If your body makes too much sebum or you don’t clean your skin properly, you can get clogged pores. This can result from: Family history: You’re more likely to develop pimples if you have a family history of acne. Friction: Shirts, backpacks, sporting equipment and other clothing that rubs against sweaty skin can cause or worsen back acne. Hormones: People who are pregnant and young people going through adolescent development (puberty) are more likely to get acne breakouts as hormone levels change. Medications: Some drugs, including corticosteroids, can cause back acne or make it worse. Poor hygiene: People with unclean hair can get back acne when oils from their hair rub against their back. Back acne can also result from dirty sheets, towels or clothing. Skin care products: Certain lotions and creams can clog pores and lead to acne. Stress and anxiety: When you have a lot of anxiety or stress, your body makes more of the hormone cortisol. As cortisol levels rise, your body produces more sebum. Trapped sweat: Sweat can get trapped between your skin and your clothing. When it does, your pores can get clogged. People who have excessive sweating (hyperhidrosis) have a higher chance of developing back acne.