Where on the body? Acne and different areas of skin

For the young people we spoke to, most typically had acne on the face. Alexandra didn’t have many spots on her face and her acne tended to be on her back. Acne can affect other parts of the body too, such as the chest. Sometimes doctors examined the skin of the young person at their appointments to see where the acne was and what kind of spots they had. Devan didn’t mind his doctors doing this, but said he wouldn’t want other people to see the acne on his back.

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 makeup, 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.

Harriet felt more self-conscious about spots on her chest than on her face.

Age at interview 21

Gender Female

Age at diagnosis 12

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Ollie found that some medical treatments were easy to use on the face, but not for areas such as the back and shoulders.

Age at interview 16

Gender Male

Age at diagnosis 13

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The main body parts affected by acne have changed for Deborah over time.

Age at interview 25

Gender Female

Age at diagnosis 12

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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 bled and other people could see.

Chris was self-conscious about people noticing acne on his face.

Age at interview 20

Gender Male

Age at diagnosis 17

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Naomi didn’t like to do hobbies (like swimming) which got her face wet because her make-up would come off.

Age at interview 22

Gender Female

Age at diagnosis 9

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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)
  • cheeks
  • jawline
  • chin
  • ears/earlobes
  • 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).

Deborah sometimes accidentally knocks spots on her jaw and nose.

Age at interview 25

Gender Female

Age at diagnosis 12

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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.

Hester found some topical acne treatments were too strong to put on spots near sensitive facial features.

Age at interview 21

Gender Female

Age at diagnosis 15

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Some people, mostly women but sometimes men, used makeup to cover up their spots. Marga described makeup as a “safety net” and Chris found blemish balm gave “a nice matte finish to the skin.” Some people said makeup 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.

Ish found shaving difficult with facial acne.

Age at interview 22

Gender Male

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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 makeup 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.

Alexandra researched about different bra fastenings which she hoped might be less painful with back acne.

Age at interview 22

Gender Female

Age at diagnosis 13

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Alexandra wore a bandage under her bra to help with pain and reduce spots popping on her back.

Age at interview 22

Gender Female

Age at diagnosis 13

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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.

Sarah remembers a time when spots on her back affected her choice of clothing, but she’s unsure why this was the case.

Age at interview 22

Gender Female

Age at diagnosis 16

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Devan didn’t want his peers to see his back acne when changing clothes for PE.

Age at interview 18

Gender Male

Age at diagnosis 13

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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.

Emma chose her clothes carefully to cover spots on her chest.

Age at interview 20

Gender Female

Age at diagnosis 10

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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.

Nina has had spots and ingrown hairs in places where she shaved, such as her armpits and bikini line, in addition to her face and back.

Age at interview 20

Gender Female

Age at diagnosis 12

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Acne over time

A lot of people we spoke to no longer had acne or their acne was less severe than it used to be. Sometimes this was...