Back Acne Scars: Treatments and Causes

Young girl with acne, with red spots on the back

What Is Acne?

Acne vulgaris is the medical term for acne, and experienced by most everybody at some point. Acne causes whiteheads, blackheads, cysts and pus-filled pimples. Severe acne can cause pockmarks (depressions across the skin) and other scarring if not treated carefully.

Let’s take a closer look at what causes acne.

Acne occurs when pores and hair follicles get clogged with sweat, dirt, oil and hair. This results in bumps, pustules, cysts, whiteheads and blackheads. Did you know that these spots can occur anywhere on the body where there are hair follicles? Though, the most common places are the face, neck, back and chest. 


Hormones play a huge role in the production of acne. When females approach puberty, they produce a sex hormone called androgen. This male sex hormone assists in pushing our bodies into adulthood.

During this process, it causes oil glands to grow and manufacture surplus sebum. As an adult, hormones still fluctuate from time to time. Typically for women, it’s when they approach their menstrual cycle. A pimple or two may pop up out of the blue.

Sorry. There’s more bad news. Genetics play a role in your overall skin type. If family members suffer from harsh acne, you most likely will as well. 


Your medicine can also cause breakouts. In fact, some medications used for epilepsy and depression are known to list acne as a side effect.

Androgen (male hormones) and lithium, are also known to increase your chances of developing pimples.

Why Do You Get It On Your Back?

The truth is, you can also get acne on your back. The same rules apply here – friction, sweat, oil, dirt and hair are usually the culprit. The oils from your hair make their way down your back. Then combine that with excess oil production, constant friction from clothing, and you’ve got a recipe for disaster.

This wonderful mess is lovingly referred to as, “Backne.” Unfortunately, if you have acne on your face AND your back, it’s typically considered more severe.

How It Happens


Your skin rubs against clothing, headbands, bras or other items. This can cause a breakout. It’s also common for teens participating in sports. The irritation from the friction causes sebum to block the pores, resulting in a clog.

Oil Production

When your body produces more oil than necessary, the overload of sebum hangs out on the top layer of your skin. This clogs the pores. As a result, they become inflamed and acne pops up. 


Bacteria actually grows on your skin. If given the right opportunity to spread and migrate, it can generate a breakout. 

How Can You Treat It?

If you can’t seem to clear your skin at home, talk to a dermatologist. There are a lot of different products that work right at home and are relatively inexpensive. The best medicine is often prevention. 


This is the easiest way to “treat” acne. As with your overall health, there are ways you can reduce the risk of having to handle acne. 

Eliminate Friction

For young adults, carrying backpacks or wearing athletic equipment is a fact of life. Unfortunately, it adds to the likelihood you’ll be breaking out the acne cream soon. The pressure from a backpack should be eliminated whenever possible. With sports equipment, if you’re able to get away with not wearing it for a while, that’s ideal. To help with sports equipment, wear a clean white cotton tee shirt under the gear when the opportunity presents itself. 

Skin Care Products

Read the labels of your skin care products. Familiarize yourself with the names of the ingredients. How does each work with your skin? Use make-up that’s non-comedogenic, meaning it doesn’t clog pores.  Avoid using oily moisturizers, sunscreens or other products on your back.

Understand that with genetics and hormone fluctuations, even when you’re doing your best to keep your acne under control, you may still experience breakouts. 

Disturbing the Area

It’s  tempting to want to pop a zit. Picking at your face and back, scratching it and otherwise messing with an already irritated area is a bad idea. Avoid it at all costs. You don’t want to create acne scarring.

Your hands should be kept away from your face and back unless they are very clean. Bacteria can easily be transferred from hands to skin.  Also, avoid excessive sun exposure. This can aggravate the skin. 


Cleansing your face and back is vital to keeping one step ahead of acne. Oils from your hair spread onto the face, shoulders and back throughout the day. This starts the process of clogging your pores.

Bacteria from sweat and dirt from the environment all gather together. Wash twice a day, in the morning, and at night before bed.  When you finish washing and conditioning your hair, wash your back to clear away any lingering conditioner. 

Over the Counter Treatments

Using over the counter creams and ointments may help aggravated acne. Look for ingredients like salicylic acid, benzoyl peroxide, sulfur and resorcinol. 

Scar Creams

Typically, these are available without a physician’s prescription. They can be used at home to treat scars. In addition, they can help diminish the itch and discomfort. On top of that, they’ll flatten and fade raised scars.

When you use these creams, the topical treatments should be applied to the entire problem area, and not only the individual spots themselves. 


Silicone dressings and bandages are handy. The research is still out, but these dressings and gels are thought to hydrate the skin which in turn reduces inflammation and pain. They need to be used on a regular basis, however, to get results. 

Document It

Your dermatologist may recommend that you document your treatment. You can take pictures of your progress from day to day. This helps you decide if the treatment has been effective. Don’t forget to document allergies or negative reactions to certain treatments. 

At the Dermatologist

Your doctor can prescribe oral medication for severe acne. This will help with nodules, pus-filled pimples and cysts. Antibiotics can kill bacteria and lessen irritation and inflammation.

These customarily are used with a topical treatment. It may be necessary to use this treatment for 2 to 6 months. It’s the best way to evaluate its true effectiveness. 

Alpha Hydroxy Acids (also known as AHAs)

AHAs treat active acne and acne scars. They exfoliate dead skin and help inhibit the skin pores from becoming clogged.

While being treated, the skin looks renewed. The exfoliation serves to reduce discoloration, which makes the skin appear less harsh. Alpha Hydroxy Acids are favored for scars. Though, cost is sometimes a factor because you need a good amount of product to cover a large area such as your back.

Glycolic Acid comes from the family of Alpha Hydroxy Acids and is made from resources such as milk and fruit sugars. It is used similarly to treat scars.

Salicylic Acid

Salicylic Acid is a familiar ingredient in topical treatments. It treats blemishes with the help of Alpha Hydroxy Acids. This helps reduce post-inflammatory hyperpigmentation. However, its strength lies in its ability to better treat active acne rather than the scars. 

Chemical Peel

They use a concoction of Glycolic Acid, Salicylic Acid and Alpha Hydroxy Acids to create a chemical peel. This can be used on your face, back, or shoulders. The mixture gets applied to the affected area, then penetrates the skin cells.

A second application of different chemicals neutralizes the ingredients in the chemical peel, while the rest is allowed to stay on the skin.

In some studies, it’s been reported that it can improve a scar’s appearance by up to a whopping 90%! This is great for deeper scars as well. Though, typically, more than one treatment is necessary to produce the desired results.

Esteemed New York Dermatologist, Dr. Max Jessner invented his own solution. It contains a blend of Salicylic Acid, Resorcinol, and Lactic Acid. This chemical peel is considered medium strength. It helps remove superficial layers of the skin, dry out current acne, remove blackheads, and lightens hyperpigmentation. It can also help reduce some wrinkling and scarring, while giving the skin an overall healthier look. It’s usually well tolerated and can be a good choice for use on the back. 

Laser Treatments

A Pulsed-Dye Laser (PDL) treatment pulses a laser over the scar tissue. By doing this, it causes the skin to become more elastic, aligned, and helps alleviate inflammation. The laser can further diminish itching and pain,  as well as diminish color, and flatten a raised scar.

As a prevention, this technology is able to decrease the size and scope of hyperactive sebaceous glands. This means it can help stop acne before it starts. It’s a great option, but this is a pricey treatment. It clocks in at an average $100 to $400 cost for one treatment. Though, take in mind that the cost depends on the severity of the acne scars. More than one session is usually necessary, but patients may see results in as little as two sessions. 

Cryotherapy or Cryosurgery

This in-office treatment freezes scar tissue. This causes the tissue to whither, die and eventually fall off. For the best results, doctors recommend a series of these procedures along with injections of corticosteroid. While they do lighten the scars, you can experience permanent pale spots on your skin. This treatment isn’t recommended for those with a darker complexion. 

Resurfacing the Skin

If you aim to slow down broad acne scarring, a dermatologist might suggest a resurfacing procedure. Resurfacing removes layers of skin, which allows the body to produce new skin cells.

There are several ways to resurface the skin. Using this technique helps heal acne scars that are flat and shallow. They include:

  • Laser skin resurfacing
  • Dermabrasion 
  • Microdermabrasion 

Dermabrasion, which works by removing the top layers of skin will not effectively heal deep acne scars and pockmarks. 

Acne Scar Surgery

It’s called surgery, but in actuality it’s less frightening. Dermatologists operate to heal highly visible scars. This simple procedure takes place in the dermatologist’s office. The purpose of the surgery is to decrease the visibility of the scar. It brings it closer to the surface to make it less visible. They also break up scar tissue and remove cysts. Typically it doesn’t require the patient being put under anesthesia. Localized numbing will suffice in most cases.  


Dermatologists also have electric tools that heat the scar tissue. They heat it enough, so it starts to die. This is best course of treatment with certain acne scars, which are referred to as boxcar scars. While it’s good for boxcar scars, it’s not the best treatment for average acne scars. With the tool, they contour the edges of the scar. Then prepare it for resurfacing which makes it less noticeable.


There are many options on the market for fillers. These are used by dermatologists and plastic surgeons to build up acne scars that are depressed. Most are temporary fixes and the patient will need to return to the office to have the areas refreshed. Results can last between 6 and 18 months. There are permanent fillers, which are typically reserved for more in depth procedures. Discuss the pros and cons of fillers with your dermatologist to determine the best course of action. 

In The End

Treating scars left from back acne is possible. There are plenty of options available today. Prevention can really make a difference in the long run. A quick fix today could turn into a permanent reminder. Treat your skin nicely. It’s the only one you’ve got.


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