The back is a microclimate all its own. Like the skin on almost every part of the body,

with the exception of the face, we don’t pay very much attention to the back until it starts to cry out for it. The upper back is particularly neglected. For one thing, you see it only when determined to, by looking in a mirror or when someone draws attention to it.

‘Bacne’ is very common, particularly in adolescence, but it can endure well into the early twenties and beyond, if you’re unfortunate enough to suffer from adult acne.

Acne on the back is the same type of acne you find on the face, but it can be more aggressive and painful as sebaceous glands on the back produce more oil. Fuelled by androgens, such as testosterone, the sebaceous glands in the upper back (particularly behind the shoulders) start to overproduce oil.

This starts to congest the pores, making an ideal breeding ground for propionibacterium acnes, which is the acne-causing bacterium responsible for pimples and inflammation.

If the problem is serious enough to cause pain or scarring, then a trip to the GP for advice is advisable. However, for milder cases, a skincare regime for the back can really help.

Firstly, teenagers should not go out into hot or direct sun to expose their backs. Though this works nicely with psoriasis, it will further inflame and worsen bad acne and can be extremely uncomfortable.

A clay mask can be very cooling as well as helpful. Charcoal is an excellent ingredient for absorbing oil.

The Body Shop Himalayan Charcoal Body Clay (€27.50) is divinely luxurious as well as effective. The lavender fragrance is blissful, while salicylic acid helps to break down oily blockages.

Since it is an oil-soluble ingredient, it can get inside blocked pores. Apply this to clean skin for 10 minutes, then rinse off for a refreshed feeling. Follow this directly with a glycolic acid cleanser applied and left for a few minutes, like a mask.

Using mild acids to help cell turnover on the back will help. As the skin tries to shed dead cells, sebum is still being produced underneath, giving the bacteria an even cosier environment to live in. By shedding the dead skin on the surface of the back, the path is cleared for oil to be expelled without lodging anywhere.

Once your clay mask has been removed, apply a glycolic cleanser to the skin, and leave it to sit for 10 to 15 minutes. Image Skincare Ageless Total Facial Cleanser (€33) and Elave Sensitive Rejuvenating Cleansing Treatment (€26.95) will both effectively exfoliate the skin when left to sit on it for several minutes. This is a far more efficient and gentle way to exfoliate acneic skin than rubbing at it with something gritty, like a traditional exfoliator.

Of course, if skin is raw or open, consult a doctor before using acids. If acne has reached that level of seriousness, topical products may not be enough to manage it. lkennedy@irishtimes.com