What Is Causing My Acne?

By Savannah Koplon

For many, pesky pimples and more severe acne breakouts can be unsightly or cause embarrassment. Some people have breakouts consistently on their cheeks. Others have breakouts confined only to their chin, and some have pimples across their entire face. But is there rhyme or reason for where acne is present?

“There is little scientific evidence to support the theories that the distribution of acne on the face can indicate internal health problems,” says Lauren Kole, M.D., dermatologist at the University of Alabama at Birmingham Cosmetic Dermatology Clinic. “However, the location of acne can give clues as to what may be contributing to the patient’s acne.”

According to Kole, acne presenting in the following areas can have some indicators for what may be the root cause of the pimple, ranging in part from hormone overload to potentially dirty cellphones.

Chin: hormonal acne

Acne around the mouth and along the jawline is commonly seen in adult female acne, which is at least somewhat hormonally driven. These patients may have excess male hormones (androgens) in the skin.

Cheeks: cosmetic product usage

Acne on the cheeks may be related to cosmetic products. Women with “acne cosmetica” may have small bumps on their cheeks, chin and forehead. Acne on the cheeks may also be linked to exposure to a dirty phone or pillowcase or other habits such as frequently touching one’s face.

Acne on the forehead may be linked to hair care products.

Forehead: hair product usage

Acne on the forehead may be linked to hair care products. Moisturizing or oil-based hair care products can clog the pores and cause “pomade acne” along the hairline and forehead.

Nose: oily skin

Acne on the nose or in one’s “T-zone” (forehead down through nose) in general may be linked to excess oil production.

Acne on the chest or back may be an indicator that a person is not showering immediately after exercising or properly cleaning their workout clothes — even wearing damp workout clothes too long.

Once pimples start appearing, the question that most people want answered is how to get rid of acne — and fast.

“We tailor treatments based on the patient’s sex, age and how the acne presents,” Kole says. “I counsel patients on lifestyle changes that can help improve their acne. I definitely choose different therapies if I believe the patient’s acne is hormonally mediated versus if it’s changing a hair product or swapping out pillowcases regularly.”

Breakouts are common, and knowing what causes them may help patients with treatment.

But tried and true tips from Kole that all people with acne can adopt are never pop pimples and do not touch your face.

Other tips from Kole and the American Academy of Dermatology include:

Wash your face twice a day and after sweating. “Perspiration, especially when wearing a hat or helmet, can make acne worse, so wash your skin as soon as possible after sweating.”

Use your fingertips to apply a gentle, non-abrasive cleanser. Kole says that using a washcloth, mesh sponge or anything else tough can irritate the skin. “Scrubbing your skin can make acne worse. Avoid the temptation to scrub.”

Be gentle with your skin; use gentle products such as those that are alcohol-free. Do not use products that irritate your skin. These products may include astringents, toners and exfoliants. Dry, red skin makes acne appear worse.

Rinse face with lukewarm water; hot water can irritate existing acne and strip the skin of its natural oils and moisture.

Shampoo hair regularly. If you have oily hair, it is recommended that you shampoo daily.

Let your skin heal naturally. “If you pick, pop or squeeze your acne, your skin will take longer to clear, and you increase the risk of getting acne scars.”

Keep your hands off your face. Touching your skin throughout the day can cause flare-ups.

Stay out of the sun and tanning beds, as tanning can damage skin further. In addition, some acne medications make the skin very sensitive to ultraviolet (UV) light, which you get from both the sun and indoor tanning devices.

At what point should a person with acne seek the counsel of a dermatologist? The American Academy of Dermatologists suggests that, even if you do not have severe acne, a dermatologist can help customize a treatment plan for a person’s individual acne.