Tuesday, November 8, 2011

Why Women Break Out On Their Cheeks and Jawline

Typically we break out in certain areas more than others.  For women, the "U-zone" or jawline tends to be the problem area.  You may heard this referred to as "hormonal acne". 

But do you know why?

The reason?  Women don't grow beards, so we have smaller pores in the U-zone than we do in the T-zone. 

When our hormones fluctuate throughout the month, we produce more or less oil depending on where we are in our cycle.  As a result, these smaller pores become more easily congested where they clog more easily and become inflamed. 

On the nose, where we experience the most shine, we are far less likely to get one of those big, under-the-skin monsters because the pores are larger and oil can come and go.  But we may or may not experience blackheads here. 

On the U-zone though, we are much more likely to experience inflammation because these pores are covered by little flaps of skin, making them much more difficult to move through.  This means when dead skin cells and sebum become trapped, we get whiteheads instead of blackheads when there's no inflammation or bacteria involved. 

Whiteheads on the cheeks typically indicate that we need to increase our exfoliation, cleanse more efficiently, or use lighter, non-comedogenic products.  Many women do not properly remove their makeup at night, which can lead to a lot of clogging in this area--especially if you have long hair or sleep on your side.  That doesn't mean you're not washing your face necessarily... It may mean you're not cleansing into the hairline or down onto your neck where you diligently blended your makeup to avoid obvious lines of demarcation.

In my experience, most women breakout to some extent on their cheeks and jawline.  And calling this "hormonal acne" is far from helpful in resolving your complexion imperfections.

Identify whether your acne is inflamed or noninflamed first.  This will help you determine whether or not your androgens are to blame. 

If you are experiencing persistent inflamed breakouts in this area, along with increased hair growth and even hair loss, then you should speak to your OB/GYN about the possibility of PCOS, especially if you are overweight. 

If you are underweight or an athlete, you may also need to discuss your breakouts with a doctor because your hormones may also be affected.

Other medical conditions can also lead to increased breakouts in this region, so I always recommend mentioning your acne to your physician, so they can rule out potential health problems they might otherwise miss.

However, for the majority of women, breakouts in the U-zone are a result of monthly fluctuations in our hormones that are perfectly normal for us to experience, or we are genetically predisposed to having acne.  And, no, we don't just have to live with it. =)

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This blog is for educational purposes only and does not diagnose or treat any disease.  Always consult a doctor about any problematic skin condition--especially if it does not respond to OTC treatment.


  1. Thank you so much for this post!!! I've been debating on going to my Dr. for my acne problems thinking I can buy some acne kit to help me but I've tried a couple and it seems to be inflaming my acne more. After reading this I'm having an "aha moment" because I have been diagnosed with PCOS so back to the Dr. I go for help in treating my acne. Thanks a whole bunch.

    1. Thank you so much for taking the time to read and comment! I'm so glad you found this helpful!! PCOS can often make acne difficult to treat at home, and there's so much that can be done now to help you cope. I think you're doing the right thing talking to your doctor. Good luck! Thanks so much for sharing your personal situation here. Keep in touch! Lots of love, Elizabeth

  2. I completed my 8 month course of roaccutane in January 2012. On the advice of my dermatologist I started using the full Clinique anti blemish range which includes a foam wash, cleanser and moisturiser, as well as the anti blemish range of foundation and loose powder. I have been using this since the beginning of January. However in the last couple of weeks I have noticed a cluster of tiny skin coloured 'spots' on my jawline/lower cheek area. Could you recommend any next steps as I just don't know what to do! What sort of foods or supplements do you recommend in circumstances like this!? Please help! I just don't know what to do next! Thank you for your help and what a super helpful and supportive blog you have! X

    1. Hey Jade,

      Thank you so much for your kind words! I'm glad you've found my blog helpful.

      First of all, what you're experiencing is not uncommon. In fact, it's so common that I can't tell you for certain what it is. Skin changes a lot while on Roaccutane (isotretinoin) and continues to change in the year following your treatment. Doctors use Roaccutane therapy in many ways these days, so I would suggest contacting your dermatologist. It could be that he took you off the medicine too soon, or that the products you're using now are too harsh because your skin is now more sensitive. Whatever you do don't try to self-medicate the problem because there are so many things it could be that all look very, very similar. It's not worth destroying your skin after all the progress you've made.

      I also would stay away from supplements for at least a year because your body still has not fully gotten rid of the medication. Vitamin A is used as a filler in many supplements, and you don't want to damage your liver.

      If you think diet is a factor, then you can try limiting salty and sugary foods, which are unhealthy for both the skin and body. You can also try cutting out dairy, as that is a trigger for a lot of people. Making sure to eat at regular intervals to maintain a healthy blood sugar is one of the best things you can do for your body overall.

      Also keep in mind that it's pollen season! Your skin may be responding to allergies as well, so try to check the weather reports to see if there's any correlation. Substituting local honey for your regular sweetener may help in these cases.

      Hope this helps! I don't feel like I really answered your question, but nonetheless, I'm here to support all of you. Keep us posted on what happens, as I'm sure it can help a lot of people. Thanks so much for commenting, and let me know if you have any more questions! =)

      Fondly, Elizabeth

  3. Hello,

    I've had cystic acne (deep inflammation, blood clots? Blackheads and whiteheads) all over my face, back, and chest. I was put on 6 months of Accutane after 6 months of antibiotics was to no avail. Around 4 months later my acne came back, except it's whiteheads all over my face in clusters on my cheeks, forehead, jawline, and neck area. Some are actually large bumps filled with sebum under the skin that come back after I extract them. However they just stay as bumps under my skin. They never become inflamed. They're very similar to the fat or oil deposits under our forearm. I'm not sure what they are or why I get them. I do have very very oily skin but I'm very careful with touching my face, washing, treating with alcohol-free and oil free toners and moisturizer. Now I am back on a second round of Accutane.

    If you could shed some light to my acne problems, that would be great, thanks

    1. Hey dayafterday,

      Sometimes Accutane treatment is stopped too quickly and a second round is needed. Also "low dose treatment" is becoming more and more popular, which is not the long term solution that the regular dosage can provide. Do you know what type of treatment you're on?

      My best advice would be to listen to your doctor and follow any post-care instructions he gives you. Also don't try to treat any of the Accutane side effects with too many topicals that can clog your pores. I see a lot of people do that, and they don't seem to get the best results.

      After you stop using Accutane, remember that your skin is still acne-prone but sensitive, and you can still develop cosmetic acne. I didn't realize this, and when I began working in a cosmetics department after college, I experienced a lot of unnecessary breakouts from using products that were too rich. I suggest not mixing and matching too many brands if possible when choosing skin care. Just keep it simple.

      Good luck! I took Accutane, and it was one of the best decisions I've ever made. I still struggle with breakouts every now and then, but fortunately they do respond to treatments now that wouldn't work before.

      Let me know if you have anymore questions.

      Fondly, Elizabeth

  4. Thank you soo much for this article :) Could you please suggest any methods of skincare to make the U-zone unclogged? Should i use a lighter moisturiser on my U-Zone than the regular moisturiser that i use on my cheeks? kind regards xoxoxo

    1. Hello Mia,

      Thank you so much for your kind comment!

      I always suggest using the most lightweight, non-comedogenic moisturizer possible. Some women may find that different areas of their skin need different amounts of moisture. Some even find they can use a serum or a toner all over their face, and then apply something more emollient only where needed. The key is to make sure that anything you apply to your face is nonirritating, so you don't cause the pores to close themselves off in response to irritating ingredients. This will lead to more acne.

      If your breakouts are occuring monthly, you may find that using a salicylic acid cleanser during the time that you normally break out can decrease those monthly breakouts. Otherwise I would consider adding a well-formulated, non-irritating AHA or BHA into your nightly routine to keep your skin clog-free.

      Hope this was helpful! Please let me know if you have any more questions. =)

      Fondly, Elizabeth

  5. I just recently started having a problem with this kind of acne when I came back to college, I've been having hormonal problems since the year started because I had stopped taking birth control, could this be a reason? I know my stress has definitely been causing acne too! :(( I'm not really sure what I should do! and yes I am a make up junkie but I'm pretty good about cleaning it all off

  6. Hi!! This article has helped me understand my acne.
    I had acne in my T zone when I was 12 and 13 which persisted for bout 2 years. I could do very little about it. Thankfully, it disappeared as my period became regular when I was 15. However, very recently, just before I turn 19, my acne has made a stellar comeback in the places afore mentioned, the U zone! (jawline and side of cheeks). My family friend recommended that I use proactive to rid since the sudden return startled me and wasn't sure how to deal with the excessive acne anymore. I've been using it for 2 weeks and haven't seen much of a difference. I also struggle to not touch the acne (I've found it's become a kind of stress relief to pick at them). I was just wondering, what can I do to rid them? How long do you think this will last? Does Proactive even work in your professional opinion?

    Please help me!

  7. hi, this is the first time iv ever posted a comment on one of these sites, like most people on here I'm a acne sufferer, since I was 11 (I'm now 23) iv always had bad skin, at first I put it down to teenage spots & hormones, but 12 years later here I am with my skin bein worse than ever before, iv been prescribed every tablet lotion & potion u could imagine.. nothing works! I'm so depressed about my skin, id say my acne is moderate, but to me is seems like the worse thing ever, whiteheads, blackheads, sore red spots.. why me? I was on the combined pill and had to come off due to high eastrogen levels, kept getting blury vision migranes and was at high risk of stroke, was put on a progestrone only pill. like I said my skins always been gross nut I feel its got a lot worse since I come off the combined pill. obviously I was at danger being on that but why oh why do I have acne? I have other on my back shoulders, sometimes chest and obviously face, I can deal with back.. but my face is my appearance! I'm 23, a adult not a spotty teenager! :(
    my skin is sooo sensitive, I can only use water to wash with, soaps, spot products, cleansers ANYTHING makes my skin bad.. literally everything.. :( please someone tell me they feel my pain :(

    1. I'm 36 and have painful, cystic acne that are huge! It's awful to look at and hurts even worse. Nothing seems to help. I've tried about everything out there, even 2 rounds of accutane. I think I'm going to try going back to the doc to ask about cortisone shots. These are supposed to help the larger puss filled acne. My acne was nearly gone in my late 20's/early 30's, but it's back with a vengeance!

  8. Hi, thank you very much for help. I am going to test that in the near future. Cheers

    Facial Cleanser for Women

  9. Hi, enjoyed your article, I found it very helpful. Now to my question. I don't wear much make up. For the most I eat pretty healthy, although I do have my binges. I work out consistently plus my four kids. No matter what I do my cheeks always break out and my chin. It just started maybe for the past three weeks and I've been taking these natural heerb supplements that help my hormones. I'm not sure what to make of this sometimes I start my period twice a month. I recently started using coq10 repair cleansing milk. What do you think? Thank you so much in advance

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  11. I thought the Jawline is the area from ears to chin between neck & jaw. What you have pictured above as the "U" is considered the chin area.