Understanding Where You Get Acne and What It Means

Face mapping, or mien shang¹, originated in East Asia and dates back over 3,000 years. It is based on the belief that areas of your face are directly related to different parts of your body and personality.

In a similar way, mapping acne in different locations on the face and other areas of the body may help us to understand what is causing our acne. However, it isn’t quite as simple as the result of a health issue with a related organ or body system.

Researchers have studied the theories around face mapping and found there is little to no proof of the location of acne being linked to an issue with the body’s organs and systems.² As dermatologists Dr. Elyse Love and Dr. Joshua Zeichner told Business Insider, “This is not like reading your palm. Unfortunately, there’s no definitive way of mapping the cause of your acne based on where it’s developing.”

Having said that, doctors and dermatologists do look at where you get acne and use it as a starting point to finding the root of the problem. Where you get pimples can give some clues as to what might be contributing to the breakout and how it could best be prevented or treated. However, the type of acne is important too.

Before we delve into the nitty-gritty, let’s recap. Regardless of where on the body the acne occurs, key causes include:

• Oil production

• Blocked hair follicles

• Bacteria growth

• Inflammation³

Certain environmental factors like sweat, hormones, diet, and lifestyle can lead to the imbalance of one of these factors, causing bacteria to grow, which leads to inflammation and pimples.

However, acne in certain places may also have a cause that is specific to that area. Here’s what you need to know.

Acne around the hairline or on the forehead

Acne along the hairline typically presents as little bumps or whiteheads close together. It can also present as pimples along the top of the neck in people with longer hair.

Hair products like shampoo, conditioner, styling products, and treatments often contain oils that can block the hair follicles and cause pimples. Some hair products can be especially waxy and build up around the hairline. In the 1970s, acne caused by long-term use of oils and hair products was referred to as “pomade acne”.⁴

This doesn’t mean you can never wear your favorite hair product again. Try to keep the product at the ends of your hair rather than the scalp so it sits away from the skin. Bangs or a fringe hanging over the face and hair that isn’t regularly washed are other factors to watch out for as they bring oils closer to the skin. It might also be worthwhile considering buying hair and face products that are non-comedogenic (non-clogging).

Have you noticed you get hairline acne more in summer or winter? When you wear hats or beanies, bandanas, helmets, or sweatbands, particularly when exercising, sweat, skin cells, and oils can be trapped against your skin and cause a buildup where pimples can form. Luckily, there’s an easy fix: Keep anything you wear on your head clean and give the skin a chance to breathe whenever possible.

Acne around the T-zone

The T-zone is such a common place for people to get acne that skincare products are designed specially to manage it.

The T-zone extends from the forehead down the nose to the chin. These parts of the face have densely populated areas of oil glands which means they are more likely to break out with pimples. T-zone acne is more common in adults than in younger people.⁵ Pimples here are also thought to be exacerbated by stress and reduced sleep.⁶

Acne around the U-zone

The U-zone covers both of the cheeks and extends around the jaw. Unfortunately, there isn’t much research to tell us why we get acne on the cheeks.

A study conducted on 914 people with acne found spots that occurred on the cheeks were more likely to be inflamed than in other areas of the face.⁵ The same study also found younger people with acne were more likely to be affected in the U-zone than older people.

When it comes to acne on your cheeks, consider environmental causes. Bacteria can build up on:

• Pillowcases or bedsheets

• Dirty cell phones

• Face masks

• Your fingers, which may frequently touch your face

Regularly wipe down phones and other potential vehicles for bacteria and clean your bed sheets every week.

Acne which forms on the cheeks, chin, or forehead may also result from using cosmetic products which contain oil. This type of acne is called acne cosmetica and typically presents as tiny bumps on the face.⁷

Oil-free makeup is designed not to clog pores and could be a good choice if you think makeup may be causing your acne. Washing off your makeup before getting into bed is also important — even when it’s the last thing you feel like doing at the end of a long day.

Acne on the chin and jawline

According to researchers, it is a well-known fact that acne on the bottom third of the face, forming a U-shape around the jawline, is likely to be caused by hormones.⁸ The jawline and chin area are sensitive to hormonal changes. Therefore, people going through puberty can often be affected there, and females at different stages of their menstrual cycle.

Studies show that 39%–85% of adult women experience worsening acne in the days leading up to their period.⁹ Androgens are the main hormones responsible as they control the amount of oil released from the skin, leading to clogged pores.⁸

Acne on the back

Also known informally as “bacne”, acne on the back is often triggered by hormonal changes causing an excess in oil production. Dead skin builds up and pimples can form. In this way, it is basically the same as facial acne.

Body acne can also be triggered by sweat. Not changing out of sweaty clothes can lead to a buildup of bacteria and clog the pores.

Tight-fitting exercise gear could be the culprit. As the clothing rubs against your skin, it can push the oils and bacteria deeper into your skin follicles. Acne related to friction and increased pressure on the skin is called acne mechanica.¹⁰ This is often seen in athletes. Other sports gear that could contribute to back acne includes the driver’s seat of a race car, a backpack, and synthetic clothing. 

If you are susceptible to back acne and are active or sweat often, try purchasing looser-fitting, moisture-wicking sports clothing, and shower relatively quickly after exercise or sweating.

Another consideration when it comes to back acne is keeping your sheets clean. Dead skin cells and bacteria can build up on unwashed bedsheets.

Acne on the chest

Chest acne, particularly in the summer when sunscreen, sweat, and humid weather are at an all-time high, can be particularly irritating. Chest acne is commonly passed down through genes or results from hormonal changes.¹¹

Similar to the back, the chest is also susceptible to acne from tight clothing pushing sweat and bacteria into the skin.

As Dr. Arathi Rana of U.S. Dermatology Partners points out, “Because the area is usually covered, trapping sweat and oil on the skin, it can be difficult to treat.”¹²

Using an acne-specific body wash each time you shower or bathe can help remove excess oils and skin cells.

The lowdown

Acne can be found almost anywhere on the body. The face and upper part of the body have many oil-producing glands, making these areas susceptible to acne.

While we know that genetics and hormonal changes are major causes of acne, it can be helpful to look at which environmental factors may be impacting acne in different locations.

If you’ve been working to improve your acne for weeks but can’t see any change, you’ll understandably be feeling frustrated. Seek the help of a doctor and/or dermatologist for a tailored acne treatment plan.