Acne (young people)
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 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.
Harriet felt more self-conscious about spots on her chest than on her face.
Harriet felt more self-conscious about spots on her chest than on her face.
And were there any differences that you felt about the sort of facial acne versus like the sporadic bits on your back and chest?
In a way I was I think more self-conscious when it was not on my face. So it’s kind of more socially acceptable to have acne on your face rather than anywhere on your body. So I wouldn’t sort of, even now if I, I’ll occasionally get sort of a little spot here [points to chest/collar], I wouldn’t wear anything that shows it cos I feel like that has more of an implication of, you know, “She’s not clean” rather than anything else, yeah.
Okay. So would you hide that acne like with clothing or anything?
I’d cover, I’d cover up with clothing. I wouldn’t, I wouldn’t put anything on it though I don’t think, yeah.Ollie found that some medical treatments were easy to use on the face, but not for areas such as the back and shoulders.
Ollie found that some medical treatments were easy to use on the face, but not for areas such as the back and shoulders.
The main body parts affected by acne have changed for Deborah over time.
The main body parts affected by acne have changed for Deborah over time.
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.
Chris was self-conscious about people noticing acne on his face.
Chris was self-conscious about people noticing acne on his face.
And, and, yeah, like every time you look in a mirror, I don’t know, even from a distance you can see like it’s, when it’s flaring up and it’s just really difficult to deal with.
• 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.
Deborah sometimes accidentally knocks spots on her jaw and nose.
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.
Hester found some topical acne treatments were too strong to put on spots near sensitive facial features.
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.
Ish found shaving difficult with facial acne.
Was that a concern for you when you sort of first started shaving, if you had acne at that time?
Yeah, I just wouldn’t shave.
Yeah.
To be honest like, it comes to that point where you experience it once or twice and you know, you’re using an aftershave but you’re still using prescribed creams on your face that just like combines, and it’s either one or the other basically. So you shouldn’t really combine chemicals to begin with. So that’s just going to make it worse.
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.
Alexandra researched about different bra fastenings which she hoped might be less painful with back acne.
Alexandra researched about different bra fastenings which she hoped might be less painful with back acne.
Yeah.
… is that something that you did research on, when you looked up about…
Oh, yeah. I did look up some stuff about that. Like, for instance, you have bras that can do a clip in the middle so you get the bra straps instead of being like that you get them to cross. But it’s, as I say, it’s quite difficult for my size at the moment, I’m quite small but my cup size is quite big so it’s kind of difficult to get the good bra straps for that. And I would like to feel comfortable in that department as well, that you don’t walk around feeling like, OK you can, everyone can see, so I’m quite comf-, used to looking at clothing that fits every part of the body that I have now and how it also interacts with my skin. So I still feel comfortable, more comfortable with various clothes that kind of cover my spots up a little bit, even if I have tiny little spots, then I would still want to cover them up as much as… I feel comfortable in, yeah.Sarah remembers a time when spots on her back affected her choice of clothing, but she’s unsure why this was the case.
Sarah remembers a time when spots on her back affected her choice of clothing, but she’s unsure why this was the case.
Do the different locations have any sort of significance for you in terms of the way you feel about it?
Now that is an interesting question because I do remember once considering wearing a backless dress and deciding not to because of acne I had on my back which is interesting because why would that be more of a problem? Is it that it’s a lot harder to cover it up with makeup? I mean I guess I could have had a friend to help me but it’s not really to ask, you want to ask of your friend. It could also be because I’ve got a kind of a faint birth mark on my back but I definitely remember it being the acne that was the problem. Is it because it somehow seems acceptable to have acne on your face and not on your back? That could be it. I remember my housemate last year, she had had acne and had taken a course of I think it was a steroid cream that had cleared it up. And kind of going on and on about how she had ‘bacne’ and how much she hated it. I think that kind of created a bit of a stigma about back acne that for some reason I don’t feel about face acne.
And was the occasion with the dress was that since you had that housemate or was that a previous experience?
I think it was since I had that housemate, I think she was a bad influence on me [laughs]. It’s not something I think of very much but this is primarily I guess because I don’t expose my back that often.Devan didn’t want his peers to see his back acne when changing clothes for PE.
Devan didn’t want his peers to see his back acne when changing clothes for PE.
It was, I sort of first noticed it on my face itself. And that was one of more places, one of the places which was sort of the worst. It was predominantly my face through secondary school… as well purely because people didn’t see my other, you know, my back, they didn’t see my back. Or they’d only see that if it was during P.E. and you’d have to get changed so they’d only see it then. But I’d sort of found different ways to come around that, to stop people from noticing by, say, wearing my P.E., P.E. clothes underneath my school uniform and different things like that. To just sort of save that hassle …
Yeah.
… of having to deal with people like that.
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.
Emma chose her clothes carefully to cover spots on her chest.
Could you say a bit more about the clothes that you bought and how it had an impact?
Yeah, so because my scarring is in this sort of area [points to chest] I’ve got a high neck thing on now, but I didn't buy any clothes that could possibly show it for quite a long time. Because I didn't want anybody to see the sort of the scarring and the scabs and things. which was always a bit of a shame, because when I’d go shopping with my friends and it would be like, ‘arr this is really nice’ and I’d be like well, I’d sort of pretended I didn't like it so much, because I didn't want it to show. Yeah and that sort of, that didn't change until I was about sort of 16 and my mum went and did some shopping and she bought me some tops which I really liked and I wanted to wear despite them showing it, so.
Do you remember what it was like when you did do that, when you started wearing tops which maybe showed a little bit more of the skin?
I guess the very first time that I ever wore one that my mum had bought me that showed it, I was a little bit self-conscious. But sort of, I think after I realised that no-one was sort of saying anything or looking then I started to sort of mind less having it on show.
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.
Copyright © 2024 University of Oxford. All rights reserved.