What Your Breakouts Might Say About Your Health Based on Where They Pop Up

Everything you need to know about facial mapping.

By Danielle Fontana Dooley, Associate Director, Digital Content · Aug 20, 2021

Getty Images / Image Used for Illustrative Purposes Only

“Facial mapping,” or studying the location of blemishes and pin-pointing their cause, is an ancient Chinese tradition that has long correlated breakout placements with different organ systems throughout the body.

While an assessment by a board certified dermatologist is the first and most important step in the treatment of acne—many cases of acne are genetic, not due to underlying health conditions, anyways—experts agree there is some benefit to the ancient practice.

“There is no scientific evidence to support the concept of facial mapping that links breakouts in specific areas of the face to distinct internal organs, however there can definitely be patterns to certain blemishes that provide underlying clues to the source and help guide ideal treatments,” says Washington, D.C. dermatologist Tina Alster, MD.

Nanuet, NY dermatologist Heidi A. Waldorf, MD says that while she does not believe a breakout’s location can reflect underlying health issues, “the distribution—aka the location(s) on the face—combined with the type of acne lesion seen is helpful in differentiating acne vulgaris from acne rosacea.”

Here, the most common places breakouts occur, what they might mean, and how to keep them from happening.

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Location: Chin and jawline

There’s a reason we tend to see more blemishes pop up right before a period begins. “Breakouts in the chin and jawline area are a very common pattern seen in hormonal acne in women, especially when they are deep, painful acne bumps that flare with periods,” Dr. Alster explains.

“Acne cysts and nodules of the chin and jawline are especially common in adult women, versus the full facial, or more upper facial acne of teen years,” adds Dr. Waldorf.

How to treat it:

“The chin is linked to the small intestine, so diet changes can make a huge difference,” adds Markland, who notes staying away from dairy and oily meals can help this area clear up while keeping digestion running smoothly.

“These types of breakouts are best treated with anti-androgen oral medications such as specific anti-acne birth control pills or a medication called spironolactone, which was originally developed as a blood pressure diuretic pill but has been found to work really well in hormonal acne,” says Dr. Alster.

According to the dermatologist, recent evidence-based studies have shown that combining both oral contraceptive with spironolactone can work better for hormonal acne together than either one can individually. “We will often combine these oral treatments with topical retinoid cream to help with comedonal acne that includes whiteheads and blackheads, which can often coexist with hormonal acne.”

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Location: Between the brows

Breakouts between your brows can mean that you’re drinking or smoking too much and eating too many fatty foods. Markland explains that this area can be irritated because of poor circulation, gallbladder problems, diets too high in fat and processed foods or heavy alcohol consumption alike. Dr. Waldorf adds that breakouts here can also be inflammation of hair follicles due to over-plucking, which can lead to ingrown hairs and irritation, or seborrheic dermatitis, “a red, scaley condition often associated with rosacea.”

How to treat it:

A significant amount of water every day is key here, as well as watching your diet and hygiene. Focus on cutting down on foods like butter and cheese while being mindful of all those late night snacks. If the problem is seborrheic dermatitis, Dr. Waldorf says it can be treated with ketoconazole cream or 1% hydrocortisone cream.

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Location: Cheeks

While hormonal imbalances, high sugar consumption and some spleen issues can be the reason for breakouts on your cheeks, the experts say germs are also a huge reason why. “Be aware of how close you’re holding your cell phone to your face,” Dr. Russak warns, explaining that the screen accumulates oil and makeup from pressing onto our faces. Markland also says that laying on dirty pillowcases and using dirty makeup brushes can also instigate a breakout in this region.

“Small red pimples located predominantly in the central face (cheeks, nose, chin), often associated with background redness, dilated capillaries, and a history of flushing is indicative of acne rosacea,” adds Dr. Waldorf, noting a common treatment plan includes a combination of specific oral antibiotics, topical antibiotics and other topicals with different mechanisms of action.

“Although Lupus may present as redness and small bumps in a ‘butterfly’ pattern of the central face, the lesions are not actually acne and the diagnosis can be made by a dermatologist,” says Dr. Waldorf.

How to treat it:

Always be sure to clean and swap your pillowcases on a normal basis, wipe your phone screens down thoroughly and don’t forget to wash your makeup brushes as often as you can. Dr. Kazin says to notice if you’re breaking out more on one specific cheek rather than the other and go from there. “Do you hold your phone on that side, sleep on that side, or hold your head on that side? These are all ways your pores can be clogging on that specific side.”

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Location: Around the mouth

“Acne here can be caused by constipation, an excess of spicy or fried foods and a reaction to a certain toothpaste,” Markland explains. However, Dr. Russak also says that this could be perioral dermatitis, a rash—typically small red or pink lumpy spots—around the mouth that can be triggered by hormonal changes, beauty products or bacteria.

How to treat it:

According to Markland, an increased intake of fiber, fruits and vegetables—as well as easing up on all the spice—can help here. As for the dermatitis, always using clean makeup brushes and reaching for good-for-your-skin makeup products made with noncomedogenic ingredients can help clear it up.

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Location: Along the hairline

“Other areas of acne can be linked more to common culprits as opposed to underlying health issues,” says Dr. Alster, pointing to acne running along the hairline for example. “This could be due to hair products that are often comedogenic, known as pomade acne,” she explains.

How to treat it:

According to the American Academy of Dermatology Association (AAD), hairstyling products that contain a high concentration of oils, such as pomades, are usually the culprit for whiteheads or papules along the hairline. Look for hair products that are non-comedogenic, or that won’t clog pores, and oil-free formulas to keep your scalp and hairline clear.

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Location: Chest and Back

According to Dr. Alster, breakouts on the chest and back can often be triggered by occlusive clothing and a build-up of sweat and bacteria triggering a condition called folliculitis, or inflammation of the hair follicles.

How to treat it:

“Often this can be treated with some behavior modifications including looser clothing, rinsing off after working out, or using benzoyl peroxide or salicylic acid-based body washes in the shower,” says the doctor.

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Location: Above the brows

The area above your brows is linked to your gallbladder and liver. “Forehead breakouts are usually linked to digestive system issues,” says Dr. Russak. “This can be an indication of food intolerance or an overburdened liver.” Markland adds that toxins and lack of water are familiar culprits to blemishes in this area.

How to treat it:

“Be sure to consume the daily suggested amount of water so the toxins are flushed out of your system, get at least seven hours of sleep, check if your facial or hair products are irritating your skin (especially if you have bangs) and exercise regularly to improve metabolism,” says Markland. Also, don’t forget to check your diet and get rid of any over processed foods that aren’t doing your skin any favors.

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Location: Nose

Because the nose is linked to the heart and lungs, breakouts here can be an indication of high blood pressure, but New York dermatologist Julie Russak, MD says that blackheads in this area are normal due to an abundance of oil glands.

How to treat it:

“Avoid energy drinks, reduce your salt intake and eat more fruits and vegetables to promote better heart health and low blood pressure,” says Danae Markland, aesthetician and vice president or business development for PCA Skin. To clear up pesky blackheads, Washington, DC, dermatologist Rebecca Kazin, MD, suggests a light chemical peel with salicylic or glycolic acid along with retinoids to keep the area clean. We like PCA Skin’s BPO 5% Cleanser ($36) for a gentle yet effective wash.