl peroxide 2.5% gel plus oral doxycycline is an effective and safe treatment option for severe inflammatory acne 5.
- Topical retinoids, benzoyl peroxide, azelaic acid, or combinations of topical agents are first-line treatments for acne vulgaris 6.
Oral Isotretinoin
Oral isotretinoin is the gold standard for severe nodular acne, but it may not be suitable for all patients due to its potential side effects.
- A study comparing oral isotretinoin with doxycycline 200 mg plus adapalene 0.1%/benzoyl peroxide 2.5% gel found that the combination therapy was noninferior to oral isotretinoin in terms of efficacy and safety 7.
- Oral isotretinoin is approved by the US Food and Drug Administration for treating severe recalcitrant nodular acne, but it is often used to treat resistant or persistent moderate to severe acne, as well as acne that produces scarring or significant psychosocial distress 6.