Body acne: What is it & how to treat it?

The ESK blog

Body acne: What is it & how to treat it?

02 September 2022

Acne on your body is the SAME acne as the spots you get on your face. Most of it happens on the trunk- your back and chest and we call it truncal acne. 

The key differences are 

  1. Studies have found that the skin on the back has less oil glands than the skin on the face and so there’s much less oil secretion on the trunk than in the face. Looks like overproduction of oil isn’t a big part of truncal acne.

  2. Truncal acne tends to happen with more severe acne. 

  3. Truncal acne is hard to get to with skincare. 

  4. Unlike the pimples on your face, you can hide your truncal acne.

    Dermatologists say they see lots of people who have never disclosed their bacne and simply avoid wearing backless dresses or avoid the beach.

    They also hide it from their doctors, and that means the people who need help most often don’t get it. But if untreated it can cause scars on large parts of the body.

For these reasons we doctors tend to jump on it harder than face acne.

How common is it?

Studies of truncal acne have been surprisingly rare! But a recent Korean review found that acne on the body is very common with 52% of teens with acne on their face also having some pimples on the trunk.

The researchers found that truncal acne most often affects the upper back (52%), followed by the upper chest (30%), lower back (22%), shoulders and upper arms (16%), and finally the neck (8%).

The worse the acne on the face, the more likely you are to get body acne as well. 

Treating truncal acne

As a rule truncal acne is treated the same as face acne. Unfortunately, it usually takes longer and more intense treatment to wrangle truncal acne under control compared to facial acne.

But, according to a 2021 International Expert Panel on acne affecting the trunk, people with acne on their backs are often more willing to tolerate harsher or less “cosmetically elegant” medications and skincare products on the trunk than on the face. Redness simply isn’t as big a deal. 

If the acne is mild enough, topical therapies are the place to start. Evidence exists for using topical vitamin A, benzoyl peroxide (best as a wash off application because it bleaches your clothes and sheets!), azelaic acid, dapsone, and topical antibiotics - either alone or in a combination. 

But for moderate to severe truncal acne, this won’t be enough. Combining treatments such as these topical agents with oral medications like antibiotics, isotretinoin, the pill, or the anti-testosterone diuretic spironolactone will usually be needed. 

Procedures including lasers, light devices and chemical peels have all been successfully used for truncal acne.

But the best evidence out of all the procedures exists for photodynamic therapy or PDT. PDT uses drugs called photosensitising agents that make your skin MORE sensitive to light.

Combining these agents with oxygen and light creates a reaction that targets and destroys oil glands. I know! We said at the beginning that your trunk doesn’t have as many oil glands as your face. But it still works! 

What are your experiences of bacne? Let us know!