What causes cystic acne on your back?
Acne is a skin condition affecting the oil glands and hair follicles. Oil (sebum), skin cells, and the hair follicle can clog together, plugging a skin pore. Trapped bacteria, such as the bacterium Propionibacterium acnes, can then irritate and inflame the plug. This causes swelling. That swelling can lead to:
- Whiteheads. The clogged pores close and bulge out of the skin.
- Blackheads. The clogged pores stay open. The top surface can darken.
- Pimples. The clogged pores have an open wall that seeps its contents under the skin, forming a red bump. The bump’s top is often filled with pus.
- Cysts. The clogged pores form deeper in the skin. They’re bigger and more painful than a pimple.
When the clogged pores become cysts — tender red bumps filled with pus — you have cystic acne. Cystic acne is the most serious form of acne.
Doctors don’t know what exactly causes acne. But they do know:
- Proper skin care can keep outbreaks from getting worse.
- It’s most common in adolescents and young adults.
- Hormonal changes — such as during puberty and menstruation — can lead to an outbreak.
Over-the-counter acne treatments aren’t strong enough to be effective on cystic acne on your back. Your doctor will probably recommend a dermatologist who can suggest treatments. Treatment may include:
- Oral antibiotic. Tetracycline or a macrolide antibiotic can reduce bacteria, swelling, and redness.
- Topical medication. Retinoid, salicylic acid, azelaic acid, or benzoyl peroxide can reduce bacteria and clogged pores. Read more about salicylic acid vs. benzoyl peroxide.
- Isotretinoin (Accutane). This medication can treat redness, swelling, bacteria, clogged pores, and excess oil. However, Accutane is only used in severe cases due to its side effects.
- Spironolactone. This oral tablet can reduce excess oil. Only females can use it.
- Birth control pills. The estrogen and progestin in birth control pills can help treat acne. Females can only use this treatment as well.
- Corticosteroid. Steroid injections into the cyst can reduce its size and pain.
- Drainage. Your doctor can cut into and drain the cyst. This is only performed in a medical office to limit risk of infection.
- Prednisone. In serious cases, low-dose prednisone may be effective.
Check with your doctor about to make sure the following steps are appropriate to include with the treatment for your cystic acne:
- Wash your back with warm water and a mild soap at least once daily.
- Avoid sunlight.
- Use water-based, noncomedogenic sunscreen. It won’t clog your pores.
- Avoid touching your back and picking at or squeezing the cysts.
- Shower after activities that caused you to sweat.
Cystic acne and anxiety
Along with physical discomfort, cystic acne on your back can affect self-image and social relationships, leading to stress. And stress may make acne worse. If you find yourself anxious about your case of cystic back acne, consider talking with a mental health therapist.