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How to Clear Back Acne – Treatment and Causes

Ep 35: Breakouts on Your Body? Back Acne Treatment & Prevention

Hi guys, welcome to my podcast Dermatologist Talks Science of Beauty. I’m Dr. Teo Wan Lin of TWL Specialist Skin & Laser Centre. In this week’s dermatology flash briefing, we’re going to talk about bacne. Bacne is actually the colloquial term for back acne, which is essentially a type of acne-like rash that occurs over certain parts of the body. Principally, the areas that produce oil such as the chest and the back area. It’s also known as truncal acne, which can affect adolescents as well as young adults. Today, we’re going to talk about what actually causes it. 

Back acne causes

When an individual enters into puberty, there are certain changes in the body that include fluctuations of the sex hormones. Specifically, the production of testosterone that occurs in both men and women also functions as a trigger for oil production. What happens is inflammation of the hair follicles in certain individuals who are genetically prone to developing acne. The true form of back acne is actually part of acne vulgaris. You’ll find that the individual likely also has acne on their face. 

When acne is not acne: Fungal acne

However, a form of back acne is actually a fungal infection- pityrosporum folliculitis. It has been termed as fungal acne, which is a misnomer, because it’s not really a form of acne, but rather a type of hair follicle infection that is caused by a yeast. This yeast overgrows in a humid, tropical, summer-like climate. It’s very common in Singapore, for example, where I practice. 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 bacne

What are the risk factors that predisposes one to bacne? 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. This yeast responsible is Malassezia Furfur. 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

For the specific triggers that can cause bacne. We’ve talked about living in a humid, tropical climate, or in individuals who get flare ups during the summer season. This is really because when the weather is hot, and you sweat more, this changes 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 you are exercising a lot and you stay sweaty throughout the day and don’t change out of your 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. Wearing tight-fitting clothing especially from nonbreathable, synthetic or elastic material. All that can occlude the surface of your skin and can cause your symptoms to get worse. 

Preventing back acne

Breathable textiles especially those that actively cool the skin, such as those with dry-fit textile technology usually help to cool the skin and do not get saturated with sweat during intense exercise. 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 for example cotton, is not suitable for many clothing styles and may not suit things like work wear. Besides, if it saturates with sweat such as in the case of sportswear, it actually becomes very heavy. 

Textiles for backne prevention

Newer textiles such as those derived from biodegradable plant sources like Lyocell, Tencell. These are actually beneficial for the skin microenvironment. Also the fact that it’s made from plant waste, all that is part of the sustainable approach towards fashion. At the same time, it is beneficial for the creating of a breathable skin microclimate. What happens really is that it reduces the humidity around the skin and the skin microbiome consequently, is a lot healthier.

Wearing the correct skin friendly fabrics will prevent recurrence of body acne and is an important part of treatment. The Lyosilk Multi-Way Wrap Dress in Dove Grey is engineered with superior moisture-wicking and anti-microbial properties which inhibit the growth of bacteria and yeast on skin. The design has minimal seams and accessories which reduce areas of friction or pressure.

Design and cut of clothing

Additionally, the importance of clothing doesn’t just stop at the material, but also the design and the cut. For the material itself, it is important that it has a smooth surface. Textiles such as wool or acrylics, these a little bit prickly on skin and would definitely worsen symptom for an individual with bacne, and eczema for that matter.

The design should allow for adequate airflow and comfortable movement. For the junction between the skin and the garment, it’s very important to reduce the chances of occlusion related dermatosis. The evolution of biofunctional textiles is also very 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. 

Tips for back acne treatment

Finally, we’re going to go on to my tips for treating bacne First of all, use an antibacterial body wash. My patients use a medical grade honey cleanser that emulsifies and also leaves a humectant layer on skin. It is naturally antibacterial. Commercially available antibacterial cleanser such as triclosan is used in Singapore by some dermatologists. However, there has been some concern about its medium to long-term effects on hormonal regulation. A prescription retinoid is also helpful in the adjunct treatment of bacne  – it can help reduce the appearance of blackheads and whiteheads. These are all forms of acne respectively known as closed and open comedones. They subsequently become inflamed when it’s infected. 

Back acne treatment: antibacterial body wash

Medical grade honey is used in the Miel Honey Cleanser which has natural emulsifying, antibacterial, anti-fungal properties for gentle and effective cleansing in eczema-prone individuals. Natural honey is also a humectant, trapping a layer of moisture for protection after cleansing.

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 in which dermatology research shows successfully suppress various acne pathways, including inflammation, scar formation, antioxidant properties, and also has minimal to zero irritation potential.

Berberine targets mechanisms in acne formation. It is ideal for acne treatment as it is anti-inflammatory, has oil control functions, is a potent antioxidant. Zero irritation formula, safe on fabrics.

Biofunctional textiles for back acne prevention and treatment

In my practice, we are also using a biofunctional textile – it is a kimono to be worn at night that’s impregnated with metallic nanoparticles that have a broad spectrum biocidal effect as an adjuvant treatment for bacne. There is an ongoing clinical study*, so contact the email at the end of this transcript if you are interested in enrolling.

Sensitive skin fabrics for back acne treatment

The Anti-Ageing 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 garments targets the skin microbiome and helps to treat body acne and eczema through its bactericidal properties.

I hope you’ve enjoyed today’s episode of Dermatologist Talks: Science of Beauty. We’ve covered some of the key characteristics of bacne and also shed some light on when bacne isn’t acne. That’s when it’s a form of fungal infection – pityrosporum folliculitis. The common preventive measures include topical medications. Oral medications may be indicated as part of acne treatment if the condition is severe. The novel concept of applying biofunctional textiles for treatment. Also some interesting tips which you can hopefully incorporate in your lifestyle when it comes to fashion choices that will reduce your chance of developing bacne. You can follow me on my Instagram at @drteowanlin and also get our podcast transcript at www.scienceofbeauty.net. 

*ongoing clinical trial by Dr.TWL Biomaterials, please contact manager@twlskin.com for more information if you suffer from eczema or body acne.