From forehead breakouts to chin pimples: Dermatologist explains what your acne patterns may reveal about your skin

Forehead acne, cheek breakouts, or chin pimples: a dermatologist explains the common triggers behind different acne patterns.

The location of acne can offer useful clinical clues, but it should not be confused with the popular concept of face mapping, which attributes breakouts in specific facial regions to problems with particular internal organs. In an interview with HT Lifestyle, Dr Akanksha Sanghvi, dermatologist and founder of Oprava Aesthetics, explains the common triggers behind the acne patterns.

“There is no robust scientific evidence that a pimple on the forehead indicates a liver disorder, that cheek acne reflects a digestive problem, or that acne in a particular facial zone can independently identify an internal disease. However, acne distribution is clinically relevant,” said Dr Sanghvi.

Acne predominantly affecting the forehead and hairline is often influenced by occlusion. (Pexel)

Forehead acne

According to Dr Sanghvi, acne predominantly affecting the forehead and hairline is often influenced by occlusion. Hair oils, leave-in conditioners, pomades, waxes, styling products and dry shampoos can come into contact with the forehead and contribute to follicular blockage. Sweat, helmets, caps, and prolonged occlusion may further aggravate the problem. This pattern is sometimes referred to as acne cosmetica or pomade acne. However, small, relatively uniform and itchy bumps along the forehead may represent Malassezia folliculitis rather than conventional acne.

Jawline and chin acne

“Acne affecting the chin, jawline and lower face is commonly associated with hormonal influences, particularly in adult women,” highlighted Dr Sanghvi. The pattern may become more pronounced in the premenstrual period or during other periods of hormonal fluctuation like perimenopause. Increased androgen activity can stimulate sebaceous glands and contribute to increased sebum production, follicular plugging, and inflammation.

Polyendocrine Metabolic Ovarian Syndrome (PMOS)

“Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a complex endocrine and metabolic condition that can present with acne as one of its clinical features,” said Dr Sanghvi. Acne may occur alongside irregular menstrual cycles, excess facial or body hair, scalp hair thinning, weight or metabolic changes, and other signs of hormonal imbalance. However, acne by itself does not indicate PMOS. A proper diagnosis requires assessment of the overall clinical picture, supported by appropriate hormonal and metabolic evaluation.

Perioral Dermatitis

Papules around the mouth are not always acne. Perioral dermatitis commonly presents with small inflammatory bumps around the mouth and may extend towards the nose or eyes. Burning, dryness, and increased sensitivity can accompany the eruption. A common mistake is to repeatedly apply exfoliating acids, benzoyl peroxide or other acne treatments to the area. Another important issue is the unsupervised use of topical corticosteroids on the face. Although steroids may initially suppress redness and inflammation, they can aggravate or perpetuate perioral dermatitis.

Papules around the mouth are not always acne. (Pexel)

Acne rosacea

The nose and central face contain a high density of sebaceous glands and therefore naturally tend to produce more sebum. Rosacea typically causes persistent facial redness, flushing, burning or sensitivity, with small inflammatory papules and pustules but usually without blackheads or whiteheads. It can be aggravated by heat, sunlight, spicy foods, alcohol and irritating skincare products. Ingredients such as metronidazole, azelaic acid and barrier moisturisers can be helpful, while persistent or recurrent rosacea may require prescription treatment from a dermatologist.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.