Welcome to Skin SOS With Dr. Pimple Popper (a.k.a. Dr. Sandra Lee), where your biggest skin-care questions are answered by the internet’s favorite zit-popping dermatologist. Send your skin questions to [email protected] for the chance to have your problems solved in an upcoming article.
“I have had chest and back acne for the longest time!!! And I don’t even drink soda or eat dairy!! I’m so confused on why I have it and others don’t, even when they eat unhealthy. It’s ruining everything for me and I’m starting to feel like I have a problem. What should I do??” —Yohana L.
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Dr. Pimple Popper: There’s no evidence that drinking soda or other carbonated drinks exacerbates your acne, and there’s only a limited association between dairy and acne, according to a 2015 review (although more research is needed). Acne is really mostly related to our hormones and our genetics. And what you get on your back and chest is the same acne that appears on your face.
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However, that means that you can treat chest and back acne with the same kinds of ingredients that you’d use on your face—with a few modifications. Look for acne-fighting ingredients in products that are designed to cover a larger area of the body—like Stridex pads with benzoyl peroxide or salicylic acid that you can swipe on your chest, or body washes with salicylic acid that can better clean the affected areas. The skin on these parts of the body is less sensitive than your face, so it’s less likely to become irritated or dry from a stronger topical medicine like retinol and benzoyl peroxide. However, keep in mind that while benzoyl peroxide can be super effective at treating acne, it can also bleach clothing, sheets, and towels. So use products with this ingredient on your body at nighttime, and wear an old white shirt to sleep to avoid any annoying staining problems. And definitely shower immediately after working out or any other activity where you’d work up a sweat to prevent bacteria and sweat from clogging up your pores. (We also like using this soothing pimple mud to clear breakouts from the Women’s Health Boutique!)
“I’ve been getting painful bumps between my eyebrows! They come back monthly. Sometimes they reveal themselves as zits and sometimes they stay under my skin. It has only been happening the last few months. Help!” —Ragen P.
Dr. Pimple Popper: I’m guessing you may be getting small acne cysts that are under the skin (but I can’t say for certain unless I examine you myself!). Sometimes they come to the surface and your body expels the inflammation. These appear as painful red bumps that slowly rise to the surface and become pustules before they resolve—the classic “pimple.” Those red, noticeable, painful pimples are actually your body’s own immune system recognizing the acne cyst as an enemy and slowly working to expel it from your body. This is why you get pus—it’s actually made of your body’s white blood cells working to destroy the bacteria inside the zit. The redness and swelling that pimples create is actually due to the response of your own immune system fighting and destroying the bacteria that is attempting to set up house in your pores!
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When they don’t reveal themselves as pus-filled zits and instead stay under the skin, this is because this cyst didn’t get irritated or inflamed. Your body didn’t try to destroy it but is letting it coexist. Try to ignore them if you can feel them under the skin but can’t see them (I know, easier said than done!). But if you manipulate them, this can cause more trouble than it’s worth. Sometimes your body takes care of them before they get to the surface, but often they are still under there and can get irritated again repeatedly in the future. It’s as if they are dormant, and can be awoken and become angry, especially if you pick at them and irritate them. You don’t want to awaken a sleeping zit monster.
In order to prevent these bumps in the future, your dermatologist can provide you with prescription antibiotics for a short time (most commonly we use doxycycline or minocycline) to help prevent bacterial buildup and give these small bumps a chance to resolve in as small and inconspicuous of a way as possible.
“I’m 34, and after two kids and recently going off birth control, I’m breaking out badly. I’ve had three microdermabrasions and three chemical peels thinking it would help, but my acne seems to be getting worse and is leaving scars. I’ve also tried DIY masks and am about to attempt hydrogen peroxide just on my acne (going to do a spot-test first). I have sensitive, oily-to-dry skin. Any insight would help!” —Jamie V.
Dr. Pimple Popper: While I applaud your diligent spot-testing, you should stop spending money on all of these expensive and time-consuming procedures. None of them will resolve your breakouts because none of them can treat the actual cause: your hormones.
It’s not uncommon for people to experience breakouts when they stop oral contraceptive pills (OCPs). OCPs can help regulate your hormone levels and keep them from fluctuating dramatically—and those fluctuations during your cycle can cause breakouts.
The easiest solution would be to go back on OCP’s. However, this is not something for everyone, because you may have other just as important reasons—whether it’s for health reasons or to grow your family—why you stopped using them in the first place.
I suggest talking to your dermatologist to find alternative methods to help regulate your acne breakouts that can steady hormone levels without resorting to OCP’s. One option I’d recommend is spironolactone, a drug which is actually a diuretic (water pill) but has the added benefit of being an anti-androgen, meaning it helps to curb fluctuations in hormone levels. It is not for everyone but there are many people who swear by the benefits of this medication. This medication requires a prescription and monitoring by your physician.
Dr. Pimple Popper sets out to promote the practice of dermatology and to educate the public on proper skincare and dermatological procedures. She provides information and solutions to common (and uncommon!) skin concerns, such as acne, cysts, rosacea, and more. For more skincare advice, visit Dr. Pimple Popper’s The Pretty Pimple, Dr. Pimple Popper, or SLMD.