This article reviews findings of studies regarding the treatment of truncal acne with benzoyl peroxide formulations and, in particular, studies utilizing a 5.3% benzoyl peroxide foam. Its formulation of micronized benzoyl peroxide particles in an emollient foam vehicle offers significant clinical and bioavailability advantages that enhance follicular penetration and skin moisturization. A key consideration for topical management of truncal acne is whether the treatment application method allows adequate skin contact time to reduce Propionibacterium acnes colony counts. The foam formulation has demonstrated significant reduction in Propionibacterium acnes on the back when used either as a leave-on or as short-contact therapy for five minutes. Short-contact therapy with a benzoyl peroxide foam is a novel approach to minimize the risk of benzoyl peroxide bleaching of clothing in truncal acne patients.