Feline Acne

By:  Dawn Skupin

Feline acne is a multi-factorial skin disease characterized by small black dots, known as comedomes.  It a common problem seen in cats, is easy to diagnose, but can be hard to control.  Feline acne can occur at any age and in any breed or sex.  It normally appears on the chin and lips in the hair follicles of the affected animal rather than over the whole muzzle area.  Hair loss over the affected areas can occur. 

There is a wide range of characteristics with this condition, ranging from a one-time case, while other cats can get recurring outbreaks or even constant acne.  Severity can range from small pimples with a brown to black crusty appearance resting on the skin below the coat at the base of the hairs to severe acne with large pus filled lesions, (similar to pimples and boils in humans), forming in the skin tissues.   These lesions are not the true underlying causes of the feline acne.  The bacterial infections that occur are secondary to the primary problem.  The secondary infections may lead to folliculitis, which is an inflammation of the hair follicles, and formation of papules and pustules from which pus can be expressed. In severe cases of feline acne inflammation of multiple follicles, pyoderma, (the opening of  pus filled lesions), develops with many discharging tracts or sinuses.   Severe cases of feline acne can cause the chin and sometimes the lips to swell. There may also be an enlargement of the draining lymph nodes of the neck and head.  When the acne becomes as advanced, as to cause swelling and skin eruption, the acne condition becomes painful to the animal. 

In humans, acne is related to hormone levels and the presence of bacteria in the skin.  A clear association between hormones, skin bacteria and development of acne has not been established in the cat.  The true cause of feline acne is unknown. Factors, including stress, poor immune system function, inhalant allergy, poor grooming habits and food, food dishes, or food mite allergy have all been considered as possible causes.  The presence of other diseases, viruses, contact or atopic dermatitis and skin conditions in which abnormally large amounts of oils are produced have also been proposed as possible causes.  Feline acne appears  more common during the spring and fall shedding season.

It is possible that some cases of feline acne are contagious, although a responsible organism has not been identified.  Feline acne can rapidly spread through a cattery, shelter, or rescue, however it is also possible that only one cat in the same situation may break with the condition.  Occasionally feline acne is associated with fungal infections including dematophytosis, (ringworm), and seldom with demodectic mange.

Two primary types of gland are found in the dermal layer of the cat’s skin; the sweat glands and the sebaceous glands.   Most of the sebaceous glands are closely associated with the hair follicles and produce an oily secretion, known as sebum, which lubricates the skin, waterproofs the cats’ hair for weather protection, and is also used for territorial marking by the cat.  Additionally, larger sebaceous glands are located under the chin and eye lids.  Sebaceous glands are also positioned on the dorsal or top surface of the base of the tail, prepuce and scrotum.

The collection of glands under the skin in the chin area may be referred to as the submental organ.  The glands around the base of the tail are referred to as the supracaudal organ.  Feline acne is viewed as over activity of the submental organs.   Over activity of the glands at the base of the tail, is often referred to as “stud tail.”  Stud tail is not limited to just male cats.  It can been observed in breeding females and neuter/spays alike.  It is the over activity of the sebaceous glands that appears to predispose cats to the feline acne condition.  It is thought that the oily secretions of the larger sebaceous glands have a role in the territorial marking behavior that cats display through the repeated rubbing of their chin, lips or base of the tail over objects.  In time the secretions build up on the cats’ favorite areas and may appear a black or greasy area on the surface the cat has marked.

Feline acne remains poorly understood in terms of an underlying cause.  It is assumed to represent a form of keratinisation disorder.  Keratin is a protein which is the main component of the hair and nails.  The general consensus is thought to be the cat’s hair follicles produce excessive sebaceous/ketatinous material. 

Treatment for feline acne and stud tail requires removal of the excess sebum, thereby eliminating the comedone formation and secondary infections, by a throughoral cleaning regimine.  This will prevent the formation of the “blackheads” and relating secondary infections to develop.  Topical ointments are of limited value in treatment for feline acne as they are licked off in the grooming process.  An antibacterial scrub such as chlorhexidine can initially be used for this procedure two to three times a day.  Other cleansing agents may include antibiotic soap, hydrogen peroxide, iodine, (Betadine), and products containing  benzoyl peroxide (such as Oxy Dex) may also prove useful in the fight against acne.   The author of this article has found the product called “Purpose” manufactured by Johnson & Johnson extremely effective in resolving mild feline acne.  Vitamin A products, (0.05% retinoic acid cream), applied daily at first then on alternate days or twice weekly has proved beneficial in some cases.  This product may cause irritation and its use should be monitored closely.  Here again, the cat may clean the product off of its skin through the grooming process.

Antibiotics are helpful in assisting with bacterial infections, but should be selected preferably on the basis of a bacterial culture and sensitivity test.  When secondary bacterial infections are present Pasteurella multocidqa, B-hemolytic streptoccodcci, and Staphlococcus spp. have been isolated as possible causes.  Antibiotics usually require a four to six week course of treatment in addition to the multiple daily cleansings.  In extreme cases a course of systemic corticosteroids, such as Prednisone, Prednisolone, or methylprednisolone may be used to reduce inflammation for 10-14 days.  Additionally,

Isotretinoin has been advocated for treatment and control of refractory cases of feline acne.  It decreases the activity of sebaceous glands and normalizing keratinization within the hair follicles.  Response to the Isotretinoin should occur within a month.  Once improvement is observed, the dose may be reduced to twice weekly for control.  There are side effects of it’s use and the cat should be monitored for them.  The side effects include: conjunctivitis, periocular crusting, vomiting, and diarrhea.  This drug is also known to cause birth defects in very small doses so caution should be observed for both the cat and the owner. 

Most cases of feline acne respond satisfactorily to treatment however some cases may require prolonged treatment due to secondary infection.  Multiple daily chin cleansing is required for all levels of infection.  Scrub hard enough to remove the comedones, but do not rub the area raw.  This causes pain to the cat resulting in a struggle between the animal and the caregiver. 

In some cats with the tendency to develop chin acne, it is recommended that metal or ceramic feeding dishes be used instead of plastic.  Plastic is porous and traps bacteria which can then be transferred to the cat’s chin in the eating process. This may assist in deterring the problem of acne from reoccurring.  If the cat is a messy feeder,  scrupulous attention to the hygiene after meals must be observed. If needed, wash the cat’s chin after it eats.  Daily washing of food and water bowls will prevent an excess of skin oils from building up around the edges of the bowls and attributing to the problem.

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