Kitty acne? Or something else?

I need some advice. I think my 7 year old cat has acne. I've noticed black specks on his fur and skin under his chin. I believe these are specks of dried blood from irritation from the acne. I use ceramic bowls that are washed in hot water before  every use.  I'm fairly certain it's not flea dirt but not positive; he never scratches himself and I've not seen the black specks anywhere else on his fur. He will let me touch the area under his chin and wash it with a vet approved mild soap which is impressive since he gets hissy very quickly and easily. I'm very willing to take him to the vet, however he is an extremely aggressive kitty that requires a high dose of medicine to sedate him for examination. 

So I have two questions: what could these black specks be? Could his ailment be worth the trauma of heavy sedation (which has its own significant risks)

Any help would be appreciated!!  My little kitty means everything to me!!

It could be flea dirt.  You could get a spot treatment from the vet and apply it and see if that helps.  That would save the trauma of a vet visit if it works.  It could also be acne.  I have a kitty who gets chin acne when she's stressed.  Just like you we use ceramic or stainless steel bowls and wash in soapy water prior to each use.  The only thing I can think of is that perhaps there's a hairline crack in the ceramic finish of the bowl and that might be breeding bacteria.