Nunatak 3D Quilt

“Hi! Great you have the courage to speak about this. I have sensitive skin, and definitely get back/shoulder acne from sweat and pack, but not as serious as you.  What helps me: Short drying breaks throughout the day, actually take clothing off and let sun hit the skin. Dipping in creeks etc as often as possible.  Merino (or alpaca) everything that has skin contact. A hipbeltless vest strap pack with 3d mesh straps and no foam/fabric on the straps, to ensure breathability, helped me for the shoulders. But for the back, you might need a trampoline back? Zpacks and Bonfus make some.  Carry water to wash at the end of the day. Invert hiking clothes and hang to air out at night.  In general, you don't need that much more, but clean sleep clothes and an extra pair of underwear is a good idea.  Strategicall, err on the side of being cooler to limit sweating.  Thruhiking hot dusty deserts might just not be in the cards for you. But there's many lifetimes' worth of cooler hikes with daily access to water on this world”