Acne is acne is acne, right? Well, sort of. It turns out that where your face acne is popping up may be especially important to treating it, because that’s one of your biggest clues as to what’s really causing it.
Regardless of where it shows up, acne is the result of pores getting clogged with an excess of oil, dirt, and dead skin. That clog becomes a comedone (more commonly known as blackheads and whiteheads). If bacteria gets into the mix, the comedone can become inflamed and become a papule (a reddish pimple) or a pustule (papules that are filled with pus and look “poppable”). And then there are the most severe forms of acne, nodular and cystic pimples, which form below the surface of the skin and are more likely to leave scars.
But there are also plenty of environmental, behavioral, and internal factors that can make you more prone to breakouts in specific regions of your face. Here, we’ll take a closer look at the major areas where face acne shows up—and what might be causing it.
Forehead acne is common in basically anyone with oily skin, Mara C. Weinstein Velez, M.D.,
dermatologist at the University of Rochester Medical Center, tells SELF. But your hairstyle can also exacerbate the issue. In particular, Dr. Weinstein says she’s seen patients who feel self-conscious about their skin in this area and get bangs to cover it up. But that only makes matters worse, since bangs will trap dirt, oil, and hair products in the area.
Forehead breakouts can also be caused by yeast that falls from the scalp and gets trapped in the pores along the hairline when excess sweat and oil accumulate in that area. This type of fungal acne (which technically isn’t acne) probably won’t be inflamed, Dr. Weinstein says, but will make the skin on your forehead feel “bumpy and rough” instead.
Fungal acne is best treated with a sulfur-based wash known as sodium sulfacetamide, which is available with a prescription, Dr. Weinstein says. And, as SELF explained previously, some people have also had success treating fungal acne with drugstore dandruff shampoo, thanks to active ingredients like selenium sulfide.
To prevent forehead breakouts of any variety, try avoiding heavy hair products like pomades or styling creams, and keeping your hats clean (especially if you wear them during workouts), Katherine Baquerizo Nole, M.D., assistant professor of dermatology at the University of Cincinnati, tells SELF.
Nose breakouts tend to be on the smaller side and non-inflamed. “Big cystic lesions aren’t common on the nose,” Dr. Weinstein explains. “It’s mainly blackheads, [which] are more common in patients who have super-oily skin.” And again, she says oily skin tends to be the culprit here. There are more sebaceous glands around the nose than on other parts of the face, which makes it an especially oily place on anyone—especially those who already have oily skin at baseline.
The real trick to treating nose acne is to resist the urge to pick or squeeze your blackheads. The more you mess with the pores on your nose, the more likely they are to dilate, accumulate even more oil, dead skin, and bacteria, and get inflamed. Instead, it’s better to use gentle chemical exfoliation (look for ingredients like salicylic acid, lactic acid, or glycolic acid) to gradually and gently unclog the pores.
If those aren’t helpful, Dr. Weinstein recommends using a retinoid or seeing your derm for a chemical peel to reduce the appearance of breakouts on your nose.
And for those who wear glasses, make sure your specs aren’t too tight or resting too heavily on the bridge of your nose. As SELF previously reported, unnecessary pressure can keep your dead skin from shedding normally and wind up trapped in your pores, leading to—you guessed it—acne
“We can’t really nail down what causes acne in this area,” Dr. Weinstein says, but there are a few possible sources. In general, cheek acne usually happens thanks to genetics, or because that’s simply where your skin tends to develop acne.
However, it could also be due, at least in part, to your everyday habits. Basically anything that’s pressed against your face for an extended period of time can cause a buildup of oil, bacteria, and dead skin cells, which can ultimately result in acne, Dr. Baquerizo Nole explains. So your phone, pillows, sheets, and even your hands (if you hold or touch your face throughout the day) could be playing a role in your cheek breakouts.
Luckily, the solution to this problem is relatively straightforward: Keep all of these items clean—and avoid touching your face as much as possible during the day. This will reduce the amount of bacteria and oil introduced to the skin.
One other thing to keep in mind is that rosacea, which can cause small, red, acne-like bumps, often shows up on the cheeks. So if you’ve tried to tackle acne in this area without success, or you find that your face also looks flushed or feels sensitive frequently on the cheeks, it’s worth getting checked out by a dermatologist to see if there might be something else going on.
Ah, the dreaded acne around your mouth, chin, and jawline. Dr. Weinstein refers to acne that occurs in this region of the face as “the beard distribution,” which is most often caused by changes and fluctuations in hormone levels.
For that reason, the most common form of treatment is oral contraception, Dr. Baquerizo Nole explains. She adds that the best results have been seen with combination birth control pills, of which there are three varieties that the FDA has specifically approved for treating acne. If your dermatologist believes there may be a hormonal component to your acne, they’ll likely recommend you see your ob/gyn for a prescription.
Aside from birth control, Dr. Weinstein says spironolactone is another option for managing jawline acne. Although this medication is normally prescribed to treat high blood pressure, it also blocks the production of androgens, or male hormones, which can contribute to the development of acne along the jawline and chin.
Although this form of acne is generally hormonally driven, keeping up your other acne-prevention strategies (regularly cleansing and exfoliating, keeping your phone and pillowcases clean, etc.) can also help prevent acne in this area.
There are easy ways to make acne prevention part of your daily routine.
No matter where your acne decides to rear its head next, there are some general ways to prevent it, in addition to the more specific options mentioned above.
Keep up a basic skin-care regimen. Regularly cleansing, moisturizing, and protecting your skin from the sun will help keep your face healthy and clear of breakouts. But make sure you’re using products that are right for your skin type. If you have oily skin, opt for products that are noncomedogenic, meaning they won’t clog your pores.
Exfoliate regularly—but gently. For most people, exfoliating one to three times a week is enough to keep skin clear of buildups of dead skin cells, oil, and excess makeup or skin-care products. In general, dermatologists recommend using gentler chemical exfoliants over scrubs or brushes, but feel free to try different options and see what works for you. However, if you notice your skin feeling dry, irritated, or sensitive, take it down a notch. Those are signs that you’re exfoliating too frequently or with products that are too harsh for your skin.
Try over-the-counter medications. Cleansing and exfoliating will help tackle mild to moderate acne that’s caused by pores clogged with dirt, skin cells, and other gunk. But to fight bacteria-driven acne or more severe cases, you’ll need something else. Try benzoyl peroxide, which actually kills the bacteria, or an over-the-counter retinoid like retinol or Differin (adapalene), which will speed up the cell turnover process.
Don’t go it alone. If you’ve been trying these strategies for eight to 12 weeks and haven’t seen any progress, don’t hesitate to call in a professional. A board-certified dermatologist can help nail down the exact source of your acne and may recommend trying a prescription retinoid, hormonal birth control, spironolactone, or an in-office treatment. Although it’s common, trying to manage stubborn acne can be an intensely frustrating experience, and you don’t need to try to tackle it all on it your own.