Effective Approaches to Lower Cheek Acne Management

Close-up view of lower cheek acne with inflammation

Intro

Lower cheek acne is a skin concern that tends to fly under the radar, often overshadowed by more prominent acne areas like the forehead or chin. However, the lower cheek region, which includes the area just beside the mouth and jawline, can often display breakouts that are equally distressing. This article sets the stage for understanding why these blemishes occur, how they can be managed, and offers insights that cater to both beauty novices and seasoned professionals.

Understanding lower cheek acne involves examining a variety of factors — from hormonal influences to skincare habits. The goal is to arm readers with the knowledge they need to tackle this skin issue with confidence and effectiveness.

Noteworthy Points to Discuss

The various causes of lower cheek acne, including hormonal changes, bacterial factors, and lifestyle choices.
Preventive measures to help minimize breakouts.
Treatment options that span from over-the-counter solutions to professional dermatological treatments.
Specialized beauty tips for managing acne when it comes to skincare routines, makeup application, and more.

As we move through the following sections, we’ll peel back the layers of this complex skin issue, providing a roadmap towards clearer, healthier skin. So let’s dig in and explore methods to not only understand but also manage lower cheek acne effectively.

Overview of Lower Cheek Acne

When it comes to the world of skincare, lower cheek acne often does not receive the spotlight it rightly deserves. This particular area of the face can be a breeding ground for various types of blemishes, challenging those who wish to maintain flawless skin. Understanding the nuances surrounding lower cheek acne is critical for more than just aesthetic reasons; it plays a vital role in one’s overall skin health and self-esteem.

Lower cheek acne can insinuate deeper issues, such as hormonal imbalances or reactions to specific skincare products. It is essential to peel back the layers—quite literally—of this condition to determine what causes it. The importance of this section lies in its ability to provide clarity amidst a sea of information. By grasping what constitutes lower cheek acne, one can better navigate its prevention and treatment.

Visiting the lower cheeks, you might notice that this area is often untouched by the popular cleaning regimes many people apply. What’s critical here is the awareness of how this location can act as an indicator for changes happening in the body or skin’s ecosystem. Therefore, this overview serves as the foundation for understanding subsequent sections in this article.

Defining Lower Cheek Acne

Lower cheek acne refers specifically to breakouts located on the lower portion of the cheeks, an area that can often be mistaken for general facial acne. This type of acne can manifest in various forms, including blackheads, pustules, or cystic nodules, which can be particularly troublesome.

The skin in this region is generally different from other facial zones; it's prone to be oilier and more sensitive. Consequently, what you see reflected back in the mirror may result not just from external factors, but from what's happening inside your body, like hormonal shifts or dietary choices.

Moreover, it is important to clarify that while many people experience acne on their face, lower cheek acne is not isolated; it may frequently occur alongside breakouts in other facial areas, creating a complex relationship between these regions.

Significance of Location

The lower cheeks are significant for various reasons, both dermatologically and socially. From a skincare perspective, the skin here might accumulate dirt, oil, and makeup residue more than other regions. Hence, the location can act like a sponge, soaking up the grime that leads to breakouts.

Additionally, many people tend to overlook this specific area during their cleansing routines, focusing on their forehead and cheeks instead. Furthermore, the aesthetics surrounding lower cheek acne may have a social implication; people often equate facial clarity with self-confidence.

"The importance of acknowledging lower cheek acne goes beyond simple skincare; it encompasses a person’s sense of self-worth and emotional health."

In summation, understanding the importance of location can help individuals devise personalized skincare regimens that address the unique characteristics of lower cheek acne. For those wrestling with this issue, recognizing the significance of this area allows them to take steps toward a clearer complexion.

Common Causes

Understanding the common causes of lower cheek acne is crucial for anyone struggling with this skin concern. Identifying the underlying reasons behind breakouts can lead to more effective prevention and treatment strategies. Each individual experiencing lower cheek acne may have unique triggers, but some causes stand out as prevalent across many cases. Here are some noteworthy factors that contribute to this form of acne, which can vary from hormonal fluctuations to environmental exposures.

Hormonal Influences

Hormones often take center stage when discussing acne, and for good reason. Fluctuations in hormone levels can lead to overproduction of sebum, the skin's natural oil. This excess oil can clog pores, setting the stage for acne to emerge. Such hormonal changes are especially common during puberty, menstruation, pregnancy, or even menopause.

Women are particularly susceptible to experiencing hormonal acne, as conditions like polycystic ovary syndrome can exacerbate the problem. It’s not just about fluctuating hormones, though; stress can also increase cortisol levels, which may, in turn, provoke breakouts. Managing these hormonal influences can be a key step in reducing breakouts on the lower cheeks.

Dietary Factors

What we eat can significantly impact our skin. Certain foods can trigger inflammation or affect insulin levels, both of which may contribute to acne. Diets high in refined sugars, dairy products, and unhealthy fats have been linked to poorer skin health.

Conversely, incorporating a wealth of fruits, vegetables, and omega-3 fatty acids can support healthier skin. Keeping a food diary to track what you eat and how your skin responds may help in identifying any personal dietary triggers for lower cheek acne.

Moreover, it's vital to stay hydrated. Water helps maintain skin elasticity and can promote clearer skin by aiding detoxification.

Skincare Products and Ingredients

Navigating the world of skincare can feel like walking through a minefield, especially when it seems like every product advertises that it can cure acne. However, not all products are created equal. Some skincare items may contain comedogenic ingredients, meaning they have a tendency to clog pores, hence leading to the very issue one is trying to avoid.

It's wise to look for labels that indicate "non-comedogenic" and to be wary of heavy creams and oils around the cheek area. Instead, prioritize lightweight, oil-free moisturizers and gentle cleansers formulated for acne-prone skin. Ingredients such as salicylic acid and benzoyl peroxide can be beneficial, but they need to be used judiciously to avoid irritation.

Environmental Influences

Often overlooked, environmental factors also play a role in the development of lower cheek acne. Pollution, humidity, and sweat can compromise skin health. For instance, city dwellers might find that the smog in urban areas clogs their pores, leading to breakouts. Likewise, high humidity can encourage bacteria growth on the skin.

Additionally, touching your face frequently can transfer dirt and oils from your hands to your cheeks, which can exacerbate the problem. Even something as simple as your phone can be a hiding place for bacteria. Cleaning devices that come into contact with your face regularly is a small yet impactful step toward maintaining clear skin.

Illustration of common causes of lower cheek acne

"Preventing lower cheek acne can often be more achievable when one addresses the underlying causes and environmental settings that exacerbate it."

Types of Acne Present on the Lower Cheek

Understanding the types of acne that can appear on the lower cheek is pivotal for anyone facing this skin issue. Identifying the specific type helps in tailoring effective treatment strategies. Each type of acne carries its unique characteristics, requiring different approaches in managing breakouts and promoting clearer skin. This article segment will detail the three primary forms of acne seen in this area: comedonal acne, inflammatory acne, and cystic acne.

Comedonal Acne

Comedonal acne primarily involves the non-inflammatory kind of clogged pores. This type manifests itself as whiteheads and blackheads. It arises when dead skin cells, oil, and bacteria build up, forming a plug in hair follicles.

The skin on the lower cheeks can be particularly prone to this. This part of the face often has larger sebaceous glands, which means that oil production can be high. If not addressed, they can lead to more significant issues over time.

It’s essential to maintain consistent skincare practices aimed at minimizing excess oil and unclogging pores.

Gentle exfoliation is vital to help remove dead skin cells.
Salicylic acid is a recommended ingredient due to its ability to penetrate the pore and enhance cell turnover.

Most individuals can effectively manage comedonal acne with the right products focusing on maintaining a clear and balanced complexion.

"Keeping the pores clean is like maintaining your garden. If you don’t regularly pull out the weeds, they’ll take over."

Inflammatory Acne

Inflammatory acne shows up as red, swollen bumps on the skin which tells you that an immune response might be in effect. Often associated with bacteria, this type can develop from comedonal acne if not treated properly. It includes inflamed pustules and papules.

This skin condition often involves factors like hormonal fluctuations, making areas around the lower cheek more susceptible to breakouts due to heightened sensitivity and sebaceous gland activity.

To combat inflammatory acne:

Topical treatments with benzoyl peroxide and retinoids can help reduce swollenness and kill acne-causing bacteria.
Professional interventions, like laser treatments, may also be effective for persistent cases.

It's beneficial to recognize that the underlying causes—like stress or poor diet—can exacerbate these types of breakouts. Maintaining a balanced lifestyle can contribute significantly toward the prevention of future flare-ups.

Cystic Acne

Cystic acne is the most severe form and can often feel more like a tormenting issue than anything else. These are deep, painful lesions that often feel like they are lying just below the surface of the skin. Unlike the previous types, cystic acne involves larger cysts filled with pus, making it extremely difficult to treat without professional help.

Cystic breakouts can lead to considerable discomfort and are often a consequence of hormonal imbalance or genetic predisposition. To mitigate this:

Consult a dermatologist for personalized treatment plans that may include oral medications like isotretinoin.
Regular professional facials or extractions can also assist in controlling ongoing outbreaks.

This type of acne demands special attention to ensure it doesn't leave lasting scars or emotional distress. Understanding this form's complexities is crucial for anyone who finds themselves grappling with such skin issues.

Preventive Measures

Preventive measures are essential when it comes to managing lower cheek acne. They not only help in reducing the frequency and severity of breakouts but also pave the way for healthier skin. A proactive approach can save individuals from the often frustrating cycle of treating acne, which is why implementing preventive strategies is crucial.

Maintaining a Consistent Skincare Routine

A consistent skincare routine is the backbone of any effective acne management strategy. This doesn’t mean you need a ten-step regimen; rather, it’s about finding a few reliable products and using them daily.

Start with a gentle cleanser that doesn’t strip your skin of its natural oils, as over-cleansing can lead to irritation and more breakouts. After cleansing, consider applying a lightweight, non-comedogenic moisturizer to keep your skin hydrated. The frequency of washing your face should be limited to twice a day, as excessive washing can exacerbate the problem.

Additionally, don’t forget about sun protection. A broad-spectrum sunscreen, ideally labeled as oil-free, should be worn every day. Excess sun exposure can lead not only to pigmentation changes but also influence oil production in the skin.

Choosing the Right Products

Choosing the right skincare products is essential in preventing acne. Ingredients play a significant role; look for products that contain salicylic acid or benzoyl peroxide, as they are known to combat acne effectively.

However, your skin type matters too. Individuals with oily skin may benefit from gel-based products, while those with dry skin should lean toward creams or oils that soothe and hydrate. An important tip is to always read labels. Ingredients like sulfates and alcohol can worsen acne, so it’s best to keep them at bay.

"Choosing the right products can be a game changer in managing acne effectively. Pay attention to your skin’s needs and adjust accordingly."

Dietary Considerations

Diet can be a silent player in the realm of acne development. While the relationship between diet and acne isn't universally agreed upon, numerous studies suggest that certain foods might exacerbate breakouts.

Increasing your intake of vegetables, fruits, and whole grains can help enhance skin health. Foods high in antioxidants help fight inflammation, which is beneficial for acne-prone skin. At the same time, it might be wise to limit dairy and high-glycemic-index foods—such as white bread and sugary snacks—as they have been linked to increased acne severity in some individuals.

Also, staying hydrated is key. Drinking enough water throughout the day not only supports your overall health but also helps keeping your skin clear.

Graphical representation of treatment options for lower cheek acne

Managing Stress Levels

Stress might not be the first thing that comes to mind when thinking about acne, but it can play a large role in skin flare-ups. When stressed, the body produces more cortisol, which can lead to increased oil production and, ultimately, more breakouts.

Implementing stress management techniques can be highly effective. Simple practices like mindfulness, deep-breathing exercises, or engaging in hobbies you enjoy can help lower stress levels. Make time for socializing and participating in activities that make you feel good, this doesn’t just uplift your mood; it can also reflect positively on your skin.

Treatment Options

When it comes to tackling lower cheek acne, the array of treatment options available is quite essential. These options cater to various skin types and acne severity levels, making it possible for individuals to choose a method that aligns with their unique needs. Understanding what treatments are accessible allows for a more effective approach towards clear, healthy skin. Evaluation of the benefits and potential side effects of each method also helps people make informed decisions in their skincare journeys.

Topical Treatments

Topical treatments consist of various creams, gels, and lotions applied directly to the skin. These can range from over-the-counter options to prescription strength solutions. One primary benefit of topical treatments is their relatively localized effect, targeting areas that need urgent attention. Products containing benzoyl peroxide or salicylic acid are particularly effective in reducing inflammation and unclogging pores.

However, it's crucial to note that while these treatments can be effective, they sometimes lead to dryness or irritation, especially if used excessively. Regular moisturization and proper usage is key here.

Oral Medications

Oral medications are a step up in the treatment hierarchy. Prescribed typically for moderate to severe cases, these may include antibiotics or hormonal medications. They work systematically, offering a broader approach to acne management. A common choice in oral treatments is doxycycline, known for its antibacterial properties.

The benefit of oral medications lies in their ability to combat internal factors driving acne, such as hormonal fluctuations. But, they’re not without drawbacks—some users experience side effects like gastrointestinal upset or changes in mood. Consulting a healthcare provider is necessary to find the optimal balance between efficacy and tolerability.

Professional Treatments

In a more intensive category, professional treatments exist as robust solutions to stubborn acne cases. These treatments, typically administered in clinical or spa settings, often deliver quicker results.

Chemical Peels

Chemical peels involve the application of a strong solution to exfoliate the skin deeply. This technique sloughs off dead skin cells and accelerates cell turnover, which can aid in reducing the appearance of acne scars and hyperpigmentation. One key characteristic is their versatility; they can be tailored to suit individual skin types and concerns.

Despite the immediate results, chemical peels come with downsides, such as potential discomfort or post-peel redness. Understanding one’s skin type and performing a patch test is wise before diving in.

Laser Therapy

Laser therapy utilizes focused laser beams to target acne. The unique feature of this method is its ability to penetrate deeper layers of skin, which can help shrink the overactive oil glands often responsible for acne. Laser treatments can also promote healing by targeting bacteria and reducing inflammation.

Although beneficial due to fewer side effects than some medications, it can be costly and require multiple sessions to achieve desired results. Balancing effectiveness and expenditure is an important consideration.

Extraction Techniques

Extraction techniques involve a trained professional physically removing comedones—those pesky blackheads and whiteheads. This method can provide immediate relief and clearer skin, making it a popular choice for those needing a quick fix. Moreover, a significant aspect is the experienced hands that guide this process, which minimizes risks of scarring when done correctly.

However, extraction may lead to temporary redness or swelling, and should not be overly relied upon. It’s best used in conjunction with other treatment methods for sustained results.

A comprehensive approach combining these treatment options, along with lifestyle adjustments, yields the best results for managing lower cheek acne effectively. Engaging with professionals can make a noteworthy difference in this journey, providing tailored solutions that promote skin health.

Lifestyle Adjustments

When dealing with lower cheek acne, it's easy to get caught up in treatments and products. However, making mindful lifestyle adjustments can create significant changes, often addressing the root of the problem. These adjustments serve not just as support for your skin but also help build a foundation for overall well-being. Let's dive deeper into how these changes can help manage and even prevent future breakouts.

Hydration and Its Importance

Staying hydrated is more than just an afterthought in skincare; it’s a cornerstone for healthy skin. Drinking enough water helps to flush out toxins from your body, which in turn may reduce the likelihood of clogged pores and breakouts on the lower cheek.

Water also maintains skin elasticity and moisture, preventing dryness that can further aggravate acne. Consider keeping track of your daily water intake. Aim for at least eight glasses, more if you live in a hotter climate or are physically active.

Additionally, incorporating hydrating foods into your diet, such as cucumbers, watermelon, and oranges, can aid in your hydration efforts while providing essential vitamins. Staying hydrated might sound mundane, but in reality, it’s a simple yet powerful adjustment toward clearer skin.

Importance of Sleep

Sleep isn’t just a luxury; it’s a necessity for your skin health. During sleep, your body undergoes repair processes that help rejuvenate not only your body but also your skin. Insufficient sleep disrupts hormone levels, often leading to increased stress hormones, which can result in more oil production and, consequently, greater chances of acne.

Aim for at least 7 to 9 hours of quality sleep each night. Creating a calming bedtime routine can help frame your sleep environment as restful. Moreover, try to keep screens away before bed to promote better rest. Simple changes in your nightly habits can influence how well your skin heals overnight, making sleep a significant player in your skincare arsenal.

Regular Exercise Routines

Exercise is the unsung hero in skincare. Getting your blood pumping does wonders for your skin, facilitating improved circulation and providing more oxygen and nutrients to skin cells. Sweating can also help expel impurities from your pores, acting as a natural detox.

When partaking in exercise, be mindful of how you manage your skin. Always cleanse your face post-workout to remove sweat, dirt, and oils that can clog pores. Consider incorporating a balanced mix of cardio and strength training. Activities like yoga could also contribute positively, not only toning your body but aiding in stress reduction—a known acne trigger.

Diagram showcasing skincare routine for preventing lower cheek acne

In summary, lifestyle adjustments such as hydration, sleep, and exercise are integral in managing lower cheek acne. These aren’t just additions to your skincare regime; they’re essential pieces of a larger picture that can lead to a healthier, clearer complexion.

"Sometimes the simplest things are the most profound."

Incorporating these practices creates a ripple effect, not only benefiting your skin but enhancing your overall health and wellness.

Psychological Impact

Lower cheek acne isn’t just a skin condition; it bears weighty emotional consequences. It can wear down one's confidence, lead to social anxiety, and shift the way Individuals perceive themselves. The connection between skin health and mental well-being is not to be taken lightly, given the pervasive influence acne can have on self-esteem and body image.

Self-esteem and Body Image

Feeling discontent with one’s appearance has a domino effect. Individuals burdened with lower cheek acne often compare themselves to flawless images projected through social media. This comparison fosters feelings of inadequacy. In fact, several studies have shown a direct correlation between persistent acne and lower self-esteem. For many, the struggle is not just about the physical symptoms but how those symptoms meld into their self-identity.

The consciousness of one’s skin often leads to avoidance behaviors. Someone might ditch social gatherings or feel compelled to wear heavier makeup to mask perceived flaws. When the mirror reflects not just acne but the story of insecurity, it becomes a challenge to manage not just skin but emotional well-being also.

The anxiety stemming from acne can trigger self-doubt.
It can lead to fixation on skin imperfections, amplifying a negative body image.
Many might feel alienated or judged, exacerbating feelings of loneliness.

Coping Mechanisms

Coping with the psychological toll of lower cheek acne is crucial for maintaining mental health. Here are some strategies that can help manage the emotional upheaval.

Open Conversations: Engaging with supportive friends or family members can alleviate the sense of isolation. Sharing personal experiences can create a network of understanding.
Realistic Expectations: Recognizing that no one is perfect helps to reframe thoughts. It's important to see that everyone has their battles, even if they aren’t always visible.
Mindfulness Activities: Techniques such as meditation or yoga can aid in managing anxiety. They allow for a focus on the present, redirecting thoughts away from worries about appearance.
Professional Help: Sometimes, consulting a psychologist or counselor can provide tools to reshape negative thoughts. Professional guidance often equips individuals with coping strategies tailored to their specific needs.
Journaling: Documenting feelings and thoughts can serve as a therapeutic outlet. Writing down concerns not only releases pent-up emotions but can also help in recognizing patterns or triggers over time.

In summary, while lower cheek acne can create a mental toll, finding effective coping strategies can help mitigate these challenges. By fostering a healthy dialogue about appearance and accepting imperfections as part of the human experience, individuals can begin to navigate their emotional journeys with increased resilience.

Consultation with Professionals

Addressing lower cheek acne often requires more than just a home skincare routine or over-the-counter products. Consulting with professionals can be key to not only understanding the underlying causes but also to devising a comprehensive treatment strategy. Skincare experts, dermatologists, and cosmetic practitioners possess specialized knowledge that can guide individuals towards effective treatments tailored to their specific skin type and the nature of their acne.

These consultations bring a wealth of benefits. For one, professionals can provide a diagnosis that helps identify whether the acne is caused by hormonal imbalances, dietary issues, or other factors. Armed with this information, a tailored treatment plan can be developed, increasing the chances of achieving clear and healthy skin.

Consideration of various factors—such as lifestyle, previous treatments, and personal skin history—can play a significant role in recovery. Therefore, seeking out an expert is crucial in creating a cohesive strategy that addresses the multifaceted issues of lower cheek acne. It’s not just about treating the symptoms; it’s about uncovering the causes and crafting an ongoing plan for skin health.

When to Seek Help

Recognizing the right moment to seek professional help is important. Below are key indicators:

Persistent Breakouts: If lower cheek acne remains despite consistent use of over-the-counter treatments for over two months, professional help may be necessary.
Severe Inflammation: Red and painful breakouts, which might suggest inflammatory acne, should be evaluated by a dermatologist as they may need advanced treatments.
Cystic Acne Formation: If the acne appears large, painful, or forms into cysts, seeking help promptly can prevent further skin damage.
Emotional Distress: If acne is affecting your mental well-being or self-esteem, consulting a specialist can provide both treatment and emotional support.

Understanding these signs can put individuals on the path toward improved skin condition faster.

Choosing the Right Practitioner

Finding the right practitioner is as crucial as seeking help in the first place. With so many options available, here are some tips to consider when selecting a professional:

Scope of Specialization: Look for practitioners who specialize in acne treatments. Their focused experience can result in more effective care.
Credentials and Experience: Ensure the individual is board-certified and has a solid track record. Experienced dermatologists often understand various skin types and conditions better.
Consultation Techniques: A good practitioner should take time to assess your skin thoroughly and listen to your concerns. Their approach should feel collaborative, not hurried.
Reviews and Referrals: Checking online reviews or seeking recommendations from trusted sources can provide insight into a practitioner’s efficacy and approach.
Accessibility: Consider the location, availability, and whether the practitioner’s office feels welcoming—this will play a significant role in your ongoing treatment journey.

In short, choosing the right professional can enhance the entire skincare experience, leading to significant improvements in treating lower cheek acne. Don't underestimate the difference that professional guidance can bring to achieving clearer skin.

Culmination

In wrapping up our discussion on lower cheek acne, it’s essential to underscore the significance of understanding this specific skin condition. This conclusion aims to crystallize the points explored throughout the article while also highlighting the journey from awareness to action.

Lower cheek acne presents unique challenges, given its location and the social perceptions associated with skin blemishes. By recognizing the many factors contributing to acne in this area—including hormonal fluctuations, environmental elements, and lifestyle choices—individuals can better navigate their skincare journeys. This awareness is empowering; it enables one to take a comprehensive approach rather than relying solely on superficial treatments.

The benefits of managing lower cheek acne extend beyond skin health. Clear skin can positively impact self-esteem and confidence, fostering a sense of well-being in both personal and social contexts. It’s a multifaceted endeavor, involving consistent skincare routines, mindful dietary adjustments, and perhaps professional consultations.

Moreover, it’s crucial not to overlook the role of patience in acne management. Skin often requires time to respond to treatments, and it’s vital to approach care with a long-term mindset.

"Understanding the 'why' behind your acne can be just as important as treating it."

Ultimately, while the journey may be fraught with challenges, the road to clearer skin is attainable through informed choices and persistent effort. Embrace the learning process, gather the necessary tools, and take charge of your skincare regimen for tangible results.

Summary of Key Points

Let's recap the pivotal points concerning lower cheek acne:

Location Significance: The lower cheek is often a hotspot for acne due to various internal and external factors.
Causes of Acne: Knowledge of hormonal influences, dietary impacts, and environmental triggers is foundational.
Types of Acne: Distinguishing between comedonal, inflammatory, and cystic acne helps in choosing appropriate treatments.
Prevention and Treatment: A well-rounded approach includes preventive measures and diverse treatment options, both professional and at-home.
Psychological Impact: Acknowledging the emotional aspects tied to acne can aid in navigating self-esteem issues.
Professional Help: Knowing when to consult a practitioner is critical for effective management.

Encouragement for Ongoing Care

Taking care of your skin is not only an act of self-love but also a continuous commitment to your health and well-being. As we have discussed throughout this article, the management of lower cheek acne requires consistent attention and adaptability. Here are some key encouragements:

Stick to Your Routine: Consistency is key in skincare—find a routine that works and stick with it. Regular cleansing, moisturizing, and treatment application can wield significant results over time.
Stay Educated: The world of skincare is always evolving. Keep yourself informed about new products, research, and methods that can aid in skin health.
Listen to Your Skin: Pay attention to how your skin reacts to different products. What works for one individual may not work for another, so adjust your regimen based on your personal experiences.
Seek Support: Joining online forums or communities—like Reddit—can provide additional insights and moral support. Engaging with others experiencing similar issues can offer both motivation and practical advice.
Be Patient and Kind to Yourself: The journey towards clear skin can be long. Celebrate small victories and don’t be too hard on yourself during setbacks.

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