Pimples on the Chin
A deep dive on what are they, their causes and treatments.
Lu Li,
June 11, 2020
What are they?
Pimples keep popping up on the chin and jawline? Before going into battle, we need to understand what we're dealing with. Several different underlying conditions could all lead to breakouts like this .
1. Ingrown Hair
Ingrown hair is a common condition where hair grows back into skin as a result of hair removal (e.g. ingrown hair on the chin caused by shaving beard). It develops inflamed red bumps like pimples, but could be distinguished by the embedded hair. Ingrown hair normally improves without treatment, however, skincare tips for acne below would also be applicable to treat its symptoms.

2. Rosacea
One subtype of rosacea is also associated with acne-like breakouts: if you have many small, red, pus-filled bumps like pimples on your chin, it could be rosacea. However, rosacea typically affects the skin on the nose, cheek, and forehead. Diagnosis and treatment for rosacea would require talking with your dermatologist.

3. Acne
Acne is normally caused by pores getting blocked by overproduction from the glands secreting oil (aka sebaceous glands) which leads to bacteria buildup and inflammation. The chin area has a high concentration of sebaceous glands and also poor skin barrier to stop the penetration of inflammatory substances. This combination makes it the perfect area for pimples growth.
Types of blemishes
Chin acne could be any kind of the following or a mix of them:
1. Comedones: both open comedones (blackheads) and closed comedones (whiteheads). This type of acne is non-inflammatory and the least severe.
2. Papules: small, raised, red bumps that occur due to the inflammation or infection of the hair follicles.
3. Pustules: small and red pus-filled pimples.
4. Cysts: large lumps, which are present under the skin. They contain pus and may be painful and tender to the touch.
Causes for pimples on the chin
1. Hormones
Though pimples on the chin could be from any other common acne causes, they are one of the most prominent signs for hormonal adult acne. The activity of the sebaceous glands depends on the estrogen / androgen (female hormones / male hormones) ratio and a lot of other hormones. Hormone fluctuations could cause the sebaceous glands to enlarge and make more sebum (oil). Continuous breakouts can appear for some people during:
  • puberty
  • getting on/off birth control
  • pregnancy
  • menopause
  • Polycystic ovary syndrome (PCOS, a hormonal disorder)
  • the week before or during the period (Studies have observed acne worsening in the premenstrual period in 60 to 70% of women.)

2. Stress
Recent studies show that sleep deprivation associated with women's modern lifestyle and stress may also be an aggravating factor for acne, affecting more than 50% of the women in studies . Stress stimulates the release of pro-inflammatory substances, leading to increased levels of cortisol (your body's main stress hormone), which further promotes acne.

3. Medication
Several hormonal medications may cause or aggravate acne. Synthetic male hormones taken by athletes and body-builders to increase muscle bulk could also lead to severe acne in some cases. A variety of other medications which affect the immune system, stimulate insulin or directly affect hair follicle could also lead to acne.

4. Diet
Though It is very difficult to study the role of diet and acne, there is growing evidence that what we eat may influence the incidence and severity of acne:
  • Consumption of high glycemic index (a measure of the rate at which a food spikes blood sugar levels) and dairy foods increases insulin levels, which triggers a series of processes within our body contributing to acne.
  • Worsening of acne by the use of dietary supplements derived from whey is observed in daily practice.
  • Diets low in zinc or high in iodine can worsen pustular acne (pimples).

5. Smoking
Studies show that tobacco is the main factor responsible for the appearance of non-inflammatory acne (comedones) for adult females. Sebaceous glands are sensitive to acetylcholine (a chemical message released by nerve cells) that is stimulated by nicotine, influencing sebum production and oxidation and increasing pore blockages.

6. Environment
Environmental factors like high humidity causing swelling of the skin and pressure from chin straps causing skin irritation would also cause or aggravate acne. That's why we've seen an increase of pimples on the chin when masks became mandatory during the pandemic.
How to get rid of pimples on the chin?
Over-the-Counter (OTC) Treatment
If the pimples on your chin are mild to moderate or periodic breakouts, you could try to treat them with some OTC products containing acne targeting ingredients, like the following:
  • OTC Retinoid (Retinol). It is a derivative of Vitamin A and treats acne by declogging pores, normalizing skin cell turnover, and working as an anti-inflammatory. Furthermore, it's also proven to improve skin discoloration and texture, which is useful to treat acne scars. Some common side effects include dry skin and increased sensitivity to the sun.
  • Azelaic acid. This ingredient can inhibit the formation of comedones, has anti-inflammatory properties and can reduce the production of melanin. Therefore it is effective for treating both acne and also Post-Inflammatory Hyperpigmentation. It is also safe to use during pregnancy.
  • Benzoyl peroxide. This ingredient kills the bacteria that cause acne, helps remove excess oil and dead skin cells. Possible side effects include dry skin, scaling, redness, burning and stinging, especially if you have sensitive skin. Be careful when applying benzoyl peroxide, as it can bleach hair and clothing.
  • Salicylic acid. This ingredient helps prevent pores from becoming plugged. Possible side effects include mild stinging and skin irritation.
  • Alpha hydroxy acids. Two types of AHA that are used in OTC acne products are glycolic acid and lactic acid. They treat acne by helping to remove dead skin cells and reduce inflammation. AHAs also stimulate the growth of new, smoother skin, which can be useful to treat acne scars.
  • Sulfur. Sulfur removes dead skin cells that clog pores and helps remove excess oil. Products containing sulfur may cause dry skin and have an unpleasant odor.
These ingredients work in different ways to treat acne and every person might react differently to them. You will have to experiment with different combinations to find what works for you. It is important to start with lower strength and lower frequency and always patch test. You could also get professional guidance with Glowism's skincare experts throughout your experimentation to minimize the risk.


Prescription Treatment
If your pimples are moderate to severe acne or you don't see improvement after two or three months of home treatment, consider seeing your doctor or dermatologist for a prescription treatment.
  • Retinoids. This includes both topical retinoid (namely tretinoin, which is normally prescribed for mild to moderate acne) and oral retinoid (namely isotretinoin, which is normally prescribed for severe or stubborn acne). Besides a stronger version of the side effects mentioned for OTC Retinoids, oral Retnoids could have other side effects like skin disorder, weight loss, hair loss and depression.
  • Antibiotics. There are both topical and oral antibiotics and they're effective in treating inflammatory acne. However, antibiotics should be taken in conjunction with other anti-bacterial topical treatments like Benzoyl Peroxide to not only have a synergistic action accelerating the response but most importantly avoids the development of antibiotic resistance.
  • Anti-androgen. This includes birth control pills and other drugs that block androgen receptors on sebaceous glands and/or suppressing androgen production, which inhibits sebum production. It is recommended that they are combined with antibiotics or other anti-bacterial topical treatments to treat the inflammation as well.
Topical treatments with OTC active ingredients are recommended during your prescription treatments for the aforementioned reasons. They're also important post-prescription treatment as maintenance to avoid relapse. It's common to relapse after discontinuation of antibiotics treatment. On average, relapse rates following isotretinoin (oral retinoids) treatment can vary between 21 and 30 percent according to studies.

Other Tips
  • Have a compatible skin care/personal care routine. A lot of the treatments (both OTC and prescription) have uncomfortable side effects like dry, peeling skin, and increased photosensitivity. A skincare routine compatible to your skin and treatments would be helpful to alleviate these symptoms and provide protection. Also, make sure your skincare, cosmetics and hair products don't contain ingredients that's pore clogging or having contraindications with the active ingredients in your acne treatments. Consult your dermatologist or Glowism's skincare experts to clear concerns in your current routine or make a new one.
  • Don't pick or squeeze pimples. Infection or scarring may result. According to studies, post-inflammatory hyperpigmentation is common and scars can occur in 20% of women affected with adult hormonal acne.
  • Watch out for what touches your face. Keep your hair clean and off your chin and other parts of the face. Also, avoid resting your hand or phone against the side of your face.
  • Be patient. Treating stubborn pimples takes time and patience. It may take two or three months of daily use of an acne product to see results. And acne may look worse before it gets better.
Reference

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