Our faces tend to get the most attention when it comes to acne. But can we real talk about our typically less seen back pimples for a second? (If your bra strap’s ever rubbed a growing zit the wrong way, you know how irritating back acne, AKA bacne, can be.)

Like with all acne, a number of things can cause it—from environmental to hormonal factors. That’s why, if the goal is to get rid of yours, you have to first figure out what’s making it flare up. Then, the next step is learning how to treat it holistically. Keep reading for advice on how to deal with your own. Unless, of course, you’re just asking for a friend.

6 common causes of back acne

1. You’re staying in sweaty clothes for too long

A good sweat session is great for your body and mind, but once you’re done, the best practice is to get out of your sweaty clothes ASAP and hop in a shower. Sweat is one of the main culprits of acne.

2. Your hormones are out of whack

Hormones are often the thing to blame when your skin seems to be revolting against you and bacne is no exception. If your pimples seem to pop up at the same time every month, it could be an indicator that it’s connected to your estrogen, progesterone, and even perhaps your cortisol levels.

3. It’s something you ate

Your diet and your acne are directly related in some cases. Certain foods are known to cause breakouts—and not just on your face. The usual suspects are dairy and sugar. But gluten, fried foods, and even eggs could be to blame.

4. Something in your shower is setting it off

Six common shower mistakes cause bacne. It could be you’re over exfoliating, have hard water, or aren’t washing in the right order, for starters. “It’s good to check ingredients in shampoo and conditioner, [too]” says Loretta Ciraldo, MD, dermatologist and co-founder of Dr. Loretta skincare. It could contain chemicals like sulfates that cause breakouts. She also says that extremely creamy conditioners can clog pores because they contain quats (like Polyquaternium 10), so be on the lookout.

5. Acne is a side effect of your medication

While many medications potentially solve one problem—they often come with a number of side effects, increased or inflamed acne being among these.

6. Your Genes predispose you to pimples

Even if your face is acne free and you haven’t fallen victim to any of the aforementioned culprits, Dr. Loretta says that sometimes bacne exists with no real cause and is just an inherited, genetic thing. No at-home kit can’t test you for an acne gene—one doesn’t exist. But a predisposition to cysts, immune system disruptions, excess androgen, or androgen sensitivity are all factors that can affect acne.

How to treat back acne holistically

1. Shower after you work out

Skipping the shower line at your studio or gym can cause a slew of skin issues. Sweaty clothing is a breeding ground for bacteria and a common cause of back acne. If you really don’t have time to wash after working out, pack some gentle wipes and a change of clothes.

2. Do your laundry on the reg—but skip the dryer sheets

Dirty towels can cause pimples. So can your bras, which tend to collect bacteria from not being washed enough. (Here’s how often you should wash your bras, FYI.) Whatever you do while washing your stuff, however, don’t use dryer sheets since the leftover film can cause breakouts.

3. Add more anti-inflammatory foods to your diet

Acne isn’t a skin-deep issue. Truly treating it holistically will likely mean adjusting your diet and taking supplements for clear skin. One of the ways you can combat breakouts is by upping the anti-inflammatory foods and ingredients in your diet. Start with this beginner’s guide to the gut-acne connection.

4. Try going dairy free

Although your skin can be sensitive to a number of foods or ingredients that could irritate your back acne further, Dr. Loretta says that dairy is one of the most common foods that can aggravate or cause bacne. Try cutting it out for a few weeks and see if there is any noticeable difference.

5. your back needs skincare too

Keeping your skin hydrated (inside and out) is one of the best ways to prevent breakouts. So, drink lots of water and make sure to moisturize your back. Because the area is so hard to reach on your own, it’s easy to avoid giving it the TLC you dedicate to your face or even the rest of your body. If you have a partner or roommate you’re comfortable with, ask them to help you out or get oils or lotions you can spray on yourself so you can mist your way to an acne free back.

6. Figure out a smart shower routine

Wash and condition your hair first—then your body. That way you’ll remove any excess product that could otherwise clog your pores.

7. Find an effecitve spot treatment for your skin type

For your new and updated shower routine, try using a skin-care product that contains salicylic acid, an ingredient that kills pimple-causing bacteria, witch hazel, or tee tree oil, depending on your skin type.  As the last step of your shower, Dr. Loretta advises put the treatment on your back for 3 minutes before washing off.

8. Exfoliate…just not too much

Sloughing off dead skin sounds like a no-brainer way to keep pores from clogging and prevent pimples. And it is—as long as you’re not overdoing it. Here’s how to tell is you’re exfoliating too much. And here’s the best way to scrub your body using both chemical and manual options. “Often it’s difficult to get an effective application of topical at home products for back acne” Dr. Loretta says. So if after trying all of the at-home remedies possible you still haven’t seen an improvement, she advises getting a 70% glycolic acid peel or hydrafacial once a month. If the problem still persists? See a dermatologist who may have some more in-depth insight or even prescriptive solutions.

Sometimes there just isn’t a one-size-fits-all solution to acne, but you can definitely exacerbate it when you’re stressed.