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Acne on top of back

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I don't know why...but the top of my back has been breaking out lately...like right at the base of my neck bone in the back. It happened last month the week before my period (I'm taking tri-sprintec birth control)...and the acne isn't going away and I've been on a new pack of pills for a week. I don't know if something is irritating it or what could be causing me to break out there. I don't really break out consistently on too many other spots on my back...but that spot seems to be the worst...I get regular pimples and blackheads all month long! Does anyone have any suggestions or advice!? Thanks!

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