Dermatologists consider where blemishes tend to appear when determining acne causes, contributing factors, and treatments, says He. Here’s what the location of your breakouts might mean.
Forehead and Hairline
Acne that appears around the forehead and temples at the hairline may be caused by a facial or hair product, says Dr. Hollmig.
Applying products on or near your hairline can put them in contact with your hair. “Hair clings to the product and holds it against your skin,” Hollmig says. This can clog pores, causing pimples to form. It’s especially common with products that contain oil or if you’re wearing headbands, hats, or helmets.
Identifying the product that’s causing your breakouts (and discontinuing use or switching to a different product) will help clear the area around your hairline, Hollmig says. In addition, wash your hair regularly, use oil-free products, and wash headbands and hats.
T-Zone: Forehead, Nose, and Chin
Acne that shows up on the forehead, nose, and chin (also known as the “T-zone”) may be comedonal acne — or whiteheads and blackheads, says Hollmig. Comedonal acne occurs when pores become clogged with oil, bacteria, and dead skin cells. The T-zone is a hotspot for comedonal acne because these areas have larger pores and sebaceous glands (organs in the skin that release oil).
Comedonal acne is best targeted by treatments that unclog your pores, such as a topical retinoid, Hollmig says.
Around the Mouth and Nose
Bumps and redness that form around your mouth or corners of your nose are sometimes mistaken for acne, but are usually perioral dermatitis, says Hollmig. Perioral dermatitis is a red rash that develops when you apply a product that irritates your skin, such as toothpaste. In addition, perioral dermatitis often develops when a corticosteroid medicine (a topical treatment for inflammatory skin conditions) sits on your skin for too long.
Treatment options for this acne-like rash include taking oral antibiotics and using gentle, fragrance-free skin products.
Cheeks
If acne tends to show up on your cheeks, consider what touches your face on a daily basis. “I’d ask patients about potentially placing dirty pillowcases, makeup brushes, or cell phones against their skin,” says He. Regularly used items like these can transfer bacteria to your skin, causing acne to develop and spread. (Research links cell phone use to cheek acne.)
Identifying and eliminating the item(s) that trigger cheek acne can help your skin heal naturally, says He.
Sometimes, acne on the cheeks isn’t acne at all — it’s rosacea, a chronic inflammatory skin condition. Rosacea often appears as red acne-like bumps that appear on your cheeks and nose. That’s another reason to ask a dermatologist to diagnose your skin condition.
Jawline
Jawline acne is often caused by hormonal changes, says He. Hormonal changes — such as those that occur during menopause, pregnancy, the menstrual cycle, puberty, and more — can cause the oil glands in your skin to go into overdrive. This causes the glands to pump out more oil that clogs pores and causes acne.
Depending on the type of acne (such as whiteheads, nodules, cysts, or pustules), jawline acne can be treated with over-the-counter (OTC) or prescription topicals like tretinoin, antibiotics, or benzoyl peroxide or a prescription oral retinoid medication .
Females with jawline acne can also be treated with hormonal birth control or spironolactone. Spironolactone is a diuretic (water pill) traditionally prescribed for high blood pressure (hypertension) but it can also be used to treat hormonal acne in women when other options are ineffective. But spironolactone must be taken with birth control because of the risk of birth defects.
Back
While not part of the face, the back is another hot spot for acne. Like other forms of acne, back acne (“bacne”) appears when your skin gets clogged with dirt, dead skin cells, and sebum. But acne on the back is often a symptom of backpacks or sweaty clothing that traps sweat against the skin, using unclean sheets or towels, or having dirty hair that rubs against the back.
Topical OTC acne treatments can help clear mild and moderate back breakouts. Showering and changing into clean clothes after sweating, and using clean linens can also help treat and prevent back acne.
See a dermatologist if back acne doesn’t improve in six to eight weeks or your blemishes are deep and tender. Your dermatologist may recommend prescription topical or oral acne treatments.
