Chin Acne in Cats

Introduction

Chin acne is an inflammatory dermatitis of the chin and lips in cats. It occurs when hair follicles in the chin and lip area become clogged with oil and debris, and is characterized by blackheads, pimples, and abscesses on the chin and lip area. It can look like your cat’s chin is dirty, or has accumulated flea dirt. If it becomes severe it can be quite painful.

Causes

• Exact causes are unknown
• Poor grooming: can be secondary to obesity or mouth pain from dental disease
• Excessive oil production
• Stress: from moving, construction, new pets, visitors, or changes in the family
• Use of plastic food and water bowls
• Compromised immune system-possibly primary illness or viral infection
• Viral infection: FIV, FeLV
• Probably not contagious
• Probably not hereditary

Diagnosis

As with any dermatologic disease, it is important to establish a diagnosis and rule out other problems before beginning treatment. Other possible diagnoses include:

• Hypersensitivity of the skin: atopy, flea allergy, food allergy, contact allergy.
• Bacterial folliculitis
• Demodicosis (mite infestation)
• Malassezia infection (yeast dermatitis)
• Neoplasia of apocrine or sebaceous glands (cancer)
• Eosinophilic granuloma complex

Diagnostic Procedures

When chin acne is mild and fairly classic-appearing, with just blackheads and some sebaceous debris noted on the skin, your veterinarian may forgo diagnostic tests, which can save money and time.

If your cat’s chin acne is more severe, it is likely that your veterinarian will do some diagnostic tests to rule out other possible causes of inflammatory dermatitis that are affecting the chin and lip area.

Diagnostic tests that may be performed include:

• Skin scrapings to rule out Demodicosis (can be a primary cause of acne)
• Bacterial culture for possible resistant infection (in severe cases of chin acne)
• Fungal culture for dermatophytosis (ringworm)
• Cytology for bacteria and Malassezia (yeast)-considered secondary invaders and not direct cause
• Biopsies are rarely needed, usually only if severe, other tests are equivocal, or if cancer is suspected

Treatment

In mild cases of feline chin acne, treatment is simple and focuses on cleansing, and/or drying, and avoiding allergens.

• Clip and clean the affected area gently to avoid irritation. Your veterinarian may do this for you the first time.
• Clean 1-2 times daily with a recommended product: chlorhexidine is good for cleaning, & benzoyl peroxide is good for drying the skin. Both must be kept out of the eyes, and peroxide may stain fabrics.
• Can purchase chlorhexidine wipes for quick and easy use.
• Can use a flea comb to gently comb away sebaceous debris. Metal combs may be more effective; plastic combs are gentler on irritated skin but may also contribute to allergies. You may want to try both depending on your cat’s condition. They are also excellent for checking for fleas.
• Topical ointment may be prescribed for mild infection, inflammation, and/or drying effect.
• Change food and water bowls from plastic to ceramic, glass, Pyrex®, or stainless steel, and clean them frequently.
• Using the dishwasher can help improve food bowl hygiene.
• Wiping or washing your cat’s chin and lips after meals can help prevent acne if they are prone to it.

In more severe cases of chin acne, treatment is more involved. Bacteria and yeast may have invaded the follicles, leading to pustules, furunculosis and pyogranulomatous dermatitis. Your cat’s chin may be quite painful from this skin infection. Don’t be afraid to ask your veterinarian for pain control for your friend if you think they are hurting.

Treatments for more severe chin acne may include:

• The previously mentioned treatments including clipping and daily cleaning, topical antibiotic and drying ointments, and food and water bowl changes
• Medicated wipes as needed
• Topical retinoids such as Retin-A® 0.1% gel
• Systemic antibiotics such as amoxicillin with clavulanate, cephalosporin, or fluoroquinolone
• Warm compresses 1-2 times daily
• Very severe cases may need isotretinoin (Accutane®) or cyclosporine, modified (Atopica®)
• Cases secondary to Demodex mites will need isoxazoline parasiticides
• Oral prednisolone for up to 14 days during periods of severe inflammation may be needed

Prevention

Because allergies may be an underlying component of feline chin acne, it is recommended to rule out allergies for your cat. This includes food and environmental allergies. If your cat’s acne recurs repeatedly, please do a food elimination trial. For the best results in environmental allergy testing, see a veterinary dermatologist as recommended by your veterinarian.

Your veterinarian can also do blood allergy testing, which gives you some information about your pet’s allergies in relation to environmental allergens in their part of the country, but it is not as reliable as the veterinary dermatologist’s skin allergy testing, which is the gold standard.

Moving forward, if you introduce new things in your cat’s environment, watch their chin for signs of an acne outbreak, in case they might be allergic to them. Even if you do not do a food trial or allergy testing, try to be aware of what your cat is eating, their protein sources, including the type of treats, and so on.

If you change the food, does the chin acne get better, or does it recur? If you introduce a new type of toy, keep an eye on their chin and make sure they don’t break out with acne. If they do, make a note of what type of toy it was, and see if you can find a pattern in what is contributing to their acne breakouts. Over time, this will empower you to help avoid what triggers them.

Potential Outcomes

Feline chin acne is a common inflammatory skin condition in cats. When treated appropriately, it usually has a favorable response. More severe cases require more intervention, such as systemic antibiotics and/or steroids, and may recur throughout your cat’s life.

Vigilant cleansing can help reduce recurrence, and although blackheads may persist, they are often cosmetic and further treatment may not be necessary if they are not inflamed. Because chin acne may have an allergic basis, it is recommended to do a food elimination trial and have your cat allergy tested if their chin acne recurs repeatedly.

Whether or not your cat has chin acne sometimes, or even all the time, with your loving care and attention, your cat will live a full, comfortable, and happy life.