I can’t see it and I can’t reach it by rubbing it. How can I get rid of the acne on my back?

Summer is here, and many people can no longer hide their belly fat, so they have to lose weight. Some people can no longer hide the acne on their backs, and they are even growing rapidly in this season.

Why do I get acne on my back?

If you search online, you will find a lot of answers, such as unclean sheets, irregular diet, and even lung heat and blocked meridians. Don't believe them.

Why do pimples appear on the back? The key is what kind of pimples they appear on. Is it acne? Is it folliculitis? There are thousands of skin diseases, and pimples on the back are not just one of them.

Today, let’s talk about several common back acne.

List of common acne

Without further ado, let’s just post the table so that people with acne can find their area of ​​concern.

Common acne on the back and its main characteristics

It can be seen that there are at least four common types of acne: bacterial folliculitis, Malassezia folliculitis, acne, and keratosis pilaris. Although they all look like acne at first glance, they can be distinguished relatively well by their appearance characteristics, accompanying symptoms, skin manifestations in other parts of the body, onset patterns, and self-healing abilities.

Next, let’s combine pictures and text to further understand the causes, treatments and prevention points of different skin problems.

Bacterial Folliculitis

Bacterial folliculitis, as the name suggests, is folliculitis caused by bacterial infection. Its characteristic is that the hair follicles are infected, which manifests as red acne or purulent acne, and the acne appears centered on the pores.

The picture below is a typical bacterial folliculitis.

Bacterial Folliculitis

Sometimes you will get folliculitis on your head after scratching it; sometimes you will get folliculitis in the beard area after shaving; and sometimes you will get folliculitis on your buttocks after not paying attention to local hygiene. They are all the same problem in different parts of the body.

If you have folliculitis on your back, but the number is small, you don't need to rush to take medicine. You can observe and wait for it to heal on its own.

If you need treatment, basically you only need to apply antibiotics externally for a few days. Common ones include Bactroban ointment and fusidic acid cream.

In order to reduce the incidence of attacks, daily care and preventive measures should also be in place, such as:

Pay attention to skin hygiene;

· Towels, bath towels and clothes should also be washed carefully and not shared with others;

· Protect your skin at ordinary times, avoid frequent friction and damage to the skin, and do not recommend excessive scrubbing;

If you have the habit of taking a bath, do not take a bath for more than 15 minutes each time and make sure to clean the bathtub.

Malassezia folliculitis

Malassezia folliculitis is a type of folliculitis that sounds unfamiliar. It is caused by the fungus Malassezia.

In fact, Malassezia is closely related to our skin. Normal people have Malassezia on their skin. It feeds on the oil on the skin and lives in harmony with people. It only occasionally stirs up trouble and causes skin infection. When it infects the hair follicles, it manifests as Malassezia folliculitis.

Malassezia folliculitis

If the skin is oily and sweaty, especially in the hot and humid summer, this type of folliculitis is more likely to occur. In addition, long-term use of antibiotics or hormones is also more likely to cause an attack.

Malassezia folliculitis does not pose much threat to health. The main problem is that it recurs, affecting appearance and making you feel bad.

There are many antifungal products and medicines to choose from. Over-the-counter medicines are easily available, such as ketoconazole lotion, which can be used 3 to 4 times a week on the back like a shower gel for about a month, and the condition is likely to be controlled.

However, sometimes the disease is more stubborn and requires other ointments or even oral medications. If home treatment is not effective, then you should seek medical attention and adjust the plan.

In addition, as mentioned above, Malassezia folliculitis is prone to recurrence. In order to reduce it, you can do the following in your life:

Use an antifungal product 1 to 2 times a week to consolidate the effect, such as ketoconazole lotion or selenium sulfide lotion;

Pay attention to skin cleanliness, take a bath frequently to avoid excessive oiliness and sweat irritation on the skin;

· Give priority to choosing clothes with good breathability, and avoid using overly greasy or heavy skin care products;

If you are using other antibiotics or hormones, use them under the guidance of a doctor and try to stop using them gradually.

Acne

Acne is commonly known as "pimples" or "acne". I guess many people know it because it is too common. Not only teenagers, but also young people aged 20 to 40 are prone to acne.

In fact, the most common part of acne on the back is the face, which is also a skin problem that affects your appearance. In addition, oily parts such as the neck and chest may also develop acne.

Acne

The big difference between it and other acne is that it not only has red pimples or pus-filled pimples, but also blackheads. In severe cases, there are peanut-sized cysts and nodules. After the pimples disappear, there are often red acne marks, black acne marks and even acne pits left behind.

The treatment of acne is more complicated, and you need to consult a dermatologist to develop a plan based on the actual situation. The ideal plan will be determined based on the location, range, severity, previous treatment effects, and personal medication preferences.

The general principle is that for mild cases, local medication can be used first, while for severe cases, oral medications may be combined with topical medications. In addition, after the treatment is completed, local consolidation is generally required for a period of time to reduce rebound.

Acne care is also important to help treat the disease and reduce recurrences, such as:

Pay attention to skin cleansing and avoid excessive oiliness;

When taking a shower or washing your face, don’t scrub too hard to avoid damaging your skin and worsening acne;

· Control your hands and don’t squeeze pimples;

· Do not abuse oily skin care products and cosmetics;

· Don’t blindly avoid certain foods. If there is a certain food (such as milk) that causes acne to break out repeatedly, eat less or avoid it appropriately.

Keratosis pilaris

"Keratosis pilaris" is also an unfamiliar word, but its common name - chicken skin, is widely known. Some people think that chicken skin only grows on arms and legs, but in fact, the face and back are also common parts.

Keratosis pilaris (from references)

Keratosis pilaris is related to heredity. Once it occurs, it will generally last for many years, with slight fluctuations with the seasons at most. For example, it becomes more obvious when the climate is dry and the humidity drops. The reason why it persists is that it is determined by genes. There will be abnormal keratinization of the pores, which is manifested as small particles in the pores. There are often keratin substances blocking the pores, and the hair inside cannot grow normally. You can often see the phenomenon of curly hair.

To treat keratosis pilaris, you must first adjust your expectations. That is, although treatment is effective, the skin will slowly return to its original state after treatment is stopped. Therefore, if you are not bothered by it, not treating it is also an option. If you do treat it, the general advice is to pay attention to avoid dry skin and moisturize every day.

If you are not satisfied with this and want better results, there are many other options, such as topical products and medicines that soften keratin and regulate keratinization. The most common ones are urea cream, salicylic acid cream or retinoic acid cream, which are all relatively easy to use. Other options include acid brushing and oral isotretinoin. After obvious improvement, the frequency of using products or medicines can be reduced to maintain the effect and avoid rebound.

If you pay attention to the details in your life, the control effect of keratosis pilaris will often be better:

Don’t take a bath with hot water. Use warm water at around 38°C. Also control the bathing time, preferably within 10 minutes, to avoid over-drying the skin.

Avoid skin friction and damage. Scrubbing is not recommended, and irritating soap is not recommended (weakly acidic shower gel is more friendly to the skin);

It is also recommended to choose comfortable and well-fitting clothes. Avoid wearing tight clothes to avoid unnecessary skin friction;

If the climate is very dry during the season change, you can use a humidifier as needed, which can also help relieve dry skin.

We have discussed above the four most common types of acne on the back, but sometimes, acne on the back may also be other rare problems, such as epidermoid cysts, multiple steatocystomas, furuncles, pigmented prurigo, etc. in medicine.

If you still cannot identify the problem after reading this popular science article, it may be a special skin problem. It is recommended that you seek medical treatment in a standardized manner and find a dermatologist to solve the problem one-on-one.

Author: Tang Jiaoqing, MD, attending physician of dermatology

Review | Feng Jun, Deputy Chief Physician, Dermatology Department, General Hospital of Datong Coal Mine Group Co., Ltd.