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Sand-like particles coming from hard lumps on chin, white balls popping out of raised areas. What is this and what can I do about it?

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General & Family Physician
Practicing since : 2005
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i have been to dr.s for a year now and have gotten worse. i started out with sand-like particles coming out of hard lumps on my chin and was told don't pick at it and given cream to aid in the healing process. said it was adult acne. now it is all down my neck with little white balls popping out of raised areas. what is this and what can i do about it. i have complete scarred up my chin.
Thu, 28 Jun 2012 in Skin Hair and Nails
Answered by Dr. Prasad 1 hour later

Thanks for the query.

I have gone through your query. I understand the white lesion that has popped up now is causing lot of worries in you. But let me assure you, they do not seem like a serious illness and definitely not related to hepatitis C infection.

A close up picture of the affected area would have helped me in understanding the nature of these lesions. I wish you to upload a clear photo of the affected area.

You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.

Based on the history provided, it looks like this could be aggravation of adult acne with pustular lesions.

Adult acne is a chronic condition which can recur. They usually heal spontaneously. Sometimes the acne may get infected which leads to white pus like collections in them. If the pus formed is large and many, like in your case, you need topical/oral antibiotics. Clindamycin is usually prescribed to treat these lesions. I suggest you to XXXXXXX your dermatologist who will prescribe you the needed antibiotics that will heal these lesions.

Meanwhile as you plan to fix an appointment with your doctor, the following measures will benefit you
1. Topical antibiotics like clindamycin that is available over the counter can be used over large lesions.
2. Do not pick them / handle them with bare fingers.
3. Cleaning the areas with mild soap might help, but avoid frequent washing. Frequent cleaning might worsen the condition
4. Physical and mental stressors have been associated with acne eruptions since ages. It is important to keep them under control. Physical exercises, good sleep as well as transcendental meditation/yoga are good de-stressing measures which will benefit you.
5. A healthy nutrition is important in faster recovery.

Hope I have provided you with the helpful information. Let me know if I have missed out on any concerns.

Wish you good health and speedy recovery.

Above answer was peer-reviewed by
Follow-up: Sand-like particles coming from hard lumps on chin, white balls popping out of raised areas. What is this and what can I do about it? 1 hour later
this is not acne that is on my neck...nor was it acne on my chin. these were bumps filled with sand-like sharp small particles like grains of salt. and now i have what looks like the measles on my neck. it always leaves a XXXXXXX round hole about half the size of a pencil eraser when the white balls come out and I think I am smelling an odor...sort of like mildew. I hope this is giving you a clearer picture. I do not have a camera phone so i can not show you a picture. the closest description i can match it to on the web is something called millnia. what can i do about it. can i treat it with anything over the counter. i have been to a couple of dr.s and they did not really even take a close look. they just said do not pick it. i wish they would have tested it somehow. it is not going away. it is spreading from the entire outline of my face, in between my eye brows and now down on my neck. also the skin on my neck where it is is like a chickens skin. strange mildewy odor also.
Answered by Dr. Prasad 9 hours later
Hi and thanks again,

It is unfortunate that you are unable to load a picture. Nevertheless, let me try to give my opinion based on your description.

Pinhead size lesions of the skin are referred to as papules. From your description, you seem to have papular lesions on the neck and chin. It is clear that these are blocked sebaceous follicles. Such lesions are associated with:

1. Milium / white comedones : These are blocked glands containing collection of white sebum. If not treated they may get infected. Though complete treatment takes few months this is treated with medicated creams or by removal techniques such as dermabrasion

2. Papular acne
3. It is some times seen in other condition such as seborrheic dermatitis.

Based on your description it closely resembles milia. They usually do not pose threats unless infected. I would encourage you to consult a dermatologist for a direct examination. It should resolve in a few weeks with proper antibiotic medications.

Hope this information is able to guide you to the next step to cure. Let me know if I have missed out on any other concerns.

Above answer was peer-reviewed by
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