Brief Answer:
Topical + oral antibiotics+-Retinoids
Detailed Answer:
Hi. Thanks for your query on XXXXXXX
Acne commonly involves face, trunk, chest and shouders (all these areas are rich in sebaceous glands). All these areas may or may not be involved simultaneously.
At 26 years its not very uncommon to have acne. Trunk acne is more resistant and more prone to relapse then facial acne(persists longer)
Another possibility i would have kept in your case is of pityrosporum folliculitis(caused by yeast) even though Pityrosporum folliculitis ITCHES a lot and is commonly seen in hot, humid weather conditions. Clinically both look the same except the itching part which is prominent in Pitryosporum folliculitis. Acne usually does'nt itch or they itch only slightly.
You said that you are already using
Benzoyl Peroxide cream as well as wash. If i were your treating doctor i would have advised you to continue with that. Its used in both OTC and prescription acne products. 5% or 10% cream/gel is recommended for use on back once or twice daily.
Benzoyl peroxide Wash/Soap is also useful and convenient to use.
In addition to that, I would advice that you be put on a course of oral antibiotics like Doxycycline OR
Azithromycin for 4-6 weeks, since the lesions on your back and trunk are inflammatory (Papules and pustules).
In my practice i start my patients on oral retinoids (
Isotretinoin) if they present me similar to you. Oral retinoids are Sebostatic(decreases oil production), normalises keratinization, are anti-inflammatory and decreases proliferation/population of
Propionibacterium acnes as well as yeast(which feeds on your oil) in hair follicles. You should visit a
dermatologist to get a prescription for oral anti-acne medications(Antibiotics and Retinoids).
Since trunk acne tends to relapse you might need a repeat course of retinoids sometime in future , if needed.
To summarize:
Topical treatment to be continued as before + Add oral retinoids + 4-6 weeks of Oral antibiotics(preferably Azithromycin if used with along retinoids) would be ideal for you
take care
regards