Understanding and Treating Truncal Acne

Truncal acne, commonly known as “bacne,” is a prevalent condition that affects the back, chest, and shoulders. This form of acne can be particularly stubborn and uncomfortable, impacting individuals physically and emotionally. Understanding its causes, symptoms, and treatment options is essential for effective management and relief.

Truncal acne is similar to facial acne, including the development of comedones (blackheads and whiteheads), papules, pustules, cysts, and nodules. It occurs when hair follicles become clogged with oil, dead skin cells, and bacteria. Several factors contribute to the development of truncal acne. Hormonal fluctuations, particularly increased androgens, can lead to higher sebum production, causing clogged pores. Genetic predisposition also plays a role, as a family history of acne can increase the likelihood of developing truncal acne. Additionally, excessive sweating and friction from tight clothing or sports equipment can exacerbate the condition, as can certain dietary and lifestyle factors, such as consuming high glycemic index foods and experiencing high-stress levels.

Effective treatment of truncal acne requires a combination of topical and systemic therapies and lifestyle modifications. Over-the-counter topical treatments containing benzoyl peroxide, salicylic acid, or alpha hydroxy acids can help reduce oil
production and inflammation. Prescription-strength topicals, such as retinoids, are also effective in unclogging pores and preventing new breakouts. Oral antibiotics like doxycycline or minocycline can reduce bacterial overgrowth and inflammation in moderate to severe cases. Hormonal therapies, including oral contraceptives and anti-androgen medications like spironolactone, can be beneficial for women with hormonally driven acne. In severe truncal acne that does not respond to other treatments, isotretinoin (commonly known as Accutane®) may be prescribed. This medication can significantly reduce sebum production and prevent the formation of new acne lesions. Laser treatments and photodynamic therapy can help reduce acne lesions by targeting bacteria and reducing inflammation. These therapies are often used in conjunction with other treatments for optimal results.

Maintaining good hygiene, wearing loose-fitting clothing, and showering immediately after sweating can help prevent exacerbations. Products like the skinfo® Clear Skin Aloe Cleanser ($24, 6.7 oz) available at our skincare boutique, skinfo® and skinfo.com, can also be beneficial. If you are struggling with truncal acne, schedule an appointment with your Advanced Dermatology medical provider to develop a personalized treatment plan that addresses your specific needs and concerns.