Tuesday, May 17, 2022

Acne Between Eyebrows: Causes, Treatment and Prevention

  • Acne between the eyebrows typically develops as a result of excess oil and debris clogging pores
  • Pimples that form in the area between the eyebrows can also indicate an underlying health condition
  • There are a number of over-the-counter, natural and prescription remedies that can help combat this acne
  • Other skin conditions such as folliculitis and milia have similar symptoms to acne   

Acne breakouts develop in areas with the greatest number of sebaceous (oil) glands, including the face, forehead, back and shoulders. This condition can be worsened by pore-clogging hair and skin products.  Acne between the eyebrows develops for these same reasons, but may also signal an underlying health condition. 

What Causes Acne Between Eyebrows?

Acne between the eyebrows presents at the top of the T-zone, the area that spans from the chin to between the eyebrows and across the forehead. Acne that develops between the eyebrows, also known at the glabellar area, is common. 

The T-zone produces more oil than any other area of the face which makes it more prone to developing blemishes. When pores become clogged with oil and debris, acne lesions develop in the form of blackheads, whiteheads, (comedones) pimples and pustules. 

Plucking and waxing the eyebrows can also increase the risk of inflamed lesions. Removing hair leaves the follicle vulnerable to not only acne breakouts, but also to ingrown hair that resembles acne. 

Several other factors may contribute to acne between the eyebrows. Using comedogenic skin care products, such as oil-based moisturizer can lead to excess oil residue which can cause blocked pores. 

Some hair care products such as serum that are used near the hairline can transfer to the eyebrow area and increase the risk of acne breakouts.

Certain health conditions such as a hormonal imbalance have been demonstrated to trigger acne, and a dysfunctional liver has been said to cause breakouts in this specific area – however there is currently no scientific proof to support this claim.

Liver health

Acne that occurs between the eyebrows is claimed to be linked to liver health. Face mapping, a Chinese medicine technique, views the face as a map and links a section of the face to a different body organ.  

Face mapping identifies a dysfunctional liver as causing acne between the eyebrows.

How to Get Rid of Acne Between the Eyebrows

There are a number of over-the-counter, (OTC) natural and prescription acne remedies that can treat acne between the eyebrows. 

Azelaic acid 

Azelaic acid is a topical treatment that is antibacterial, anti-inflammatory, antikeratinizing and rich in antioxidants. It can effectively reduce inflammation, irritation and redness, and can smooth and exfoliate skin. 

This acid is available in 15% to 20% concentrations in cream and gel formulations. It is safe for all skin types and can even be used by women who are pregnant or breast-feeding. 

Benzoyl peroxide 

Benzoyl peroxide is an effective, topical treatment for acne that can kill Cutibacterium acnes (formerly known as Propionibacterium acnes) bacteria. It reduces redness and inflammation, and is one of several treatments considered in first-line therapy for inflammatory acne.

Benzoyl peroxide reduces excess oil on the skin and helps clear pores. It’s available as an all-over or spot treatment and ranges in concentration from 2.5% to 10%. This treatment is known for staining fabric and hair, so use caution when applying it.

Glycolic acid

Glycolic acid is the smallest alpha-hydroxy acid, which enables it to deeply penetrate pores to clear buildup, promote skin cell turnover and reduce existing comedones. Studies have shown that this acid is a bacterial and can also inhibit C.acnes in the ph range of 3–4.5.

Glycolic acid is available in creams, gels, cleansers and face masks. 

Retinol

Retinol, a vitamin A derivative, offers several skin benefits such as reducing the signs of aging, increasing collagen production to strengthen skin, and improving texture and tone. As an acne treatment and preventative, it deeply exfoliates to clear pores of oil, debris and dead skin cells. 

It has been shown to complement the effects of benzoyl peroxide as it works through a different mechanism of action. 

Retinol is available in creams and gels in various strengths. Side effects tend to occur most often with high concentrations and long-term use; these include dryness, irritation and redness.

Rosehip oil

Rosehip oil is a natural extract that can treat both noninflammatory and inflammatory acne due to its anti-inflammatory and antimicrobial properties. It can help regulate oil production to prevent comedones and pimples from forming, and reduce the swelling and inflammation associated with inflammatory acne.

Rosehip oil is generally considered safe for all skin types and is associated with few side effects. It is available in topical and oral supplement formulations.

Tea tree oil

Tea tree oil is an essential oil and a well-known natural remedy for acne and other skin conditions. It has anti-inflammatory and antibacterial properties. In one study, 5% tea tree oil significantly improved acne by reducing the number of both inflamed and noninflamed lesions. 

Tea tree oil, as with all essential oils, should be diluted with a carrier oil before using. Side effects are mild, and include itching, dryness, burning, swelling and redness. 

Preventing Acne Between the Eyebrows

You can take steps to prevent or reduce acne from forming between the eyebrows:

  • Do not squeeze or pop pimples; this can spread bacteria and cause worsening symptoms in addition to scarring
  • Avoid plucking, waxing and threading eyebrows – instead, use a small brow trimmer to shape your eyebrows
  • If you wear bangs, consider growing them out or pinning them back, as natural oil and hair products can contribute to breakouts 

Professional Treatment Options

If preventative measures and OTC acne remedies aren’t effective, contact your dermatologist as you may need a prescription-strength medication or a professional treatment including: 

  • Chemical peels offer more dramatic results than OTC products and have been shown to significantly decrease the number of comedones, papules and pustules
  • Light therapy uses specific wavelengths of LED light to kill acne-causing bacteria and target inflammation
  • Oral contraceptives regulate fluctuating hormones that cause acne breakouts
  • Prescriptions such as isotretinoin increases skin cell turnover; this medication is prescribed only for severe and treatment-resistant cases 
  • Retinoid cream speeds up skin cell turnover and rejuvenates skin
  • Surgical treatment of severe cystic acne lesions, including draining and removal
  • Topical or oral antibiotics main mechanism of action is to reduce inflammation caused by bacteria 

Other Bumps That Appear Between the Eyebrows 

In addition to acne, there are other skin conditions that can cause bumps that appear between the eyebrows.  

Folliculitis 

Folliculitis is a common skin problem that occurs most often from Staphylococcus aureus bacteria entering a hair follicle and causing an infection. It presents as tiny, red or white pus-filled bumps. 

Plucking eyebrows can cause this to develop as well as ingrown hairs, viruses and fungi. 

Milia 

Milia are small, white bumps under the skin that are caused by excess keratin buildup in the pores. While they can develop on the upper trunk and extremities they typically present on the face.

Seborrheic dermatitis 

Seborrheic dermatitis is characterized by scaly patches of skin, flakiness and redness. It most commonly develops on the scalp but can also affect oily areas of skin including the eyebrow area.

Takeaway

Acne in the form of inflamed lesions or comedones and pimples can form between the eyebrows. This is typically due to the combination of excess natural oils, debris, dead skin cells, and oily hair and skin products.

Various OTC and natural treatments are available to treat acne by clearing pores, exfoliating the top layer of skin and killing acne bacteria. They can also ease the accompanying symptoms of irritation, redness and swelling.

If these methods are not successful in treating your acne, see your dermatologist who will assess your skin. They may prescribe a medication or recommend treatments such as chemical peels or laser therapy.

Sources

  • MATSUOKA, Y., YONEDA, K., SADAHIRA, C., KATSUURA, J., MORIUE, T. and KUBOTA, Y. (2006), Effects of skin care and makeup under instructions from dermatologists on the quality of life of female patients with acne vulgaris. The Journal of Dermatology, 33: 745-752. https://doi.org/10.1111/j.1346-8138.2006.00174.x
  • Bosanac SS, Trivedi M, Clark AK, Sivamani RK, Larsen LN. Progestins and acne vulgaris: a review. Dermatol Online J. 2018 May 15;24(5):13030/qt6wm945xf. https://pubmed.ncbi.nlm.nih.gov/30142728/
  • Valle-González, E.R., Jackman, J.A., Yoon, B.K. et al. pH-Dependent Antibacterial Activity of Glycolic Acid: Implications for Anti-Acne Formulations. Sci Rep 10, 7491 (2020). https://doi.org/10.1038/s41598-020-64545-9
  • Fulton, J.E., Jr., Farzad-Bakshandeh, A. and Bradley, S. (1974), Studies on the Mechanism of Action of Topical Benzoyl Peroxide and Vitamin A Acid in Acne Vulgaris. Journal of Cutaneous Pathology, 1: 191-200. https://doi.org/10.1111/j.1600-0560.1974.tb00628.x
  • Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust. 1990 Oct 15;153(8):455-8. doi:10.5694/j.1326-5377.1990.tb126150.x
  • Sharad J. Glycolic acid peel therapy – a current review. Clin Cosmet Investig Dermatol. 2013;6:281-288. Published 2013 Nov 11. doi:10.2147/CCID.S34029

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