Back Acne - Causes, Prevention & Treatment for Back Acne

Many people suffer from acne in one form or another. Along with facial acne, back acne is also quite common. It can be very embarrassing and sometimes even painful.

This condition can limit people from doing many activities. Men sometimes find it awkward going shirtless when swimming or enjoying the beach. Women don’t want to wear clothing that will show the infected skin and can find it very limiting.

There aren’t only emotional consequences with back acne; there are also physical damages as well. When the area becomes very painful, it is normally because the person suffers from cystic acne. This can cause a great deal of discomfort when wearing certain clothes and also being in different positions.

Causes of Back Acne
Back acne is the manifestation of injuries inflicted to cells lining the sebum canals within the hair follicles because they could not sustain a sudden outflow of sebum to the surface of the skin. This is commonly caused by increased levels of the hormones: testosterone and androgen. The hormone androgen begins production when puberty occurs and is responsible for the levels of  sebum production.

Since much sebum is produced it then begins to work its way to the surface of the skin. As the sebum travels to the hair shaft it mixes with dead cells which causes the hair follicle to become blocked. In blocked pores bacteria that live in symbiosis with us in the sebum glands and now in an environment without oxygen start proliferating to much or uncontrolled and produce chemicals that damage our cells.

Within the follicular canal of humans there are bacteria which are indigenous to the follicular lining. Among the bacteria flora present are anaerobic, gram positive organisms called Proprionibacterium acnes. It is interesting to note that they are present in abundance in pathologically affected sites. They are reduced during oral antimicrobial treatment and their absence from nonhuman animal skin is striking especially since animals do not exhibit acne vulgaris.

Proprionibacterium acnes bacteria lives on the keratin lined follicular canal in symbiosis with us, thus providing us certain benefits.
Humans have a symbiotic relationship with very many species of bacteria. This means that they live on various bits of us and obtain somewhere to obtain food and reproduce and we gain something in return. The essence of a symbiotic relationship is that both partners benefit.

Many bacteria live on our skin and mucous membranes (mouth, genitals, sebaceous glands, etc) and provide different benefits to us. The particular benefit that resident Proprionibacterium acnes bacteria living on the keratin lined follicular canal  bring to us is that they help the sebaceous glands produce the oil that lubricates our skin and keeps the pH of skin at a level that does not allow for other bacteria to live on our skin surface and within the follicles.

Proprionibacterium acnes ingests the sebum produced from the sebocytes of the sebaceous glands. This nascent sebum is largely lipid in composition and also contains DNA, RNA, proteins and other cellular components that result from the breakdown of sebocytes themselves. The Proprionibacterium acnes which have an affinity for lipids, feed on the nascent sebum.

It has been shown that Proprionibacterium acnes are found only in sebaceous rich areas. If the nutrients increase due to an active and large sebaceous system, then colonization and high growth rates of Proprionibacterium acnes will form. Then the resident bacterial flora will produce biologically active molecules such as histamine, extracellular enzymes and peptides which are responsible for the movement of cell created by our immune system in reaction those chemical stimulus (chemotaxis) leading to the inflammatory infiltrate chracteristic of acne vulgaris.

Since in many cases the follicular lining in the pilosebaceous unit is intact while still there is inflammation it has been theorized that if colonization of Proprionibacterium acnes occurs in sufficient numbers, they could produce initiating antigenic molecules that promote the initiation of inflammation.

Proprionibacterium acnes can produce proteinases, lipase and hyaluronate lyase all of which may serve as the catalysts or initiators of the inflammatory infiltrate which has been shown to be composed of neutrophils and lymphocytes.

Acne starts with the formation of a characteristic lesion: the comedo. This produces a blockage in the pilosebaceous canal following dyskeratinization of the infundibular zone of the canal. A major effect of the blockage is to modify the rheology of the sebum and the physicochemical properties of the area. Such modification allows resident cutaneous strains to hyperproliferate which in turn triggers an inflammation reaction in the organism.

The comedo is created by retention of layers of dead skin known as keratin in the lining of the follicles. In addition to hyperkeratosis (which is thickening or retentative layering of keratin), there is an accumulation of sebum which is the lipid-laden product of the sebaceous gland. The cells of the sebaceous glands in which sebum originates are the sebocytes. The combination of the keratin and the sebum produces a plugging of the mouth or opening of the follicular canal and papules are formed by inflammation around the comedones. Depending upon the degree of inflammation, pustules, cysts, nodules, granulomatous reactions, scars and keloids may develop.

Most typical forms of mild acne vulgaris demonstrate the predominance of comedones with the occasional pustules. Pustules and papules predominate in more severe cases. These can heal with scar formation; that is, fibrosis of the lesions which are deep and penetrating. In moderately active cases, larger cystic lesions can develop.

Hormones another key factor in the development of acne

In adolescence, for example, it is thought that androgens can interact with receptors on the sebaceous glands and cause stimulation of the sebaceous gland, to hypertrophy and hence form more sebaceous production of lipids and free fatty acids which distend the follicular canal.

More specifically, there is evidence for increased peripheral metabolic conversion of the androgen testosterone to dihydrotestosterone at the level of the skin in people who suffer frequent acne breakouts.

It is further hypothesized that receptors on the sebaceous gland for the active androgen dihydrotestosterone can exhibit various degrees of sensitivity and that a heightened sensitivity response may be partially or entirely genetically predetermined.

Many elements can cause plugging of the follicular canal or pores on the back and thus back acne.

One such element is tight clothing. When excess sebum is produced and form fitting clothes are worn, the sebum mixes with sweat and blocks the pores which causes back acne. Exercising and sweating can also be reasons, since the skin will produce extra sebum and may not be washed away in a timely manner. Friction on the back is also a factor of back acne. When irritation occurs from something such as a backpack, acne can be the consequence.

Oily hair can also cause the sebum ducts to become blocked. When oily hair is constantly touching the back, clogged pores can occur from the extra oil.

Stress and diet also need to be at a healthy level since they can affect hormonal levels. Preventing back acne can be as simple as having a healthy diet and learning to cope with mild stress.

A number of treatments are presently known for treating acne, some more successful than others.

There are two modes of treatment, topical and systemic.

Some of the topical treatments that are presently employed are: topical erythromycin, clindamycin, benzoyl peroxide, 2% sulfur, 3% resorcinol, a tetracycline derivative (meclocycline sulfosalicylate 1%), 2% salicylic acid and tretinoin.

Some systemic treatments for acne that are presently employed are antibiotics such as oral tetracycline; oral erythromycin; minocycline; doxycycline; oral trimethoprim-sulfamethoxazole and isotretinoin.

Some of the undesirable side effects of orally administered antibiotics are abdominal cramps, black tongue, cough, diarrhea, fatigue, irritation of the mouth, loss of appetite, nausea, vomiting, fever, hearing loss, jaundice, rash, rectal and vaginal itching and superinfection.

Benzoyl peroxide has been known for several years to be a particularly interesting keratolytic agent among recognized therapeutic acne treatments. In addition, it has good bacteriostatic properties.

Use of standard antibiotics in acne treatment is also widespread. They do, in fact, shown considerable bacteriostatic and anti-inflammatory activity. Orally administered active antibiotics are numerous. Among these, clindamycin and especially erythromycin show topical activity.

Antibiotics have previously been combined with benzoyl peroxide in order to increase the activity of topical anti-acne compositions. In particular, erythromycin has already been combined with benzoyl peroxide

However, a major drawback of the use of antibiotics (either alone or in combination with benzoyl peroxide) lies in their prolonged use whereupon bacterial flora become resistant, rendering the antibiotics less effective in subsequent treatment. Further, benzoyl peroxide-erythromycin combinations are unstable over periods of time.

Especially in the treatment of people with inflammatory lesions, benzoylperoxide is often used in combination with orally administered antibiotics, e.g. tetracycline, erythromycin and the like. However, many questions have been raised concerning the safety of short and long term use of orally administered antibiotics in the treatment of acne. Moreover, as a general rule, it is desirable to avoid oral therapy in the treatment of skin problems whenever an effective topical treatment modality is available.

There are various acne cream products designed for the body, as well as body washes that unclog pores that are not irritating and have, compared with products that may be very harsh and drying to the skin, and containing natural ingredients that are very effecive in treating acne bacteria which also support the immune system at the site of the acne lesions and quickly repair skin lesions and avoid acne scarring.

BIOSKINFORTE is an all natural treatment cream designed to help prevent and eliminate facial and body acne. This product supports the immune system by helping it to quickly repair damaged cells and by fighting uncontrolled acne bacteria. When inflammation occurs or when excess sebum is produced BIOSKINFORTE helps your skin maintain control. This can treat back acne, facial acne and also difficult cystic acne.