Acne at the Neck and Cheek Junction: Causes and Solutions

Q: Acne at the Neck and Cheek Junction: Causes and Solutions

Hello： Regarding your issue, it pertains to deep-seated acne. <br>If there is pain, it is advisable to start with oral anti-inflammatory medications (anti-inflammatories and corticosteroids) for about 1-2 weeks. <br>Topically, you can use retinoic acid. <br>If there is no respons

Acne appears at the junction of the neck and cheek?

Since July, I have been experiencing acne at the junction of my neck and cheeks, as well as on my chin.
I visited a dermatologist and was prescribed oral medication and a topical treatment.
Initially, the acne persisted and spread to my right and left cheeks, but the quantity was not significant.
The lesions were cystic, hard, and large, taking a long time to resolve, leaving deep scars.
I initially thought it was related to my diet and lifestyle, so I changed my eating habits and daily routine.
Although there has been some improvement, recently, the acne has concentrated on the left side of my neck and cheek, with many lesions appearing almost daily, which is very distressing.
Additionally, there is a hard lump on the left side of my neck that does not feel like an acne cyst.
I have researched some medical information online, suggesting that it could be related to endocrine issues, liver problems, or lymphatic system disorders.
I have also seen discussions regarding potential digestive system issues.

Could you please advise if I should consult a different specialty for this condition? If so, which specialty would be most appropriate? If I do see another specialist, will I still need to continue taking oral medication from the dermatology department?

Arctic, 20~29 year old female. Ask Date: 2008/10/05

Dr. Zhang Zhibo reply Dermatology

Hello: Regarding your issue, it pertains to deep-seated acne.
If there is pain, it is advisable to start with oral anti-inflammatory medications (anti-inflammatories and corticosteroids) for about 1-2 weeks.
Topically, you can use retinoic acid.
If there is no response within a month, a biopsy can be performed.
Generally, if traditional acne medications have not been effective after three months, oral retinoids can be used for treatment.
Other endocrine issues are rarely seen in males!

Reply Date: 2008/10/05

More Info

Acne at the junction of the neck and cheek, particularly when it presents as hard cysts that are slow to heal and leave deep scars, can be a frustrating and distressing condition. Your experience of the acne spreading from the neck to the cheeks, particularly on one side, suggests that there may be underlying factors contributing to this localized breakout.
Acne is primarily caused by the clogging of hair follicles with oil and dead skin cells, which can lead to inflammation and infection. However, several factors can exacerbate acne, including hormonal changes, dietary habits, stress, and even certain medications. In your case, the persistence of acne in a specific area, along with the presence of a hard lump on your neck, raises the possibility of other underlying issues.

1. Hormonal Factors: Hormonal fluctuations, particularly those related to puberty, menstruation, or conditions like polycystic ovary syndrome (PCOS), can lead to increased oil production and acne. If you suspect hormonal imbalances, it may be beneficial to consult an endocrinologist who can evaluate your hormone levels and suggest appropriate treatments.

2. Dietary Influences: While you have made changes to your diet, it’s important to consider specific foods that may trigger acne. High-glycemic foods, dairy products, and certain fats can contribute to acne in some individuals. A consultation with a nutritionist may help you identify any dietary triggers.

3. Skin Care Routine: The use of topical medications is essential, but it’s also important to ensure that your skin care routine is appropriate for your skin type. Overuse of harsh products can irritate the skin and worsen acne. A dermatologist can help you refine your skin care regimen.

4. Underlying Conditions: The hard lump on your neck could be a sebaceous cyst, lymph node, or another type of growth. If it is persistent and not responding to treatment, it may warrant further investigation. An ultrasound or biopsy may be necessary to determine its nature. Consulting an ENT specialist or a general surgeon could provide insights into this lump.

5. Psychological Factors: Stress can also play a significant role in acne flare-ups. If you are experiencing stress, it may be helpful to explore stress management techniques such as mindfulness, yoga, or therapy.

Given your symptoms and the persistence of the acne, it may be prudent to seek a multi-disciplinary approach. You could continue your treatment with the dermatologist while also consulting an endocrinologist for hormonal evaluation and possibly a nutritionist for dietary advice. If the lump on your neck continues to be a concern, an ENT specialist or a general surgeon could provide further evaluation.

In summary, while continuing your treatment with the dermatologist, consider consulting with other specialists to address potential hormonal imbalances, dietary influences, and the nature of the hard lump on your neck. This comprehensive approach may help you achieve better control over your acne and improve your overall skin health.

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