I just received a wonderful email from Jennifer, one of my web customers. She has suffered for years from back acne brought on by sweating. Bacne, as some people call it, is a problem that plagues athletes, people who sweat because they work out regularly to stay healthy, and folks that live in humid climates where sweating is a way of life.
It’s emails like Jennifer’s that keep me writing for my website and adding the skin care routines that I’ve developed for my patients’ skin problems over the years that I’ve been practicing dermatology.
Jennifer’s email is so nice I want to share it with you. She wrote:
Dear Dr. Bailey,
I cannot thank you enough for your information on back acne and the zinc soap. I have dealt with back and chest breakouts for almost 20 years, and have been to numerous dermatologists – not one ever mentioned pyrithione zinc as a solution. I thought I had tried everything – sprays, washes, etc. – and all they did was dry out my skin and make it itchy – and I would still get breakouts the minute I broke a sweat.After a couple of weeks of using the zinc soap at night and benzoyl peroxide wash in the morning, my back and chest were completely clear – which has never happened in my entire life. And a few months later, they are STILL completely clear. I can finally wear tank tops again. My skin is soft and smooth, and my husband comments on it all the time. He can’t believe the difference. So glad I found your website. Thank you so much.
Jennifer B.
Back acne is one of the more frustrating forms of acne; it’s poorly understood and tricky to treat because acne products are designed for facial acne, which is different for many reasons. I see a lot of patients with back acne (bacne). I, my husband, and my kids are also prone to it, so at my house we really care about fixing it… and I’ve developed a great skin care routine to do just that. These products are in every shower in my house! I combined the 3 most effective topical treatments I’ve ever found into a Bacne Skin Care Routine Kit. It’s what has helped Jennifer, me, and my family and it’s the treatment that I rely on in my practice for my bacne patients.
In my Bacne Kit, I use a combination of:
- Pyrithione zinc to control the pityrosporum yeast that causes most cases of bacne, in my experience.
- Benzoyl peroxide in a strong 10% foaming cleanser to control acne causing bacteria and to help unclog clogged pores and to loosen blackheads, all of which play a role in bacne too.
- Physical exfoliation with the Salux cloth, a brilliant invention that helps smooth out the skin, loosen clogged pore debris, and scrub the medicated cleansers deeper into the skin.
Click here to see my Back Acne Kit for Bacne
Jennifer, thanks for the lovely email. It is readers and customers like you that make this web project so satisfying for me.
Photo: thanks and gratitude to Lululemon Athletica (makers of some of my favorite athletic clothing, FYI!)
Back pain is really a big problem for me …at the end of each day i feel pain allover my back…thnx for sharing such a good info.
What about scalpne (I just made that up)? What causes it and what can you do? It hurts!
I love it! Same thing, pityrosporum yeast. The Zinc Cleanser in the Back Acne Kit is perfect, but not the benzoyl peroxide. That Zinc Cleanser is really a foaming cleanser that’s a great shampoo. Add a scalp scrubber and it’s a perfect one-two punch on the scalpne… and yes they hurt at the same time they often itch too.
I haven’t really had any problems with back acne compared to how much I’ve noticed on some friends and family members. However, I recently started seeing a bit on my back lately. I do not want it to spread or get worse. Although, I’m kind of worried about what treatment options are available. I usually like to use natural products on my body since I do not use any pharmaceutical medications unless there is no other option available. Are there any side effects associated with using your back acne kit? Is it safe for sensitive skin?
I have had very good results from a new treatment called Acnezine.
Hello Lyanna,
The benzoyl peroxide can irritate sensitive skin. A gentler alternative that also uses what would be considered more ‘natural’ products would be to scrub the skin with the Salux Cloth or a Body Buf Puf Sponge with the handle and the Calming Zinc Soap. This gives the same pyrithione zinc soap but in a totally natural soap base that does not need preservatives because it isn’t liquid. Even better would be to use the Calming Zinc soap with the Clarisonic Brush and it’s Body Extension Handle!
Hi Dr. Bailey,
Thanks for interesting blog. It’s nice to hear doctor’s perspective on many natural and alternative acne treatments. I wanted to comment on your post about foods that are good for acne, but alas the comments were closed already.
While I mostly agree with it, I would say that vegetables can really cause problems for some people. Nobody denies that they are healthy, but some of us have guts that don’t agree with vegetable fiber.
I’m not sure if you are aware, but there’s quite good evidence to suggest that gut problems are linked to skin problems. They are much more prevalent in skin patient population and treating them with probiotics or antibiotics often also helps the skin.
And people with IBS and other gut issues often have limited tolerance to fiber, especially insoluble fiber. For example many studies show that insoluble fiber aggravates some IBS symptoms. Anecdotally this is true for me personally. After tracking food intake and gut symptoms I’ve been able to identify many cases where fruits or vegetables cause gut problems. Can’t say for sure from anecdotal observation, but it does seem like when my gut turns sour I can expect a flare up on the skin the following day.
Any thoughts on this?
Hello Seppo,
I totally agree and if you mine the content on my blog you will see that I’m a big proponent of probiotics BUT my preference is strongly toward probiiotic rich foods over supplements. You’ll also see that I think most of a diet should be veggies and fruit, ideally organic and with variety. People with gi disease have to moderate that based on their symptoms though. There usually are fruits and veggies that a person with gi disease can tolerate. There is also the option of juicing with a centrifuge juicer and removing some of the fiber that way. Lastly, it’s possible for a person with gi disease to build towards the goal of a predominantly plant based diet that included probiotic rich foods. This would be done slowly under their doctor’s supervision and the concept is that as their gut heals they slowly proceed.
I think diet and skin are more linked than people realize, and of course that means the gut plays a huge role. I also think our poor intestinal world has been altered hugely by our modern liberal use of antibiotics and lack of probiotic rich foods. Our body’s chemistry is also wacky because of too much dairy, meat, refined carbs and not enough fresh plant based foods. If you scan the content in my Diet, Nutrition and Natural Health blog category you’ll find a lot of my recommendations and thoughts on the subject.
Thanks for taking an interest in a juicy, and gradually less controversial, topic.
Warm Regards,
Cynthia Bailey MD
I just found out that inadequate cleanliness is not the cause for acne outbreaks. Scrubbing my face too often does not do any good.
I’m going to check out your Bacne kit.
thanks for the information
Nathan
Dear Dr. Bailey,
Let’s hope that the diet-acne relationship becomes less controversial. Too often dermatologists still outright deny any connection between diet and acne.
I also agree that one should eat a wide variety of fermented foods. Research shows that benefits from probiotics are often strain-specific. And we often don’t know what strains probiotic supplement manufacturers include into their products. So eating a wide variety of fermented foods helps to ensure a broader intake of probiotics. And I don’t like to depend on supplements.
Best,
Seppo
Dear Dr Bailey,
Thank you so much for your website- your articles on fungal skin conditions such as seborrheic dermatitis and fungal folliculitis have been so helpful to us.
I purchased your calming zinc soap for my teenage daughter who has seborrheic dermatitis and pityrosporum folliculitis acne on her face (thank you so much for selling fantastic products such as these too- zinc soap is not available in my country). Thanks to the soap we now have pretty much beaten the seb derm, but outbreaks of fungal acne are still a problem.
I was wondering if you could advise me on the best way to use the soap for maximum benefit. Do you wet the soap and apply it directly to the face, or is it best to just use the soapy water you get on your hands if you rub the bar between them? Is it best to leave it on the skin for a little while, or should it be rinsed off straight away? And is it better to just rinse the skin with water and leave the residual film, or should the skin be wiped to remove traces of the soap? She uses Differin for normal acne which is probably making her skin a bit more sensitive than it would be otherwise.
Any tips would be much appreciated. She doesn’t do well on anti-fungals, and sodium sulfacetamide cleansers are not available where I live, so we need to get the best we can out of the zinc soap.
KInd regards,
Jennifer
Hello Jennifer,
I have my patients lather the soap in their hands, on a Buf Puf sponge or a Clarisonic brush and then wash their face with the lather. The later two options will make the skin more sensitive though and may be too harsh for some skin types. Differin makes skin more vulnerable and sensitive. The soap can be left on for a few seconds then rinsed with water, again skin sensitivity is the limiting factor. I think it’s best not to use a toner to remove the medicated soap residue, but instead to simply rinse with water.
Diet is also important as pityrosporum yeast loves carb loaded skin. Acne in general is worse on the same high-glycemic foods and diets heavy in dairy, meats and the “bad” fats present in modern Western foods. Diets heavy on veggies, fruits and with only complex carbs and “healthy” fats like omega-3 rich salmon are best for helping to control acne. We are going to see more and more about this diet/acne link in the coming years.
Warm Regards,
Cynthia Bailey MD
Dear Dr. Bailey,
I’m new to your blog but let me say I am absolutely loving it!!! THANK YOU!!!
I read a post on medications for rosacea you did but the comments are closed on that one. I have rosacea and breakouts (whiteheads, blackheads, and little bumps). I saw where you stated that you use doxycycline at a “therapeutic dose to get in and get out without causing a super germ”. I was wondering if you can tell me what dose you use and how long you keep your patients on it so I may talk to my derm about it. She usually does the 3 month route at I think 100mg but I worry about being on antibiotics since this would be the 3rd time in a year. I read where people have stated that doxycycline was good but when they came off of it their breakouts were worse then before they went on it… I’m pretty concerned with that….can that really happen? I’m currently on finacea. I got the Elta MD Clear sunscreen you recommend for acne prone/rosacea skin and the 3-4 days I used it I noticed an increase in bumps…is that maybe just coincidental or do you think there is another one I should try for my rosacea/breakout prone skin. I want to go on a tretinoin but I know I can’t do that unless I find a sunscreen!!!! I ordered your zinc soap but find it a little drying so I’m waiting on the Glycolix Elite moisturizer to come in to use with it. Soon I hope to order the Replinex Cream also…wish I could get samples to see how it goes before buying the whole bottle! Hope you and your family have a wonderful weekend and I look forward to hearing from you!!!
I can only give general information on how I approach rosacea in my patients. With doxy I use 100mg until their skin is clear plus a few weeks then taper off. I let my patients use it as needed to control the beginning of flare ups, which is often just a day or two. Typically, once we find the right skin care routine they need very little doxy. I put all antibiotic patients on probiotics and tell them to eat probiotic rich foods daily. I also encourage my rosacea patients to really examine their diet and tweak it towards veggie heavy (as noted in my diet posts).
Rosacea does wax and wane and small increases is lesion count don’t need major intervention. Nor does the presence of a few pimples signal that a product is not working. It’s larger trends that I look for.
I find a routine for a patient that helps quiet the skin then add potentially provocative products one at a time. I try to allow 4 to 6 weeks between changes so that I don’t make decisions based on the small daily ups and downs of rosacea but instead based on the bigger trends. Replenix CF or Green Tea Antiox Skin Therapy/Power of Three is a foundation product of my rosacea skin care and I always start that right away. If Calming Zinc is too drying I have my patients wash with Toleriane Cleanser, Aquanil or Cetaphil Cleansers. My preference is Toleriane. The Calming Zinc lather can be diluted with a dollop of Toleriane or used every few days alternating with Toleriane, sometimes that helps me to get the pyrithione zinc into the skin care below the threshold for irritation. Elta Clear is one of my favorite sunscreens for my rosacea patients. So is the Glycolix Elite Sunscreen and the Suntegrity products. Rosacea can flare up from sun exposure so finding a sunscreen is important.
I hope these general ideas give you something to discuss with your doc.
I have a massage client that has some sort of skin condition on his back that causes little white bumps. They don’t look like a typical white head. They are all over his upper back and seem somewhat deep. Doesn’t look like you could pop them. Any suggestions?
Thanks,
Marguerite
ScottsdaleSkinRejuvenation.com
Hello Marguerite,
There are is a varied range of possible diagnosis from benign adenexal neoplasms to keratosis pilaris, scars to prurigo nodules, milium to non-inflammatory acne lesions etc. Your client needs to start with an exam by a dermatologist. Treatment always follows diagnosis and I can’t offer any diagnosis on my blog or over the web.
Warm Regards, Cynthia Bailey MD