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The Acne.org Back Regimen - moderate to severe

Important Important: For best results, the Back Regimen should be performed twice a day, about 12 hours apart if at all possible. Follow the steps outlined below precisely. This regimen is the result of years of trial and error and works best when followed exactly.

Wash Gently

Important Important: Irritation can aggravate acne. It is important to be gentle with the skin of your back. Let your hands gently glide over your skin. Do not use soap on the Back Regimen; it can overdry and strip the skin which is the last thing we want. Normally, it is safer to find a gentle cleanser which is specifically made for the face and simply use it on the body.

shower The above video was taped during my morning shower. I have found that it's easiest to simply take another quick shower at night to wash the back again. Washing the back at the sink can get tricky, but feel free to wash at the sink if you can manage that more easily.

  • Dispense two pumps of cleanser into your palm and get a good lather going.
  • Gently wash each side of your back for only about 5 seconds and with a gentle touch. All you are doing is prepping the area for topical treatment later. Rinse gently.
  • Upon exiting the shower, gently dry your back. Do not rub. Just let the towel sit on your skin and absorb the wetness. You may not get it completely dry with the towel this way, but that's preferable to irritating rubbing.
  • Wait 10-15 minutes until your skin is completely dry. Feel free to do other normal daily activities during this time.

Medicate with benzoyl peroxide

  • Wash and dry hands.
  • Dispense one pump of benzoyl peroxide onto your palm. Spread it on one side of your back very gently. Do not rub. Just allow your hand to gently glide over the back until the benzoyl peroxide is more or less absorbed. Dispense another pump of benzoyl peroxide and repeat on the other side of your back. If you are using a store bought benzoyl peroxide, be sure to dispense it liberally-when in doubt, use more. The back is a tough area and can take it. (For some people, two pumps may be needed.)
  • Wait 5-15 minutes for your skin to dry. Do not rinse off the benzoyl peroxide. Once it is applied, you will leave it on the skin.

Apply 10% alpha hydroxy acid

  • Wash and dry hands.
  • Dispense one thick finger's length worth of alpha hydroxy acid cream or gel to each side of the back.
  • Apply very gently, allowing your hand to gently glide over the back until the alpha hydroxy acid is more or less absorbed.
  • Wait for skin to dry before getting dressed. Note: Read below for more on how benzoyl peroxide tends to bleach fabric.
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neck Benzoyl peroxide tends to bleach fabric. This is the most annoying part of this regimen. Even after the benzoyl peroxide is dry, even a slight sweat during the day can reactivate the benzoyl peroxide and ruin your favorite colored shirts. I recommend wearing a white undershirt while on this regimen. Alternately, you can try this regimen minus the benzoyl peroxide and see if that works well enough. I currently have very light back acne and the alpha hydroxy on its own has proved sufficient. When I had more moderate to severe back acne, the benzoyl peroxide was required to get me clear, and I just wore white under shirts.

backpack Backpacks: Reducing irritation is important in clearing acne. But let's face it, you have to sit in chairs and wear clothes, so something will be touching your back much of the day and there's no need to obsess about it. Backpacks in particular, however, can create more direct and ongoing irritation which may aggravate back acne in some people. You may want to try carrying your stuff in something other than a backpack until you are clear on this regimen. At that point, you can start wearing your backpack and see if you stay clear, or if a backpack in your case is simply too much irritation.

neck The neck is much more sensitive than the back. If you are treating the back of your neck with this regimen, it is vital that you start with a small amount of benzoyl peroxide and work up the dosage over time to avoid unnecessary redness, dryness, and itchiness. I recommend strongly that when treating the neck, you start only once a day for the first week and use only a pea sized amount of benzoyl peroxide and AHA. Go to a pea sized amount twice a day the second week, and slowly work up the amount until you are using a generous coating by week four.

armpit Armpits: The skin right around the armpit can be sensitive. If you experience some redness or dryness in this area, try being a bit more careful to avoid this area when applying products.

sun Alpha hydroxy acid increases sensitivity to the sun and increases the chance of sunburn. Use a sunscreen and limit sun exposure while using alpha hydroxy acid and for a few weeks afterward.

Fabric softener: A few experienced doctors and estheticians I have spoken to have mentioned that fabric softener can leave a waxy residue on clothing that can aggravate acne. I have not come across scientific evidence about this issue but just to be safe I choose to not use fabric softener myself. Anti-static balls are one alternative. You should be able to find these balls if you google them.

Allergy: A very small percentage of people are allergic to benzoyl peroxide. If you suspect that you might be sensitive to benzoyl peroxide, apply a small amount of benzoyl peroxide for the first few days to a quarter-size area of the upper back to test for sensitivity. Allergy is evidenced by severe crusting or swelling of the area. If you experience either symptom, stop using benzoyl peroxide immediately.

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