"A pox o' your throat, you bawling, blasphemous, incharitable dog!"

January 26, 2012 8:08 AM

Dermatology Filter: what the eff is this rash/acne on my chest that won't go away!? What can I do? I can't afford to see someone unless important... is this important?

[warning: links to pictures involve cleavage/bra. NSFW]

I've had this splotchy, looks like acne, rash on my chest for almost 2 weeks. It seems to be spreading up towards my shoulders and arms, as well as across my breasts. I have no idea what to do about it; it's extremely embarrassing, and my current financial/insurance situation makes seeing a doctor about this unlikely unless absolutely necessary.

It's not present anywhere else on my body. I haven't come into contact with any "poison-" plants; I can't believe this is chicken pox. It doesn't itch at all until I come home at night and get ready for bed... where upon I change clothes and feel really hyper-aware of my skin.
I've been blessed with almost no history of acne beyond occasional whiteheads on my nose/chin, so this would be an unprecedented case of acne in an extremely unusual place.

Washing daily didn't help; puncturing (gently!) the whitehead spots and releasing the liquid in them doesn't make them go away.
Leaving it all alone seems to lessen redness but does nothing to slow spread or diminish the population of whitehead-looking spots.

What is this? What can I do?

posted by anonymous to health & fitness (28 answers total)

Traditional questions:
Are you using any new cleaning products? (for laundry, or for your body, including shampoo, moisturizer, etc)
Do you wear any neck-based jewelry, or a lanyard?
Is that area often exposed in clothing you wear - ie could it be your jacket coming in contact with your skin?
Have you made significant changes in what you eat?

(I'm not a dermatologist, but I've had fun contact dermatitis for many years).
posted by sciencegeek at 8:21 AM on January 26 [1 favorite]

I once had a fungal infection that resembled what you've got going on there. The rash was made up of little pimples that didn't disappear when they were popped, just like yours. I did have to go to a doctor for it, but the medication was el cheapo. And it was definitely worth the trip.

I am in the same boat as you -- we don't go to the doctor unless we absolutely MUST. But I would consider your situation a must.
posted by Coatlicue at 8:37 AM on January 26 [1 favorite]

If you "release the liquid" and it's sort of crusting over....there's a chance it could be impetigo, or something acting like it; I was having a big problem with that on my chin for the past couple months. I called my doctor and she didn't even bother to have me come in, she just suggested I try putting neosporin on it twice a day, and I also tried hydrogen peroxide. Also, I was washing it with antibacterial handsoap.

Cleared everything up within a week.
posted by EmpressCallipygos at 8:42 AM on January 26

There's unfortunately no way that anyone on Metafilter can diagnose you. I'd go to a doctor. Your health is important.
posted by k8lin at 8:51 AM on January 26 [1 favorite]

i am not a doctor, but i have edited a ton of dermatology books!

it doesn't look like chicken pox. it does kind of look like acne, but if it's spreading, it's probably not acne.

as above, if you'd recently changed detergent, dry cleaners, lotion, etc. that might be the culprit. stop using for 1-2 weeks and see if it gets better.

have you tried using otc acne stuff? has that done anything? if not, i would try an otc fungal cream. if that does nothing, it might be time to go to a doc. a GP should be able to help you unless it's one of those rare creepy things (which it isn't!).

good luck!
posted by misanthropicsarah at 9:00 AM on January 26 [1 favorite]

If it doesn't itch, it could be keratosis pilaris. Gentle exfoliation and moisturization (milk-based moisturizers may work particularly well, the lactic acid is thought to be helpful) is about all you can do. If you exfoliate too much, it's thought that that may stimulate the skin to produce even more extra keratin. You can use steroid creams to reduce it but not over very long periods.

Keratosis pilaris is completely harmless and cosmetic but there's not a lot to be done about it, you just have to live with it. Mine is typically on my biceps but colonized up to my neck when I was pregnant. It commonly appears in just one place and may wax and wane. Some people outgrow it.

You probably should see a doctor but I have to admit that when I first noticed I had KP I didn't for like ... um, possibly two years? Since it didn't itch and wasn't spreading and didn't seem to be impacting my life, I kept forgetting. You may need to see a dermatologist specifically, I've found that GPs aren't a whole lot of help with skin rashes, since so many of them look the same and they can be totally harmless or something that really needs treatment.
posted by Eyebrows McGee at 9:04 AM on January 26

My doctor just looked at it and prescribed "triamcinolon 0.1% cream, which does require a prescription. He said he didn't really know without testing what the exact cause might be, but this was the treatment for any of them. It worked. Stopped the itching and spreading right away and the spots fully cleared after about a month. But faded greatly within days. The cream, at my pharmacy, was about $10. And I only used about 1/3 of it. I don't know if there are OTC equivalents, but your pharmacist undoubtedly woud.
posted by uncaken at 9:06 AM on January 26

Keratosis Pilaris (KP) doesn't usually cause redness around the individual follicles unless irritated/picked at, and they are generally smaller than those pictured. I've had success with mine with dietary changes (low-carb) and taking extra vitamin E.

If it's a skin allergy to recent changes (like laundry detergent, or a pre-bed snack/food), try getting some allergy medication, like loratadine (generic Claritin) - it's cheap and non-drowsy for most people. If you have Benadryl pill/spray/cream (or equivalent) at home, you can test if it gets less itchy when you use an antihistamine.

Definitely use the questions from sciencegeek to determine what could be causing this.
posted by bookdragoness at 9:26 AM on January 26 [1 favorite]

My kids' pediatrician once recommended "Try hydrocortisone for a week or so and if that doesn't help try an anti-fungal." If you put hydrocortisone on it and it gets worse quickly, switch to anti fungal stuff. I recently had a strange rash that I was sure was flesh eating bacteria of doom. 88 cent anti fungal lotion from Walmart made it feel better in an hour. It took a couple of weeks to go away completely. (After two weeks of thinking it was my new detergent or the new dryer sheets or a new lotion allergy or something. I tried cortisone and it got awful in one day.)

My husband has a weird chest rash sort of like yours. The dermatologist told him to get ZNP bar soap, which is dandruff medicine in a soap. (Pyrithione Zinc 2%.)

That's three cheap things to try, anyway.
posted by artychoke at 9:29 AM on January 26 [2 favorites]

I'm going to concur with lots of people up there that is both common and probably treatable with over the counter stuff. I get a weird rash on my chest if I use different laundry soap or even if I don't clean my freakin seatbelt.

This is what I would try:
First, think about all the things that touch you there. Bras, workout clothes, seatbelts, shirts, whatever. What has changed? What might be dirtier than you thought? Its weird, but I absolutely have to clean my seat belt that touches my chest every month or so or I get something like this. Sport bras? Washed out at least in the sink every single time.

Twice a day, wipe the area down with hydrogine peroxide/witch hazel/alcohol/oxy pads etc. something astringent and bacteria fighting.

Then try a little dap of Neosporin on anything that looks infected. Next, find an antifungal lotion or soap. There are a handful of antifungals out there, some work for different things, keep trying OTC creams until you find somethign that makes a difference.
posted by stormygrey at 9:40 AM on January 26

You should see a doctor immediately, especially since it is spreading. Go to a free clinic or whatever you need to do. If it itches, put calamine on it, but don't bust them open anymore. You might be setting yourself up for a lot of scarring. Go to the doc asap. This is something you really need to have looked at.
posted by anniecat at 9:46 AM on January 26

Oh, and it also looks like something we call "heat rash". If you get sweaty, take a cold shower, it helps with the inflammation.
posted by stormygrey at 9:49 AM on January 26

There are a lot of urgent care providers that charge a flat fee (around $100 if you don't have insurance). It could be shingles or anything.

There is no way anybody on Metafilter can diagnose this, especially since it's spreading. You really need to see a doc somehow.
posted by anniecat at 9:53 AM on January 26

If you're in a cold climate, don't rule out your winter scarf. Maybe give it a good wash if you haven't washed it in a while, or especially if it's new; people in stores try on scarves, and... well, you know.
posted by heyho at 9:55 AM on January 26

Just chiming in to say, I don't think that's keratosis pilaris. I have KP on my biceps and the red dots are a lot smaller, and don't have whiteheads. If you really really don't want to go to the doctor right now, I'd second the recommendations to try hydrocortisone, and then an antifungal if that doesn't work. But really, if only for the peace of mind and because it's spreading, I'd say go to a flat-fee urgent care clinic.
posted by yasaman at 9:57 AM on January 26 [1 favorite]

I've had chickenpox, detergent allergies, heat rash, and a rash as a side effect of mono - and they *all* looked like this. So, it could be ANYTHING.
posted by easternblot at 9:59 AM on January 26 [2 favorites]

(And if it *is* chickenpox, you do NOT want to puncture/break them. Scars...)
posted by easternblot at 10:00 AM on January 26

If you can't afford to see a doctor have you considered seeing a pharmacist? If its something that can be treated OTC they may be able to help or at least tell you if you really need to see a doctor. Pharmacists don't do all that schooling just to stick labels on pre-packaged boxes of pills.
posted by missmagenta at 10:37 AM on January 26 [3 favorites]

Have you had strep throat recently? I can't tell very well from the pictures but that may be guttate psoriasis.
posted by chicxulub at 11:39 AM on January 26

It doesn't itch at all until I come home at night and get ready for bed...

I'd think about that...
posted by matty at 11:42 AM on January 26 [2 favorites]

I have a rash that looks (and feels!) almost identical to that, and have had it off and on for a couple years. Went to a dermatologist and they told me, like many people on here have said, to change EVERYTHING (shampoo, conditioner, face and body wash, detergent, hairspray, EVERYTHING) and use hydrocortisone until it went away. Then they did a weird blue light thing.

Now, I am not telling you to skip the dermatologist step, because IANAD! GO TO THE DOCTOR!

However, when I went, and changed my whole beauty cabinet to non-allergenic stuff...It didn't really work. Well, it got better for about a week, but then it started creeping up my chest and shoulders again. You don't want to use hydrocortisone for more than a couple days on your chest area, because it thins your skin and makes it more susceptible to sun damage. Even if there isn't much sun where you are, that's one of those places that use ladies really don't want getting damaged at all (hello, cancer).

You might need to change your weekly cleansing routine, unfortunately. What I do is, once a week, dissolve about 10-15 tablets of cheapo asprin in a small dish of rosewater and gently scrub all the affected areas, rinse after about 3-4 minutes, and then follow up with yogurt smeared all over the rash, and rinse that off after as long as you can possibly stand the smell of slowly warming yogurt, yuck. Using a cream with zinc seems to keep it down to a minimum too, and diaper cream is really the best product out there for that (sounds weird, but it protects you from sun damage while drying out little pimples, but not trashing your skin). I use aveeno, but YMMV. I just rub it in to clean skin every other day or so.

Can I just re-iterate GO TO THE DERMATOLOGIST, because I really am not an expert on anyone's weird pimply chest/shoulder stuff but my own? But, you already know that. It's a huge pain in the ass to change EVERY PRODUCT THAT YOU USE OMG, so get samples from the doc if you can!

Also, wash your bras more often, if you don't already (don't be insulted if you wash em religiously, many people don't like to), and wash them in the shower/hang dry rather than the machine. A lot of bras seem to retain more of the soap from a machine than other garments, and the machine shortens their expensive little lives, too.

Hope this all helps! I feel for you, since it's a pretty unhappy place to have a pimply looking rash thing. Also, don't forget...HORMONES are a big deal! If you recently changed your BC, that could be a major factor. And finally...skin has bumps. If nothing works at all, keep trying but don't be too freaked out.
posted by zinful at 1:41 PM on January 26

Oops, reading comprehension fail... you can't see a doctor. I'm sorry.

Try all of the other stuff above! At least change your detergent and body wash, and make sure your hair isn't splashing shampoo all over you in the shower. Also, sounds weird, but maybe change your deodorant too. The aluminum in most traditional antiperspirant can cause a pretty weird reaction (also, it's a carcinogen, which is why I use non-aluminum deodorant), and the effects are usually located more in the breast area than your armpits.
posted by zinful at 1:48 PM on January 26

Have you been in any hot tubs lately?
posted by bq at 3:05 PM on January 26

Could be a form of herpes zoster or shingles.
posted by modernnomad at 4:59 PM on January 26

(and if it is, yes, you need to see a doctor)
posted by modernnomad at 4:59 PM on January 26

It looks like dermatitis that I had on my face for months. My doctor prescribed promiseb, and I used that and exfoliated with a homemade sugar/coconut oil scrub that I made, and it went away in a few weeks. I'm not saying that homemade exfoliant will be good for you, or that putting oil on your skin will be good for you, but exfoliating definitely helped me more than just using promiseb, and I liked that I wasn't putting more chemicals on my face. *shrug* definitely would be good to see a doctor though so they can tell you what it is for sure, but just wanted to share what I had that looked like that, so you can do more research about what to do even if you can't get to the doctor.
posted by never.was.and.never.will.be. at 7:06 PM on January 26

Do you by any chance wear sweaters without shirts under them? I used to get similar (but less severe) rashes whenever I wore a wool sweater without an undershirt (or an undershirt with a much lower scoop neck).
posted by elizeh at 8:05 PM on January 26

I know this post is old but I'm posting this just in case. I had something nearly identical under my armpits/on the sides of my ribcage. There weren't as many spots as you have, but I swear it looked just like little whiteheads like that. I went to the doctor and it was some sort of staph infection that cleared up after a few days on antibiotics and using some prescription cream.

I am definitely a "don't go to the doctor unless absolutely necessary kind of guy, but you don't want to fool around with something that could possibly be a staph infection.
posted by nakedandalone at 9:27 PM on February 19