[39F] With persistent chin lesions and suspected parasitic infection

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

• Acneiform Eruptions: Given your history of cystic acne and the use of acne treatments, it's possible that what you're experiencing is a form of acne or a related skin condition. Acneiform eruptions can sometimes present with unusual features, such as the particles you describe.

  • Treatment: Continue using acne treatments like salicylic acid, benzoyl peroxide, sulfur, and niacinamide. Your doctor might also consider other treatments like retinoids or antibiotics.

• Folliculitis: This is an inflammation of the hair follicles, which can cause red bumps, pustules, and sometimes a sensation of something being under the skin. It can be caused by bacteria, fungi, or even physical irritation.

  • Treatment: Topical or oral antibiotics may be prescribed if a bacterial infection is suspected. Antifungal treatments might be used if a fungal infection is suspected.

• Demodex Infestation: Demodex mites are tiny parasites that live in hair follicles and can cause skin issues, particularly on the face. They can sometimes cause a sensation of something being under the skin and can be associated with acne-like eruptions.

  • Treatment: Topical treatments like tea tree oil, which you are already using, can be effective. Your doctor might also prescribe other treatments specifically targeting mites.

• Contact Dermatitis: This is a skin reaction to an irritant or allergen. Given that you use various topical treatments, it's possible that one of them is causing irritation.

  • Treatment: Identifying and avoiding the irritant or allergen is key. Over-the-counter hydrocortisone cream can help reduce inflammation.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

1. Continue Using Blemish Patches: Since they seem to help flatten the area and remove the burrow-looking lines, continue using them as needed.
2. Maintain Good Skincare Hygiene: Keep the affected area clean and avoid picking at it to prevent further irritation and potential infection.
3. Use Gentle Skincare Products: Stick to gentle, non-irritating skincare products. Avoid using too many products at once, as this can sometimes worsen the condition.
4. Monitor Your Symptoms: Keep track of your symptoms, including any changes in the appearance of the lesions or new symptoms that develop. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
5. Hydrate and Protect Your Skin: Ensure your skin stays hydrated and protected from environmental factors like sun exposure.

What you should look out for

Reasons to see a doctor more urgently include:

• Increased Pain or Discomfort: If the area becomes significantly more painful or uncomfortable.
• Signs of Infection: If you notice increased redness, warmth, swelling, or pus, which could indicate an infection.
• Systemic Symptoms: If you develop a fever, chills, or other systemic symptoms.
• No Improvement: If your symptoms do not improve or worsen despite your current treatments.

Remember, while I can provide information and suggestions, it's important to seek care from real health professionals to receive a formal diagnosis and appropriate treatment.