Acne Face Mapping: How to Determine the Cause of Your Breakouts

If you pay close attention to where blemishes appear on your face, you might notice that they often show up in the same places over and over. According to an ancient Ayurvedic technique called face mapping, the location of your acne may have something to do with what's happening inside your body.

Whether your forehead, jaw or chin, temples, cheeks, or t-zone are giving you blemish-related grief, this guide can help you identify the possible causes of your acne, as well as the most effective treatments.

What Causes Acne?

When your sebaceous glands, which produce oil (called sebum), become clogged by dead skin cells, excess oil, or bacteria, stubborn acne may pop up on your skin. There are different types of acne—including whiteheads, blackheads, cysts, nodules, papules, and pustules.

There are a number of reasons why people develop acne. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, no matter where they develop on the skin, factors that cause acne generally include:

• Changes in hormones. People who are experiencing hormonal changes because of puberty or their monthly menstrual cycles may notice more acne breakouts than normal.
• Hygiene practices. Not washing your hair or face on a regular basis may cause excess sebum to build up on your scalp and skin.
• Use of cosmetics. Some cosmetics that are not non-comedogenic, meaning they have ingredients that block your pores, can cause pimples to pop up on your skin where you apply the products.
• Interactions with certain medications. Acne may occur as a side effect of some medications—including steroids (corticosteroids), lithium, and barbiturate, as well as some birth control pills.
• Irritation to the skin. Sweating, wearing tight clothing, not removing your makeup at the end of the day, and touching your face may irritate your skin and cause unwanted blemishes.
• Diet. Foods that pack a lot of sugar and grease may cause acne breakouts.

What Is Face Mapping?

Face mapping associates facial skin areas with different internal organs. When the practice was first developed thousands of years ago, the location of blemishes on the face helped healthcare providers diagnose internal health problems. The practice can still be used to help zero in on the health- or lifestyle-related factors that might be bringing on breakouts.

"Our facial anatomy determines the type of skin in [a] specific area," said Amanda Doyle, MD, a dermatologist at the Russak Dermatology Clinic in New York City. "The skin around our eyelids is 10 times thinner than the skin on the rest of the face. That's why facial mapping is very important in terms of caring for your skin." Dr. Doyle added that she has previously employed facial mapping before conducting skin treatments in her office.

What Do Different Breakout Areas Indicate?

The location of your breakouts can also help alert you to what type of acne you have, whether it's basic acne or the hormonal kind, according to Dr. Doyle.

Forehead

Your forehead may break out because of certain hair products and stress, as well as changes in hormones and poor hygiene.

Just like for blemishes around the edges of your face, hair products may be the issue causing acne on your forehead. The medical name for this type of acne is acne cosmetics. Discontinuing the use of acne-causing hair products can help clear the appearance of whiteheads, blackheads, and pimples across your forehead.

Dr. Doyle also said that forehead acne can occur due to stress. However, stress acne may also show up on your jaw and chin. No matter the cause of the acne, consistent forehead breakouts are worth bringing up with your healthcare provider.

Between the Eyebrows

Blemishes between your eyebrows may link to your liver.

You can improve your liver health, and possibly eliminate any more pimples between your eyebrows, by avoiding alcohol. Excess alcohol may lead to alcoholic fatty liver disease, which causes inflammation and damage to the cells inside your liver.

Fatty liver disease is inflammation and damage caused by activities other than drinking alcohol, like eating a lot of foods that do not pack a lot of vitamins or nutrients. So, it may be helpful to add rich foods to your diet.

Jaw or Chin

It's a safe bet to blame jaw and chin breakouts on hormones, Dr. Doyle said. Hormonal acne is caused by an excess of male androgen hormones—which includes testosterone—Dr. Doyle explained. These hormones can over-stimulate the oil glands and clog pores where the acne bacteria grow. A hormone-related breakout might also occur about seven to 10 days before a person's period.

Dr. Doyle recommended prescription-strength products to treat hormonal flare-ups that occur fairly regularly. Dr. Doyle also suggested asking your dermatologist about Aczone, a topical gel that is commonly prescribed to treat hormonal acne.

"Also, spironolactone can be quite helpful. This is an oral medication that is prescription strength," added Dr. Doyle.

Another option for treatment could be birth control pills; some versions with drospirenone—a progestin medication—are approved for treating moderate acne. Of note, there are some birth control pills that can actually make acne worse, so talk with your healthcare provider to determine the best option to try.

Near the Edges of the Face

Breaking out along the hairline, near the ears, or in the cheek area can fall into the hormonal acne category, Dr. Doyle said. "I also think about exogenous factors, such as hair products containing oils and chemicals that can clog or irritate the pores," Dr. Doyle added.

You can try switching up your beauty routine for a few weeks to incorporate more natural products and see if you notice any skin improvements. Or, consider having your dermatologist or healthcare provider look at the ingredients in your favorite products—makeup, hair, and skincare included—to point out any common irritants.

Wearing dirty workout headbands, hats, or earmuffs can also transport bacteria to the edges of your face, so wash your gear frequently.

Cheeks

Acne in the cheek area can be a sign of high sugar consumption, explained Dr. Doyle. Research has suggested that eating foods that don't cause your blood sugar to rise quickly—i.e., a low-glycemic diet—has led to a reduction in acne. Thus, cleaning up your diet and limiting your intake of sweet stuff may help cheek breakouts clear up.

You should also be aware of how close you're holding your phone to your face.

"Our cell phones are notorious for carrying germs, and the screen accumulates oil and makeup from pressing against our face," said Dr. Doyle. Clean your smartphone with a disinfectant wipe regularly to prevent transferring germs to your skin.

T-Zone

The T-zone—forehead, nose, and down to the chin region—is generally a bit slicker because it has more oil glands than the rest of the face, Dr. Doyle explained. That makes it prone to blackheads and whiteheads. The makeup you're using can also bring on breakouts.

"I see a lot of patients with clogged pores from using makeup that isn't non-comedogenic, meaning that it does not clog the pores," noted Dr. Doyle.

Dr. Doyle said that the best way to extract black and whiteheads is manually at a dermatologist's office. Still, those blemishes often come back.

"Topical retinoids can also help, as this serves to expel the sebum from the actual pores when used appropriately," explained Dr. Doyle.

Treatments and Prevention Options

Per Dr. Doyle's advice, there are a number of cleansers and moisturizers that can tame acne breakouts. Opt for products that include benzoyl peroxide and salicylic and are non-comedogenic. Depending on your skin type—dry, oily, or combination—certain products may work better than others.

Or, if you want to try a natural remedy, apply aloe vera, tea tree oil, apple cider vinegar, or zinc to your skin using a clean cotton pad.

You may want to consult your healthcare provider about an oral or topical medication if you have severe acne. Oral antibiotics or topical retinoids can help prevent the spread of acne.

There are other steps you can take to stop future acne breakouts from occurring, like:

• Wash your body once per day, and cleanse your face twice (especially after exercising) per day.
• Shampoo your hair once per day if it's oily.
• Limit the use of cosmetics that are not non-comedogenic.
• Avoid touching your face or popping current pimples.
• Do not wear tight clothing, like tight hats or headbands that trap and rub oils and sweat on your skin.
• Always remove your makeup at the end of the day before going to bed.

A Quick Review

Face mapping can be a helpful starting point for pinpointing the cause of your pimples—but it's not foolproof. If your acne doesn't seem to clear up after a couple of weeks, or you have additional symptoms—stomach problems or extreme fatigue, for example, which may indicate something more serious beyond breakouts—make an appointment with your healthcare provider.

"It's best to be proactive, and there are so many options to treat acne, prescription, and non-prescription," said Dr. Doyle. "Talking to a professional who can customize your regimen and incorporate both is best. Many products, even some over-the-counter products, are not safe for use in pregnancy or breastfeeding as well, so having someone to guide you through that process can be helpful."