Obviously, we shower to keep our skin blemish-free. But what if your daily ritual was actually causing breakouts? It turns out that certain bad habits in the shower can contribute to acne—or bacne, or buttne—in ways that you’d never expect. Weren’t expecting that one, right?

Don’t worry; we’re not telling you to stop showering. Instead, we tapped a few dermatologists to pinpoint the main back acne causes, share what shower habits could be making things worse, and reveal exactly how to get rid of pimples with the right back acne treatment.

What causes back acne?

When you think about acne, it’s probably the kind on our face. Unfortunately, bacne—which involves red pimples, whiteheads, or blackheads on your back—can be just as frustrating to deal with. You can even experience painful cystic acne on your back.

“We think of acne as being caused by excess oil and dead skin cells that clog the pores, acne-causing bacteria known as Cutibacterium acnes, and inflammation. These are the same triggers for breakouts on the back and the face,” says Marisa Garshick, MD, FAAD, a board-certified dermatologist in New York City. “For some individuals, there can also be a hormonal component to breakouts on the back, as can also occur with breakouts on the face.”

If you’re dealing with cystic acne on your back in particular, Dr. Garshick says it could go beyond a combination of inflammation, bacteria, and oil production. “It may also have a hormonal component,” she says. Then there’s the issue of blackheads on your back, which she says are “related to excess oil and buildup that contributes to clogged pores.”

Another factor that may contribute to bacne or shoulder acne is sweat. “It’s common for people to notice more acne on their back if they’re exercising and sweating more,” says Dr. Garshick. “When sweat sits on the skin for an extended period of time, it can lead to clogged pores.” And, of course, back acne may be influenced by our shower routines, too.

6 shower habits that can cause back acne

1. The water’s too hot or too cold

Do cold showers help back acne? And do hot showers cause acne? There are a lot of questions surrounding how different water temperatures affect our skin. According to dermatologist Neil Sadick, MD, the founder of Sadick Dermatology, you have to play Goldilocks to get it just right. “Cold water tightens the skin’s pores, which doesn’t allow the natural secretion of sebum and acne-causing bacteria,” he says. “Hot water opens pores and stimulates excess sebum production that leaves it prone to further irritation.”

While he claims the best strategy is to use lukewarm water in the shower, you could see some cold shower acne results. Dr. Garshick says cold showers don’t make your skin clearer, but the icy temperature may help make your acne look better, as it helps to reduce the appearance of redness.

2. You shower too frequently

Hate to break it to you, but Dr. Sadick says more than one shower per day can irritate your skin. Choose yours based on what you’re facing that day: “In the morning to remove byproducts the body has naturally eliminated overnight; before bed to remove pollutants; or after workouts to remove perspiration,” he says. And know that if you skip the post-workout shower, there are lots of other genius ways to freshen up that fitness instructors swear by.

3. Your shampoo and conditioner contain pore-clogging ingredients

If you’ve heard that shampoo and conditioner cause back acne, the rumors might be true. “Shampoos, especially those containing sulfates, can trigger back acne as they’re rinsed away,” says Dr. Sadick. “Choose sulfate-free and preferably organic products.” And to help lock in moisture, a lot of traditional conditioners will use quats (like Polyquaternium 10), which bind to your hair as you go about your day. Unfortunately, they can also cling to your skin and clog your pores in the process.

4. You’re washing up in the wrong order

If you tend to rinse out your conditioner at the very end of your shower, you may want to switch things up. This could not only lead to bacne, but also neck and shoulder acne. Even natural products could potentially lead to breakouts as they’re rinsed out of your hair and down your back, says Terrence Keaney, MD, FAAD, a dermatologist and the founder of SkinDC. The best way to avoid that? “Shampoo and condition first, then wash your body afterward. This gets rid of any residual conditioner that wound up on your back,” says Dr. Keaney.

5. You over-exfoliate

Of course, you exfoliate to get rid of dead skin cells and help prevent zits, but it’s a lesser-known fact that overdoing it can have the opposite effect. “Overzealous scrubbing with exfoliants, body brushes, or loofahs can cause significant skin irritation and lead to breakouts,” warns Dr. Sadick. “Less is more with exfoliating,” echoes Dr. Keaney. “If you’re over-aggressive with exfoliating, it can cause redness and dryness, which is not good for the skin.” Post-shower, always make sure to rehydrate skin with a non-comedogenic moisturizer.

6. You’ve got hard water

We’ve heard rumors that Cameron Diaz only washes her face with Evian, and it made sense for the first time when Dr. Sadick said tap water isn’t always conducive to clear skin. “Water coming from the tap is hard in most areas and full of heavy metals that impede proper rinsing of cleansers,” he says, noting that a filter could be a good idea. “They can’t eliminate all heavy metals, but they may help prevent acne.”

5 back acne treatments to try

1. Use the right body wash

Choosing the right back acne treatment can clear things up in record time, starting with a body wash that contains ingredients that combat acne-causing bacteria. “Back acne can be treated using cleansers containing acne-fighting ingredients like benzoyl peroxide or salicylic acid,” says Dr. Garshick. Try Neutrogena Body Clear Pink Grapefruit Acne Body Wash ($8) or CeraVe Body Wash with Salicylic Acid ($13).

2. Plan your daily shower post-workout

If you can swing it, try to plan your daily shower after your workout. “For many people with back acne, it can result from the buildup of sweat on the back that can lead to clogged pores,” says Dr. Garshick. “For this reason, it is important to always change out of sweaty clothing and make sure to shower after exercise.”

3. Stop picking and squeezing

If you’re wondering how to get rid of back or shoulder acne, it definitely doesn’t involve picking or squeezing those pimples… no matter how badly you want to. Doing so is only going to make your acne worse, so it’s best to leave it alone. “It’s important to avoid picking, popping, or squeezing any breakouts, as this can lead to more inflammation and scarring,” says Dr. Garshick. “This may result in the pimple or breakout taking longer to heal.”

4. Use the right exfoliating ingredients

Dr. Garshick says exfoliating the right way could help clear up bacne, especially when you’re dealing with blackheads on your back. “In general, blackheads are best treated using exfoliating ingredients, such as salicylic acid, which helps to unclog the pores and get rid of dead skin cells,” she says.

5. Schedule an appointment with a derm

If you’re experiencing cystic acne on your back, or if your bacne just won’t go away, it may be related to your hormones. If none of the above tips are clearing things up, schedule an appointment with a dermatologist to go over a treatment plan that can zap those zits for good.

Frequently asked questions about back acne

Why do I have back acne even though I shower every day?

While bacne can come about for many reasons, your daily shower could be one of them. Certain shower habits can actually be responsible for bacne, including using a shampoo or conditioner that contains pore-clogging ingredients, not washing away any residual product that winds up on your back post-hair wash, and over-exfoliating. By avoiding these common mistakes and utilizing some of the tips on how to get rid of pimples above, you can ensure that your daily shower isn’t making matters worse.

Do hot showers cause acne or make acne worse?

Cranking up the heat feels oh-so-soothing. But do hot showers cause acne? According to the experts, you may want to stick to lukewarm water instead. “Hot showers can lead to potential dryness and irritation of the skin, which may aggravate back acne,” says Dr. Garshick. In addition, Dr. Sadick notes that hot water opens up your pores and stimulates excess sebum production, which can leave your skin prone to further irritation.

Do cold showers help back acne?

Now you know that cranking the heat is a no-go. But do cold showers help back acne? Not necessarily. However, there are some cold shower acne results worth noting. “Cold showers may help to reduce the appearance of redness,” says Dr. Garshick. “Colder temperatures help to vasoconstrict the blood vessels, making [acne] appear less red and inflamed.” So, if you want to end your shower with a burst of cold water, go for it. (Especially since cold showers can boost your mood and energy levels, too.)

Why does my acne look worse after a shower?

One second, your skin looks fine, and the next, it’s red and inflamed. If you’re wondering why your acne looks worse after a shower, there’s an explanation for that. Dr. Garshick says the heat and pressure in the shower may trigger increased redness, which may make your breakouts appear worse. Avoid super-hot temperatures and instead aim for a gentle, lukewarm shower.

Should I shower twice a day if I have back acne?

While it’s tempting to shower more than once a day to try and “wash away” your bacne, derms say doing so is only going to irritate your skin further. Dr. Sadick says it’s best to stick to one shower a day, if possible, so try and plan accordingly.