Uncommon Acne: Causes, Symptoms, and Treatment Options - Dermatology

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Understanding uncommon acne can be quite complex, as it often involves various underlying factors, including skin conditions, allergies, and even hormonal changes. Based on your description, it seems you are experiencing two distinct issues: one on your neck and another on your face. Let's break down your concerns and explore potential causes, symptoms, and treatment options.


1. Neck Bumps
The bumps on your neck that appear after scratching could be a form of folliculitis, which is an inflammation of the hair follicles. This condition can be caused by bacteria, fungi, or irritation from scratching. The fact that these bumps resemble acne but do not hurt suggests they might not be typical acne lesions. Instead, they could be:
- Folliculitis: This is characterized by small, red, pus-filled bumps that can appear after irritation or infection of hair follicles. They can be itchy and may resemble acne.

- Allergic Reaction: If your skin is itchy and you scratch it, it could lead to a rash or hives, which can look like acne. Allergies to products like soaps, detergents, or even fabrics can cause such reactions.

- Sebaceous Cysts: These are non-cancerous lumps beneath the skin that can occur when sebaceous glands become blocked. They are usually painless and can appear anywhere on the body.


2. Facial Acne
The "爛痘" (which translates to "rotten acne") you mentioned could refer to a more severe form of acne or possibly a condition known as cystic acne. This type of acne is characterized by large, painful lumps beneath the skin's surface. The fact that you have had previous surgeries to remove similar lesions suggests that these could be cysts or nodules related to acne.

The itching and subsequent breakout after scratching could indicate:
- Irritation: Scratching can exacerbate existing acne or cause new lesions to form due to skin trauma.

- Acne Mechanica: This is a type of acne that occurs due to friction, heat, or pressure on the skin, which can happen from scratching or wearing tight clothing.

- Hormonal Fluctuations: Hormones can play a significant role in acne development, particularly in adults. If you notice these breakouts coincide with hormonal changes (like menstrual cycles), this could be a contributing factor.


3. Treatment Options
Given that antibiotics have not been effective for you, it may be time to explore other treatment options. Here are some suggestions:
- Topical Treatments: Over-the-counter products containing benzoyl peroxide or salicylic acid can help reduce acne. For more severe cases, a dermatologist may prescribe topical retinoids or stronger medications.

- Oral Medications: If antibiotics are not working, your doctor might consider hormonal treatments (like birth control pills for women) or isotretinoin for severe acne.

- Lifestyle Changes: Maintaining a consistent skincare routine, avoiding harsh scrubs, and using non-comedogenic products can help manage acne. Additionally, reducing stress and ensuring a balanced diet can also be beneficial.

- Professional Treatments: Procedures like chemical peels, laser therapy, or drainage of cysts can provide relief and improve the appearance of your skin.


Conclusion
It is essential to consult with a dermatologist who can provide a thorough examination and possibly recommend a tailored treatment plan based on your specific symptoms and skin type. Additionally, keeping a diary of your breakouts, including when they occur and any potential triggers, can help your healthcare provider identify patterns and develop a more effective treatment strategy. Remember, managing skin conditions often requires patience and a multi-faceted approach, so don't hesitate to seek professional help.