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I think a lot of it has to do with hormone levels. Some months, days, weeks, or whatever we are suppressed well, and others we are having a flare up (as you could call it). My doctor always told my mother that if I was showing signs of acne, it meant that I was undersuppressed and needed to take my blood levels again. I think it all just depends on her hormone levels and how they are being dealt with. At 6 years old, I wouldn't necessarily call it the fact that she is going through puberty. I hope that you figure things out and good luck with it.
