Ugly skin problem as an adult

[Taysie]

I never really had acne as a teenager.  A few pimples now and then, largeish pores on my nose that would get blackheads.. my mother tried to get me into this crazy system of products for face care that she said would clear up my skin altogether, but I didn't have a whole lot more in the way of pimples than she did, and given my age, I didn't see the point.  So I've never been on for fancy skincare.

However, when I was in high school, I had some pimple-like bumps that would happen on my legs.  Sometimes just raised spots with pus in them, sometimes they'd get red and inflamed.  Mom took me to a dermatologist, she biopsied one of them, said the results were inconclusive, and declared that I had pittariasis lichenoides chronica (spelling on that is a phonics guess).  Basically, as I understood it.. I'd get little bumps that would end up looking purpleish when they healed because I didn't get enough sunlight.  She told me to take some antibiotics (erythromycin) and come in for UV treatments.  Didn't do squat, I stopped after about six months.  It was unattractive, but as an adult now, I tend not to wear much in the way of clothes sitting around at home, and my legs get plenty of UV and that's all gone.

But.. sometime in college, I started getting acne on my breasts.  Whiteheads, primarily.  I should note that, in college, I was a DD, and now I'm a saggy terrible I-cup.  So, the skin on the undersides gets *no* air, light, or anything else, since basically they just lie flat and deflated-looking on my stomach, unless they're in a bra, and even that doesn't help much.  The area is prone to yeast infections because of the lack of air.  However, while the density of whiteheads (a liquidy pus-filled center, usually with very thin skin over it, surrounded by red skin is more typical, but sometimes they'll be just red bumps with a more solid pus center, and sometimes it's just a white lump under the skin) is higher on the undersides, I do get them on the rest of the breast skin as well.  They vary in size, some as small as about half a mm, some as large as three mm in diameter.  After 20 years of this, my skin is all scarred up (and, as these mammoth mammaries have grown, the scars have stretched, which is lovely; my boobs look like the surface of the moon), and I just don't know what to do about it.

My ob/gyn suggested I wash with antibacterial soap, but that doesn't seem to be making any difference, aside from drying out my skin a little.  I've tried a few acne facial solutions, but.. well, they don't seem to make any difference either, and considering how much surface area I've got to cover, it would be *expensive* to do regularly.

Is there anything I can do that would make any difference?  I don't have insurance or a job right now, so there's no seeing a doctor or spending a bunch of money on Proactiv or something (although, again, I have about twice as much (or more) surface area to cover as anybody with facial acne, so the cost for something like that would be astronomical, even assuming that would address my problem).  The antibacterial soap is cheap, but if it doesn't do anything except dry my skin out, I don't see a reason to do it.  Is there just nothing to do for the skin underneath at all, shy of walking around with my boobs held up in the air or something?  It's just so frustrating, but it's so ugly, and every time I see a new doctor (new gyn this year) I have to go through a whole 'gosh, what's all this?' process.. the stretch marks make sense, but the scars and acne collect questions.  And, yes, the ones underneath tend to scar a little purple, probably again because they get no light.

There's no hormonal fluctuation, and never has been; it's consistent all the time.  I'm on depo-provera now, but even before then it was the same.  It doesn't seem to matter if I scrub myself raw, or go two weeks without bathing (I'm in the Houston area, and last fall after Ike, with no power or clean water, bathing was iffy.  We've been through similar several times over the years).  Diet makes no difference.  Climate changes make no difference.  

Any ideas?  I really wish I could have boobs that weren't all ugly and covered with zits some day.  Preferably before I'm 60.

[loiloi]

Hi. Acne occurs when your body has more androgens than needed. Androgens stimulate the sebaceous glands which leads to oily skin. Bacteria on the skin feeds off this excess oil resulting in spots. The Depo shot can make acne worse, and a combined oral contraceptive pill such as Yasmin or Diane35 would be a much better choice as the oestrogen they contain block the actions of androgens on the skin.
Erythromycin is not particularly effective against acne, Oxytetracycline or Lymecycline would be better.
Clinique make a Chest & Back Spray which is more economical for large areas of acne than a lotion or gel.
Eloise.

[Taysie]

Well, my problem isn't technically acne, it's just whiteheads and pustules.  And my skin isn't oily at all, and I don't use any kind of body lotion or anything to make it so.  It's constantly moist-ish and dark underneath the breast, as I said, but that's not oil-moist, that's sweat-moist from never getting any air.  The water around here is pretty drying on skin, with all the chemical junk they've got in it for purifying, and I prefer it that way, precisely so as to avoid having greasy skin.

The depo-provera seems to have had zero effect; I have just as many whiteheads as before I started, and I couldn't switch to a pill anyway because the primary reason for me being on this drug is to keep from having periods (apparently my cramps and bleeding are as bad as someone with endometriosis, except I don't have it, and yes, the doc's sure), and my doc thinks this is the best alternative.  I tend to agree; I was on pills for a while, and it did absolutely nothing to lessen my monthly issues, it just made them slightly more predictable.  Since the depo eliminates all monthly cycles, and I only have to take a dose once every 12 weeks (and its effectiveness doesn't rely on me taking it at exactly the same time every day), I vastly prefer this.

Yeah, I've learned since then that erythromycin is kind of a **** antibiotic, but that's what she gave me.  Another doc gave me .. shoot, something else I don't remember now.. later, and it did just as much nothing.  I've been on antibiotics a few times over the years for different things, but never has the drug affected what happens on my chest.

That Clinique spray you mention, though.. that sounds interesting.  I found it on their website, and when I have $20, I'll try some out.  Thanks.