Will back acne and chest acne ruin your summer? Strappy sun dresses, tank tops and bathing suits are all part of summer. Is your skin ready to be exposed to public viewing or do you have to think about adding clothing that hides pimples and marks on your back and chest? Tune up your skin for summer's clothing with some simple tweaks to your skin care now.
A lot of people have acne on their back and chest, but you don't see it because they cover it up with clothes. There's also not a lot of advice out there for treating back and chest acne, which means that I see many of these folks in my dermatology practice.
Most of my back and chest acne patients have the type of acne called Pityrosporum folliculitis. This type of acne is caused by a different acne germ than the more common form of acne called acne vulgaris. Pityrosporum folliculitis needs different treatment than acne vulgaris in order to improve. Pityrosporum folliculitis is caused by a yeast called Pityrosporum (also called Malassezia).
In my dermatology practice I use medicines and skin care that get rid of the yeast that causes Pityrosporum folliculitis. I also treat the more common bacteria (P. acnes) that causes acne vulgaris because it appears to co-conspire with the yeast to really drive back and chest acne. Most regular acne treatments don’t treat this yeast and some don't treat the bacterial. I hit them both!
Dermatologist's 5 step plan to treat back acne and chest acne:
- Wash the back and chest skin with medicated products that specifically treat this type of acne. Products need to kill yeast and unclog the pores. They also need to kill the bacteria. I developed my Back Acne Kit in order to make this step easy for my patients. It has one cleanser with 2% zinc pyrithione to fight the yeast and another with 10% benzoyl peroxide to unclog pores and treat the bacteria. The cleansers are applied with an exfoliating cloth to help the medicines penetrate into the skin. I instruct my patients to leave the cleansers on their back for 2-5 minutes so that the active ingredients have a chance to penetrate skin. They then rinse will and some of the ingredients will stay behind to work after toweling skin dry. My kit comes with complete instructions.
- Keep the back and chest skin as sweat and oil free as possible. The yeast germ that causes this type of acne feeds on oil and sweat. Showering at least once a day with the medicated cleansers is important, but so is showering as soon as possible after workouts or any other sweaty activities. If it’s not possible to shower immediately after sweating, I recommend, at least degrease the skin with rubbing alcohol or my acne treatment pads and changing into a clean dry shirt.
- Special skin treatments such as ‘back facials’ and light skin peels can really help. These are done in the dermatologist’s office or by aestheticians. I usually recommend they be done every month until the skin clears up.
- Diet matters with back and chest acne. The yeast thrives on sugar rich oily skin. Eating low carb, low fat foods puts the yeast on a starvation diet. My Alkaline Mediterranean diet is perfect for people with back acne; it provides you with nutritionally rich foods while closing the restaurant to the yeast.
- As an absolute last resort, a little careful sun exposure often helps this type of acne. Sun exposure is highly controversial, and I only recommend it to my patients with severe back and chest acne who aren't improving enough in spite of doing everything I’ve already mentioned-AND who have a big event where they need clear skin (like prom, a wedding etc.) A careful amount of mid-day sun unfortunately can help clear back and chest acne in a pinch. Sun works because it suppresses the skin’s immune cells that are fighting the yeast in the pimples. 5 minutes of mid-day sun, without a sun burn, can sometimes help heal the pimples pretty fast. It can cause post inflammatory hyperpigmentation of the healing acne pimples. This is the brown spots that result from healed lesions. Sun of course causes permanent damage to the skin in the form of freckles, wrinkles and skin cancers. The damage can never be reversed, so sun exposure is a last resort and only done for the short period of time before the event. Tanning beds are an absolute no-no and should never be used.