If your breakouts always appear in the same spots, your skin may be trying to tell you something.
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“Acne is common, so it seems like it should be easy to treat,” says dermatologist Amy Kassouf, MD, “but so many factors play into it, including genetics, hormones and the natural flora, or healthy bacteria, of your skin.”
One clue as to what’s going on? Location, location, location.
Acne location and what it means
A zit or two here and there may be coincidental or genetic. But if you continually have acne on the same parts of your face, your breakouts may be linked to a deeper issue. This is sometimes known as acne face mapping.
“Where on your face you have acne can help determine how to treat it,” Dr. Kassouf says. “Most dermatologists don’t physically ‘map’ people, but we do recognize various zones of the face to help us figure out what’s going to work best for our patients.”
Keep reading to learn more about common places for facial acne and what they mean — plus, how you can keep future breakouts at bay.
Forehead and nose
If you’ve ever read a beauty blog or magazine, you know about the T-zone, the T-shaped area across your forehead and down your nose. It’s a prime locale for classic blackheads and whiteheads because this area tends to have bigger pores and sebaceous glands than other parts of your face.
This type of acne is called comedonal acne. “Blackheads are open comedones, where the air can get to the sebum and dead skin cells in the pores, which oxidizes and turns them black,” Dr. Kassouf explains. “With whiteheads, the pore is still sealed, and the dead skin cells and the sebum don’t see the air, so they stay naturally white.”
Treatment options for acne on your forehead and nose
Treating your T-zone acne is all about unclogging those pores. “When it comes to comedones, we turn to medicines that help those skin cells come out of the pores and turn over,” Dr. Kassouf says.
- Salicylic acid: Available in lots of over-the-counter (OTC) products, this ingredient helps break up dead skin cells and clear out pores.
- Benzoyl peroxide: Another easy-to-find ingredient in OTC acne creams, this also helps clear plugged pores and dry out acne. But it can interact with some other topical acne treatments, so don’t mix and match without talking to a doctor.
- Retinoids: “Retinoids like adapalene help with cellular turnover, which makes them effective acne fighters,” Dr. Kassouf says, “but they tend to work better as long-term maintenance than short-term spot treatments.” Topical retinoid creams and lotions are available in prescription and OTC strength.
Chin and jawline
Acne in these two locations can often be blamed on an age-old culprit: hormones.
Teens assigned male at birth (AMAB) often get acne along the jawline during growth spurts, while people assigned female at birth (AFAB) of all ages may see their chins erupt during their menstrual cycles as hormones ebb and flow.
“Acne here is likely to be deeper, bigger and more inflamed than acne elsewhere on the face,” Dr. Kassouf says. Ouch!
Treatment options for chin and jawline acne
Hormonal acne can be tricky to treat because, well, hormones themselves often present a complex puzzle. But Dr. Kassouf says medications and topical treatments can tackle the hormonal component of acne and help clear things up.
- Hormonal birth control: If you’re prone to period-related pimples, going on birth control pills may help get your acne under control. But some types can actually make breakouts worse, so ask your doctor about one that helps, not hurts.
- Retinoids: This superstar acne fighter, derived from vitamin A, can help ward off hormonal acne. “They make dead skin cells a little bit less sticky so they come out of the pores and turn over,” Dr. Kassouf explains.
- Sulfur: Topical treatments containing sulfur can help reduce the inflammation of deep acne. They’re available in over-the-counter and prescription varieties.
Unlike breakouts on your chin or T-zone, spots on your cheeks don’t reveal much about the underlying cause. “Cheeks don’t tell us much,” Dr. Kassouf admits.
Acne here could be genetic, or it could be a fluke. It could also be caused by contact with bacteria: Think dirty makeup brushes, a germ-ridden cell phone or unwashed pillowcases.
Treatment options for acne on cheeks
“The skin on your cheeks tends to get dry and irritated more easily than the skin on the rest of your face, so don’t go overboard with acne treatments,” Dr. Kassouf cautions.
You can treat cheeks with the same products you use elsewhere, including salicylic acid, benzoyl peroxide and retinoids. But instead of applying it daily, go for every other day on your cheeks. You’ll still get the benefits without the irritation.
To try to prevent cheek acne, keep things clean, from your hair to your bedding to, yes, that cell phone you probably never think to clean. Did you know that your cell phone can harbor more germs than a toilet seat?
If you’re only seeing pimples along your hairline, you may not be experiencing standard T-zone acne. These zits can actually be caused by hair products, like mousse or dry shampoo. “Hair products tend to be very waxy and can build up at the hairline and cause flare-ups,” Dr. Kassouf explains.
Treatment options for acne along your hairline
If you suspect your favorite hair product is to blame, focus it on the ends of your tresses and steer clear of your scalp. Or try switching to a different product to see if fares better for your face.
Ways to prevent acne on your face
Always try to resist the temptation to pop a pimple, which can damage your skin if it’s done incorrectly. If you have a zit that has come to a head and started to weep on its own, you can put a pimple patch atop it to try to speed up its healing.
But how can you keep breakouts from happening to begin with? Dr. Kassouf shares general skin care tips that can help fend them off going forward.
- Stay clean: Wash your face once a day with a gentle cleanser. “Sometimes, all you need is a good washing routine,” Dr. Kassouf notes.
- Favor foam: She recommends foaming cleansers rather than lotion cleansers because the suds are better at lifting oils and dirt from your skin.
- Exfoliate with care: If you scrub too aggressively, you might irritate your skin and make acne worse. “A little bit is good. A lot is not better,” Dr. Kassouf says. Use exfoliating brushes or scrubs once or twice a week at most, and if they cause irritation, back off.
- Wash your makeup brushes: They can easily become gunked up with bacteria and oils, which contributes to plugged-up pores. Try shampooing them every week or two with a gentle, fragrance-free shampoo.
- Adapt your diet: Lactose and sugar have both been found to stimulate acne in some people, so if you’re struggling to keep your skin clear, take note. “Lowering your dairy intake and watching your simple sugars can be preventive,” Dr. Kassouf says.
We all have to take our lumps sometimes. But if you can read the clues in your breakouts, hopefully, those lumps will be few and far between.