Acne Breakouts: The Message The Placement Is Giving You

Acne Breakouts: The Message The Placement Is Giving You

One of the most prevalent skin issues is acne, which affects more than 85% of teenagers.1 This skin problem usually begins at puberty and gradually resolves as the person reaches 20, although some may continue to have them well into their 40s and 50s.1

Despite its cosmetic and non-threatening nature, the effects can cause a significant emotional and psychological impact on patients, even more so than the physical effects.1

The changes in skin appearance may change one’s perspective of their body image.1 In turn, it can lead to emotions, such as shame, fear, anxiety, depression, and embarrassment1. Subsequently, it may also induce bullying and stigmatisation within peer groups.1

The reduction in life quality has been estimated to be comparable to those related to diabetes, arthritis, asthma, or epilepsy.1


Acne is a condition caused by multiple factors, such as genetics, stress, androgens, and excessive sweating.1 Usually, acne could be characterised into four grades:

Grade 1: Comedones. These skin bumps can come in two forms: open and closed.2

Open comedones are caused by sebum blockage at the pilosebaceous orifice on the outer layer of the skin. In contrast, closed comedones are caused by keratin and sebum obstructing the pilosebaceous orifice under the epidermis.2

Grade 2: Inflammatory lesions such as small red papules are present.2

Grade 3: Pustules start to appear at this stage.2

Grade 4: Presence of larger, more inflammatory nodules and cysts that can lead to more significant scarring.2

Medical drugs, such as corticosteroids, oral contraceptives, compounds like iodides, bromides, and dioxins, and chemical elements like lithium are known causes of acne eruptions.1

Moreover, it’s observed that acne is worse among smokers. Nevertheless, contrary to popular myth, factors such as lack of exercise, change of diet, and greasy hair hanging over the face can affect the acne’s severity.1

Here are some specific reasons acne may worsen:

  • Consuming food with high carbohydrates, such as dairy products (which can affect your hormones when consumed), junk food, and chocolates, which can cause insulin-like growth factors that may lead to pore blockage2
  • Using oil-based cosmetics and facial massage2
  • The leaking of sebum from the bulging pilosebaceous duct before a period occurs. This happens in 70% of females2
  • Experiencing severe emotions, such as anxiety or anger, may aggravate acne since it can stimulate stress hormones2

Acne can leave various scars after healing, which may be depressed, hypertrophic, or keloidal.2 While hypertrophic and keloid scars are similar, the size difference distinguishes them. A keloid scar is bigger than the acne lesion that led to the scar, while a hypertrophic one is the same size.2

Acne location

However, there are a few messages the acne is sending, depending on the area the acne appears. Here are some examples and how to combat them:

Around the hairline

This can also be known as “pomade acne” because pomade is an ingredient that you can find in thick, mineral oil-based hair products.3 Pomade can prevent the natural oil or sebum in our hair follicles from coming out of the pores.3 Hence, a pimple can form from the blockage.3

Heavy hair-care products, such as hair conditioners or leave in treatments, are also possible causes of pore blockage around the hairline.4 Moreover, this acne can also be caused if you wear hats, since the friction from the fabric can also result in breakouts.4

If you constantly find pimples along your hairline, the best is to try to use less of the products that have pomade in them or ensure that you wash your face after application. Do also consider using a clarifying shampoo. The best is also to look into market products that are non-comedogenic (non-clogging).4

Around the T-zone area (forehead and nose)

Should you get breakouts around the forehead and nose, known as the “T-zone area”, it may be caused by oil and stress.3 A study conducted on 160 high school boys in Singapore has revealed that while stress does not affect oil production, it can worsen the acne.3

Another study, published by Acta Dermatol, also states that people who wake up tired are likelier to have acne.3 Hence, if you have an upcoming exam, it is advisable to incorporate acne treatments, such as salicylic acid, to help control possible acne breakouts.

Since stress and lack of sleep can worsen acne, try to practice good sleep hygiene if you notice a pattern.3 Listening to music or exercising for a short while (e.g one-minute cardio exercises) are also excellent ways to relieve stress.3

Listening to music or exercising (even for one minute) are also natural ways to relieve stress.

Avoid touching your forehead because an average person touches their face hundreds of times daily. This can spread oil and dirt directly into the pores.3 If your skin is naturally oily, look into face washes that can help to reduce the grease. Read the labels to ensure that the products also cater to your skin type.

You may also want to lay off the chips and candy to avoid worsening the acne by reducing the amount of fat in your diet.4 Try to increase your water intake to remove toxins and bacteria on the skin, lowering the possibility of pore-clogging.4

On the cheeks

Unlike breakouts on the T-zone or the chin, acne on the cheeks doesn’t really reveal a lot about the underlying cause, but it can be agreed that some habits can lead to a breakout on your cheeks.

This can be quite telling especially if you have acne on one side of your face, since they can be due to dirty phones, pillowcases, and other habits, such as touching your face.3

It is best to constantly clean your smartphone with a disinfectant wipe to lower the frequency of breakouts. If you use your phone a lot for work, consider a Bluetooth headset or headphones that allows you to talk to the other party with a built-in mic.3 Do also change your pillowcases at least once a week.3

While you can treat your cheeks with the same products you use elsewhere, such as salicylic acid, do remember that the skin on your cheeks can get dry and irritated easier than the T-zone area. Hence, don’t go overboard with acne treatments.5

Around the jawline

Chin and jawline acne is often caused by hormone fluctuation, since they are sensitive to hormones.5 During growth spurts, teenage boys often get acne around the jawline.5 Girls and women may find their chins getting a breakout more often due to their menstrual cycles (a week before the period3), which causes their hormones to ebb and flow.5

Usually, hormone changes may mean that your endocrine system is disrupted.3 It’s usually from excess androgens, which can overstimulate the oil glands and clog pores.3 

An unbalance of hormones can also be related to diet. While diet can affect the acne around the T-zone, there is also a thin correlation between diet and hormones.3 After all, high-carbohydrate foods or dairy with added hormones can affect your hormone levels.3

The acne at the jawline is usually deeper, bigger, and more inflammed compared to the other areas, such as the T-zone.5  

While hormonal changes are unavoidable, you can try examine your food intake. Try and see if cutting back on sugars, white bread, processed foods, and dairy can help clear your acne.3 Moreover, you can lessen the effect by getting enough sleep, drinking enough water, eating more vegetables, and keeping your skin clean.4

Keeping your skin clear

By identifying where your acne tends to appear, you can have a helpful start in clarifying the cause of your breakouts. Address these issues by making lifestyle changes, practising good skin hygiene and skin care, and trying topical treatments to help clear your acne.

However, please do note that it’s not a one-size-fits-all solution. Should the above methods still not work for you, it’s advisable to visit a dermatology clinic in Singapore.

In this case, AYD is here to aid you. With in-depth experience and knowledge in both medical dermatology and dermatological surgery, our leading dermatologist, Dr Angeline Yong, is dedicated to caring for those whose confidence has taken a blow from various skin conditions.

As a testament to her renowned skills, Dr Angeline Yong has earned Mohs Micrographic Surgery and dermatological surgery fellowships from Seoul National University Hospital and St John’s Institute of Dermatology in UK.

Moreover, she has won the National Skin Centre Service Champion Award (Gold) and Health Manpower Development Programme (HMDP) award for Mohs Micrographic Surgery, Procedural, and Laser Dermatology.

Therefore, whether you are planning to get a picoway or picosure laser in Singapore or aren’t quite sure which skin treatment is suitable for you, you can be sure that she will be able to come up with a unique skin treatment plan that can clear up your acne without any scarring. Contact us today to start your journey in restoring your healthy and radiant skin!


Ayer, J., & Burrows, N. (2006). Acne: More than skin deep. Postgraduate Medical Journal, 82(970), 500–506.

Sutaria, A. M., Masood, S., & Schlessinger, J. (2022, May 8). Acne vulgaris. National Library Of Medicine. Retrieved August 10, 2022, from

Rabach, M. (2020, June 22). What acne spots on your face mean, according to science. Healthline. Retrieved August 10, 2022, from

Ferguson, S. (2016, January 5). Here’s exactly what the pimples on every part of your face mean. Teen Vogue. Retrieved August 10, 2022, from

Fenneld. (2021, August 20). What does it mean when acne is on certain areas of your face?. Cleveland Clinic. Retrieved August 10, 2022, from