Banish the Blemish! Pinpointing Acne’s Triggers

Few things are more likely to spoil a perfectly good day than a dreaded pimple popping up unexpectedly. At thirteen, it was a routine part of life; at twenty-five, it’s starting to feel ridiculous. But whereas in my youth there was no predicting its placement, now that I’m older, certain areas are definitely more prone than others, and people I’ve consulted (read: complained to) concur.

Blemishes have the maddening ability to make us feel at any age like dirty-faced adolescents, but breaking out actually has little to do with hygiene. In fact, where we find them on our faces can tell us more about their triggers than we realize.

The Real Acne Culprits
Most people assume that breakouts are caused by a lack of cleanliness or an abundance of fried foods or chocolate in one’s diet. The truth is that neither one is to blame. The roots of our acne problems are actually at the roots of our hair—hair follicles get plugged up by skin cell debris and excess oil produced by neighboring sebaceous glands. After the follicle is clogged, it creates one of four types of blemishes: a whitehead (the clog pushes against the wall and forms a head); a pimple (the area around the follicle gets infected and turns red); a blackhead (the wall opens and exposes the clog to outside air); or the infection goes even deeper and keeps the clog beneath the surface of the skin, which causes a painful red lump without a head.

What causes the plug in the first place can be a number of things. Hormonal changes, particularly in teenagers and women, seem to be the primary cause. Androgens (male hormones), which stimulate oil production in the sebaceous glands, increase in concentration during puberty and certain times in a woman’s menstrual cycle. Medications containing steroids, such as cortisone, can also prompt acne. Hereditary predisposition is also a factor—if your parents battled acne, chances are you will, too. Other potential triggers include air pollution, cosmetics containing oil, frequent use of cell phones, helmets, and other items that constantly rub against the face, and, oddly enough, washing the face too much. (All that scrubbing can irritate the surface and dry the skin out, making oil glands secrete more to compensate.)

Stress is also blamed for making us break out, but that’s only true if people are already prone to acne. It can make the situation worse, but stress alone doesn’t create acne.

Decoding Pimple Facial Placements
All of these factors could cause unsightly spots on our faces, but where those spots end up sheds more light on where to point the finger.

Forehead
Breakouts on our foreheads and nose (otherwise known as the T-zone) are most common during puberty, when oil production in that area is in overdrive. In adults, bangs and oily hair—or using hair products that contain oil—are the main agents of forehead acne. For women, using oil-based foundation can cause blemishes, too.

Cheeks
Resting our cheeks on our hands when we sit or sleep is something many of us are guilty of (I was doing it mere moments ago) and the primary cause of flare-ups in that area. Anything that rubs against the skin and causes friction and excess moisture will make breakouts that much more likely.

Chin
Like cheeks, chins often end up resting on our hands when we’re sitting, so that’s a common cause. However, it gets a little more complex with women because our cyclic hormonal vacillations (particularly with androgens, the oil-causing hormone mentioned earlier) also cause us to break out on our chin and jaw area. As a group, pubescent males may get more severe acne because of the influx of male hormones, but while their bouts of acne drop off with adulthood, females can continue getting occasional pimples or whiteheads until menopause because of their menstrual cycles.