Acne on breasts?

I am 36 years old. For approximately 4 years now I have been experiencing 'white-heads' on my breasts.  (every now and again the puss is yellow) Some of them when 'popped' take a very long time to heal.  I wear all cotton bras.  My breasts are large and I wear bras that keep my breasts lifted away from my body.  I have lived in the same (hot) climate for 17 years.  If I get hot the underneath of my breasts look like a plucked chicken.  (Only description I can think of to create an accuate visual).  Each of these pores has white puss in them and I could make a day of popping them.  (that is not to say that I have) I have tried antibiotic ointment as well as Lamisil.  The white heads are not itchy or painful.  The majority of them are on the underneath but occasionally on top, never on the nipple or immediately surrounding.  Menses does not seem to affect the severity of the break outs.  HELP! Thank you for your time, talent and wisdom.

[Kevin Pho, MD]

You may want to try topical antibiotics such as various combinations wtih Benzyl Peroxide (i.e. Benzyl Peroxide + Erythromycin or Benzyl Peroxide + Clindamycin).  

The next step to be considered would be oral antibiotics (examples can include Doxycycline, Tetracline, Amoxicillin or Bactrim).  They can be taken for an extended period of time.  

There are some studies that a topical retinoid cream can help as well (i.e. Retin-A).

Other considerations would be oral contraceptives that can help reduce acne.

Each of these options should be discussed with your personal physician.  You also may want to consider a dermatology referral.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b