Itching burning enflamed skin

[purturbed]

Thanks for taking my question.
Regularly (e.g. twice a month) I will experience a sudden, intense burning/itching sensation on my chin. When I look in the mirror, the skin in the area is slightly red and slightly swollen. The swollen area is "squishy" (from fluid?)involving more than the surface layers of skin. It's sort of a welt-looking thing that's red, itchy and burning. It does not seem to "come to a head" like a pimple does. Meanwhile, I pick at it (of course). And only clear fluid comes out. The itching and burning continues. It also remains swollen and raised. After a day, a soft scab will start to form (brownish/grayish-looking). It is still moist with fluid. Its almost like you can see the fluid moving around under the scab. When I picked at it, the scab seemed to get bigger because the fluid spread under the skin instead of coming out. My chin has scars on it from where these "welts" have come and gone. I occasionally get them on my cheeks (near the jaw line). I am African American female (36 yrs, hypothyroid/taking synthroid, healthy height/weight proportion, had acne as a teen/returned after having child in early 30's). MY SKIN HAS BECOME TERRIBLY SCARRED FROM THIS (to the point that my family has become concerned). What could it be. I'd like to stop them before they start. Thank you for your help.

[Alan Rockoff, MD]

Most of what you describe is secondary to scratching and picking, especially the pigmentation you're calling scarring.  You absolutely must leave the chin alone, or else you'll never clear up.  My advice is that you arrange to see a skin doctor on an unscheduled basis next time this 'welt' happens.  I will add that your description does not remind me of any conditions I can think of.  You might also pick up a lotion in the drugstore containing pramoxine, a non-prescription anesthetic.  Use that when you feel the burning.  But again, do not pick.  The scabbing is all secondary to picking.

Best.

Dr. Rockoff