Where on the body? Acne and different areas of skin
There can be different concerns and difficulties depending on the location of the acne. This can impact on things such as: confidence/emotions, clothes and make-up, sleeping and hobbies (e.g. swimming). Some concerns were held about acne regardless of where it was on the body – such as it being difficult to find a sunscreen that didn’t cause breakouts. Acne on the face
The face was the main location where most young people had acne. They thought this was a difficult place because it’s often visible. Harriet said this visibility meant acne was “an outward struggle”. Molly found it embarrassing when spots bleed and other people could see. Acne often affects the face because there are a lot of sebaceous glands there (see causes). Some people found their acne affected all parts of their face, for others there were specific bits. This included:
• T zone (forehead and/or nose)
• hairline and scalp.
Deborah gets large spots on her jawline, which were painful if she touched or knocked them. Harriet waited till her acne had mostly cleared up before getting her ears pierced as she sometimes got pimples there. Ish said the parts of his face affected by acne could change on a day-by-day basis. Ollie and Abbie had both changed their hairstyles to keep their hair off their foreheads (see also: skincare and self-styling). Some people talked about having spots on their neck. Alexandra used to get a few spots there and kept her hair long, rather than getting it cut short, to cover them up. Deborah tended to wear high-collar tops/dresses when she had a spot on her neck.
Having spots on sensitive parts of the face, such as near the eyes and lips, could have extra concerns too. Hester once had a large and inflamed spot which “ended up tugging on my mouth” when she turned her head. This was uncomfortable and knocked her confidence. Some people (mostly women but sometimes men) used make-up to cover up their spots. Marga described make-up as a “safety net” and Chris found blemish balm gave “a nice matte finish to the skin”. Some people said make-up didn’t always cover spots very well and could even highlight the acne even more than wearing none. Yi thinks she used “the wrong shade” of foundation and found it wore off after a few hours.
Shaving facial hair was an issue for some men with acne on their faces. Will described it as a “catch 22” because growing hairs irritated his spots but shaving was painful. Acne on the back and shoulders
Some people had acne on their back and shoulders as well as their face. This had extra difficulties, like:
• reaching to apply topical creams
• pain whilst lying down – Hester took painkillers to get to sleep at night
• blood on clothes (e.g. t-shirts) and bedding from popped spots
• pain when clothes pressed on back spots (tight tops, bra straps)
• embarrassment wearing some clothes (like summer/beach clothes, backless dresses)
• others seeing the back acne (e.g. when changing for PE classes at school)
Eli, Deborah, Hester and Naomi found that their back acne cleared up quicker than that on their faces. The acne on Devan’s back though has cleared up slower and he thinks this is because it’s tricky to put on topical medicines. Some found that spots on the back, where the skin is thicker than the face, were more painful and prone to scarring. Naomi’s parents sometimes helped her to put the treatments on the spots she had on her back.
Clothes and make-up were sometimes used to hide back acne, as for Alexandra. Hester didn’t feel comfortable dressing up whilst she had spots on her back. Deborah’s thrown away white t-shirts as well as bedding that have been stained with blood when back spots have popped. Many people saw back acne as more embarrassing than having it on the face. They thought it was less socially accepted. Tom said it had been difficult to know how severe your back acne was because it’s hard to see in the mirror. He asked family members to check his back and was relieved not to have any. Naomi thought it was a better location than the face though, as it’s less frequently seen by others. Acne on the chest
Some people experienced acne on their chests. Often they used clothes to cover this area of the body up. Tom didn’t have acne on his chest, but he thought it could be a difficult body part and would’ve rubbed on his judo robe.
Emma had some chest acne and used to feel self-conscious when getting changed for PE classes. She avoided going swimming and would wear clothes to cover the area when with friends. She had keloid (raised) scarring on her chest which she had steroid injections for. The treatment helped flatten Emma’s scars, which made her feel more confident. Other body parts and acne
Rebecca also had some spots on her arms as well as her back and face. She sometimes picked at these spots, a behaviour which later developed into a psychological condition (called dermatillomania) after her acne had cleared up. This included Rebecca picking the skin on areas of her body where she had never had acne, such as the legs.