How to Treat Cat Acne (and What Back Bumps Mean)

Cat acne shows up on the chin and lips: black specks that look like dirt, then sometimes red bumps, pus and scabs. Your vet chooses the treatment. It usually means gentle cleaning with a cat-safe medicated product, plus antibiotics or anti-inflammatory medicine if the skin is infected. Please don't squeeze it, and don't reach for hydrogen peroxide or your own acne cream.

Found the bumps on your cat's back instead? Then it is most likely not acne. Small crusty bumps along the back are a classic sign of flea allergy, and a greasy patch at the base of the tail has its own name (stud tail). Both are covered below.

What cat acne looks like

Feline acne (also called chin acne) is a problem of the hair follicles on the chin. The skin makes too much keratin, a tough protein, which gets trapped in the follicles and plugs them. Those plugs are comedones, the same blackheads people get. If bacteria get into a plugged follicle, it becomes a red bump or a pimple filled with pus.

It can start at any age. In one study of 22 cats with acne, the first signs appeared anywhere from 6 months to 14 years of age, with a median of 4 years.

Here is how it usually progresses, from mild to serious:

1. A "dirty" chin. Tiny black specks on the chin or the edge of the lower lip. They are easiest to see on white and light-colored cats, and many owners try to wipe them off first.
2. Red bumps and pimples. Plugged follicles get inflamed or infected (folliculitis). You may see small red bumps, pustules and crusts.
3. A swollen, sore chin. When infected follicles rupture (furunculosis), the chin and lips can swell, ooze, bleed and lose hair. This stage hurts, and the lymph nodes under the jaw may enlarge.

In that same study, the most common findings were blackheads (73% of cats), hair loss (68%), crusts (55%), small raised bumps (45%) and redness (41%). About a third of the cats were itchy, which is why some cats rub their chin on furniture or scratch at it.

Bumps on your cat's back are usually not acne

Plenty of owners call bumps on the back "cat acne," but vet sources place feline acne on the chin and lips. When a cat has bumps along the back, the usual suspects are different:

• Flea allergy (miliary dermatitis). Many cats are allergic to flea saliva. Part the fur and you feel or see lots of tiny, crusty bumps, like millet seeds. The Merck Veterinary Manual says these bumps are typically spread over the back, neck and face. They are not the bites themselves but an allergic reaction to them, and the whole cat itches. Our guide to miliary dermatitis in cats goes deeper.
• No fleas in sight does not rule fleas out. Flea-allergic cats groom so much that you often find no fleas or flea dirt at all. Your vet may use your cat's response to thorough flea control as the test. See flea allergy dermatitis.
• Stud tail (tail gland hyperplasia). There are oil glands on the top of the tail near its base. When they overwork, the fur there turns greasy, the hair thins, and blackheads and crusts can form. It is most common in unneutered males but can happen in any cat, especially one that has trouble grooming.
• Skin infection or other allergies. A superficial skin infection in cats can show up as heavy scaling on the back near the tail. Food and environmental allergies can also cause small crusty bumps and itching.

All of these need a vet to sort out, because the treatment is completely different from chin acne. A flea allergy, for example, is managed with ongoing flea control for your cat, every other pet in the house and the home itself, not with a chin wash.

Why cats get chin acne

Nobody knows the exact cause. Vets describe feline acne as a disorder of keratinization, with stress, infection and environmental triggers all suspected. Other possible contributors include:

• Allergies, which make cats rub and scratch their faces
• Rubbing the chin on objects to scent-mark
• Poor grooming, for example in older, arthritic or overweight cats
• A weakened immune system or a viral infection
• Plastic food and water bowls. Scratches in plastic can hold bacteria, and there may be a link with chin acne, although it has not been proven.

Persian cats are sometimes said to get a "severe form" of acne. That is a different condition: idiopathic facial dermatitis of Persian cats is an inherited skin disorder of its own, and it needs its own workup.

How vets treat cat acne

The first job is to confirm it really is acne. Several problems look the same on a cat's chin:

• Mites (demodicosis) and ringworm. Your vet may do a skin scraping and a fungal culture. Our pages on ringworm in cats and mange in cats explain those.
• Bacterial or yeast infection, checked by looking at a skin sample under the microscope (cytology), sometimes with a culture.
• Eosinophilic granulomas, raised pink or yellowish lumps that often appear on the chin and lips.
• A tooth root infection. An infected lower tooth can swell the chin and mimic acne, so your vet may suggest dental X-rays.

• Rarely, cancer or an immune-mediated disease. If the lesions look unusual, a biopsy sorts this out.

Once acne is confirmed, treatment depends on how bad it is. Blackheads that are not bothering your cat may need little or no treatment. For the rest, your vet may:

• Clip the hair on the chin so the skin can be cleaned and treated properly
• Prescribe a cat-safe medicated cleanser, wipe or shampoo, such as a benzoyl peroxide or chlorhexidine product. Only use products your vet recommends: some are irritating to cats, and benzoyl peroxide can dry the skin.
• Add an antibiotic ointment, or oral antibiotics when the infection runs deep
• Use anti-inflammatory medicine, or stronger prescription treatment, for severe or stubborn cases
• Suggest an omega-3 fatty acid supplement

Your vet chooses the product, the dose and how long to use it, so follow your vet's plan rather than stopping when you think the chin looks fine.

Cat acne tends to come back. Some cats have one flare and never another; others need long-term care with a vet-recommended cleanser to keep flares small. Most cases respond well once there is a plan.

What you can do at home (and what to skip)

Your part is mostly about the environment and keeping your hands off.

Safe steps

• Swap plastic bowls for smooth, nonporous glass, ceramic or stainless steel ones. Scratched plastic is harder to keep free of bacteria.
• Wash food and water bowls every day with soap and water.
• Clean the chin only with the product and method your vet gives you. Be gentle: a sore chin can make even a sweet cat bite.
• Watch for changes. Spreading redness, swelling, oozing or scabs mean it is time to call your vet.

Skip these

• Squeezing or popping. Texas A&M's vet school calls popping "the absolute worst thing you can do". It hurts, damages the hair follicle and can spread infection across the chin.
• Hydrogen peroxide and rubbing alcohol from your cabinet. The Texas A&M Pet Talk team advises avoiding alcohol and peroxide-based products, which can irritate the skin and make things worse. The Merck Veterinary Manual notes that hydrogen peroxide is toxic to healthy tissue, which is why vets don't use it to clean wounds either. An infected chin is broken, inflamed skin. A benzoyl peroxide cleanser your vet prescribes is a different product; use it only the way your vet tells you.
• Your own acne products. Human acne medicines can be very harmful to cats.
• Home remedies. Aloe, oils and other kitchen-cupboard fixes have no evidence behind them for cat acne. The aloe plant is on the ASPCA's list of plants toxic to cats, so skip it.

When to call your vet

• Call now if the chin is swollen, oozing, bleeding or painful, or your cat won't let you touch it. Infected chin acne can turn into a deep skin infection.
• See your vet soon if you see red bumps, pimples or scabs, or your cat keeps rubbing or scratching its chin. Book the visit even if your cat acts fine: inflamed acne needs vet treatment.
• Mention at your next visit if all you see is a few black specks and your cat doesn't care. Your vet can confirm it is acne and not mites, ringworm or a tooth problem.
• Bumps on the back or near the tail? Book a visit and ask about flea allergy, especially if your cat is scratching or overgrooming.

Cat acne FAQ

Is cat acne contagious?

Cat acne is not considered contagious to other cats or to people. In a 2006 study, though, one cat from a home where all five cats had acne had a virus (calicivirus) in its chin skin. If several of your cats get chin problems at the same time, tell your vet.

Will cat acne go away on its own?

Blackheads that don't bother your cat may need little or no treatment. But acne often comes back, so many cats need ongoing chin care to keep flares small. Infected acne should always be seen by a vet.

Is cat acne painful?

Blackheads alone usually aren't. Once the skin is inflamed, swollen or oozing, it is likely sore, even if your cat hides it.

Originally written by Akosua Kumi Nyarko. Updated by the I Love Veterinary editorial team.

Sources

• VCA Animal Hospitals: Chin Acne in Cats
• Texas A&M College of Veterinary Medicine, Pet Talk: Managing Feline Acne
• Merck Veterinary Manual: Pyoderma in Dogs and Cats
• Merck Veterinary Manual: Pyoderma in Cats
• Merck Veterinary Manual: Fleas of Cats
• Merck Veterinary Manual: Flea Allergy Dermatitis in Dogs and Cats
• Merck Veterinary Manual: Allergies of Cats
• Merck Veterinary Manual: Eosinophilic Granuloma Complex in Cats
• Merck Veterinary Manual: Hyperplastic and Seborrheic Syndromes in Animals
• Merck Veterinary Manual: Initial Wound Management in Small Animals
• VCA Animal Hospitals: Stud Tail (Tail Gland Hyperplasia) in Cats
• Zoetis Petcare: Decoding Chin Acne in Cats
• Rosenbaum M. Identifying, managing feline acne, non-parasitic otitis and allergic dermatitis. dvm360
• Jazic E, et al. An evaluation of the clinical, cytological, infectious and histopathological features of feline acne. Vet Dermatol 2006
• ASPCA Animal Poison Control: Aloe

This article is for general information and is not a substitute for advice from your veterinarian.