Why You're Breaking Out — and How to Banish Blemishes in Your Trouble Spots

What is your breakout telling you? Find out how genetics, diet and lifestyle habits, and other factors can contribute to acne, and how to attain clearer skin.

Acne isn't a sign of "dirty" skin. In fact, various factors, like genetics, hormones, and even diet may play a role in causing breakouts.Susana Ramirez/Stocksy

Let’s face it: There’s never a “better” place on your skin to have acne. Breakouts are always inconvenient — and they always show up when you least expect them, such as before a big job interview, a presentation at work, or a promising date.

It's clear that acne can take both a physical and an emotional toll. According to a study published in the September–October 2016 issue of the Indian Journal of Dermatology, acne may negatively affect your personal relationships, your job or schooling, and even daily tasks like grocery shopping and tidying your home.

Severe acne requires treatment from a dermatologist, notes the American Academy of Dermatology (AAD), but for less-frequent and less-severe acne, the location of your breakouts can give you a hint about what caused them and how you can ward them off.

We tapped dermatologists to get the breakdown on breakouts.

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What Is the Scientific Definition of Acne?

Pimples, blackheads, whiteheads, pustules — call them what you will. Put simply, they all arise from inflammation. “Acne is a chronic inflammatory condition in the skin caused by a combination of silky skin cells within your pores that block oil, promote bacterial growth, and lead to inflammation,” says Joshua Zeichner, MD, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City.

Why Is Acne Appearing on My Skin? 

No, acne isn't the result of "dirty" skin, notes TeensHealth.

In fact, according to MedlinePlus, the exact cause of acne isn't known. “Hormonal fluctuations, diet, cosmetic use, and stress can all lead to acne breakouts," Dr. Zeichner says.

Family history also plays a role. “The number one reason someone has acne is because of genetics,” says Amy Wechsler, MD, a dermatologist in private practice in New York City and the author of The Mind-Beauty Connection. “There’s a lot of randomness to acne and its pattern.”

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How to Prevent and Treat Acne by Problem Area

While it’s impossible to pinpoint the exact reason why you’re breaking out, there are some clues that can help you determine what’s behind your breakouts — and how you can get rid of them.

1. Chin, Jawline, and Neck Acne

“Hormonal acne tends to live in the lower part of the face — the chin, jawline, and neck — and it tends to be more cystic rather than little blackheads or whiteheads,” Dr. Wechsler says. In this case, “hormonal” doesn’t mean “teenage.” “Acne in adult women tends to occur on the lower third of the face, jawline, and neck, and around the mouth,” Zeichner says.

What to Do

Develop a skin-care routine. “Stress leads to hormonal surges that rev up your oil production,” Zeichner says. “If you’re approaching a deadline or a test at school, you may notice a breakout in the areas of your face that tend to have the highest concentration of oil glands — notably your T-zone, including the forehead, nose, and chin.” Taking care of yourself and having a skin-care routine can help you regain some control. “For most people, that means a gentle cleanser, possibly a toner, and a moisturizer with sunscreen in the morning,” Wechsler says.

Try acne medication. When it comes to treating acne, over-the-counter products can help. “Look for products that contain ingredients such as benzoyl peroxide and salicylic acid, which kill acne-causing bacteria,” Zeichner says.

“The full face should be treated to get rid of pimples that you see and to prevent new ones from popping up in other areas,” he says. “If you tend to have mostly red, angry pimples, try benzoyl peroxide. If you tend to have more blackheads and whiteheads, go for salicylic acid, which can help open up pores and remove excess oil from the skin. If you have a combination skin, use both for optimal results.”

Just make sure not to layer too many products at once. Benzoyl peroxide is very drying (and can also stain your pillowcase and towels), so you may want to consider pairing it with a moisturizer. “Be mindful: If you keep buying products but you’re getting worse, not better, it could be that you’re getting irritated by the products,” Wechsler says.

Do you suffer from hormonal acne? Make an appointment with a dermatologist, who may prescribe hormonal treatments like oral contraceptive pills and spironolactone, Zeichner says. Topically, prescription dapsone has been shown to be particularly effective in adult women, he says.

2. Hairline Acne

Acne along the periphery of your face — particularly around the crown of your head — could be a product of styling gels and mousses blocking the pores around your face. “Hairline acne could certainly be from a hair product, sweating, or hair oils,” Wechsler says.

What to Do

Don’t overdo the makeup. Concealer and foundation might help cover up pimples, but they don’t always help them heal. “Some people buy concealer to cover up their acne, not knowing it’s going to make it worse,” Wechsler says. Instead of grabbing whatever’s on sale, she recommends making sure that everything that goes on your face is noncomedogenic, meaning that it won’t clog pores and cause pimples.

According to the AAD, these products are often labeled as such, or they may include a label that says "won't clog pores." The AAD also advises against sharing makeup, makeup brushes, and makeup applicators, as these habits can increase your risk for breakouts, too.

And if you're going to wear makeup, be sure to wash it off before bed. Don't scrub the makeup away with cleanser and water, but rather gently wash it away. If that doesn't work, try using an oil-free makeup remover to take off the rest of the product, advises the AAD.

Say yes to sunscreen. “There’s a myth that acne gets dried up in the sun, but what happens is a delayed onset,” Wechsler says. “You might notice your skin is better for a couple of days after you’re out in the sun, but a few days later it will get worse.” Plus, the sun interferes with your immune system’s ability to fight acne, she says.

Not to mention that limiting sun exposure can help reduce your risk of skin cancer, notes the Skin Cancer Foundation. The Vitamin D Council says your vitamin D needs can vary based on factors like where you live, your ethnicity, and the time of year. Talk to your healthcare team to find out how much sun exposure you need to get an ample amount of the sunshine vitamin.

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3. Body Acne

When it comes to body acne, your clothing could be the culprit — especially if you sit in sweaty gear. “For example, female lacrosse players wear goggles that they sweat under, so sometimes they’ll get acne under the goggle line,” Wechsler says.

In football and lacrosse players, she also notices chin-strap acne. “If you’re sweating under something on your face, head, neck, or body — or hanging out in sweaty clothing or equipment — that can be a problem for sure,” she says.

What to Do

Keep a face towel on hand. Before you dry off after showering, think of using different towels for your body and head. “Have a towel in your bathroom that’s just dedicated to drying your face, so you’re not using a towel on your face that has hair oils on it,” Wechsler says.

Wear the right gym attire. There’s no specific reason for chest or back acne (“backne”), but some workout clothes can make body acne worse. When it comes to butt acne, underwear choice could be to blame. “A lot of women work out in a thong and Lycra bike shorts or spandex pants,” Wechsler says. “All of these materials are made to wick the sweat off your skin, but they don’t breathe very well and tend to hold moisture in, too.” Her solution: Wear full-coverage bikini-cut underwear or boy shorts (opt for cotton when possible) and take off your workout clothes as soon as your sweat session is done.

Keep your skin-care products handy. That's especially true if you're headed somewhere after the gym, or if you're handling oily or greasy food while also sweating at work. TeensHealth recommends washing any acne-prone areas of your body ASAP after your sweat session at the gym or work.

Clean your cell phone. “If you tend to break out on your cheeks only, make sure that you clean your cell phone often,” Zeichner says. “They’re a breeding ground for dirt, oil, and bacteria, which can lead to breakouts when coming into contact with your face on a regular basis.”

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Why There's No One-Size-Fits-All Solution for Taming Acne Trouble Spots

Ultimately, your dermatologist can help you determine what may be triggering your breakouts and how to best treat them. Sometimes blemishes are out of your control, but take comfort in knowing that tweaking some of your daily habits can go a long way to helping you keep your complexion clear.

Additional reporting by Melinda Carstensen.