Acne Face Mapping Has Existed for Centuries, but Is It Legit?
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Months of recurring acne in the same spot on my face and one panicked Google search later, I landed upon face mapping—i.e., a millenniums-old Chinese medicine practice that links the location of skin conditions to underlying internal issues. In this scenario, my cheek acne sounded the alarms and my liver is the so-called culprit. Naturally, I panicked more, until I spoke to the experts. Modern Western medicine says that while your body can send signals in the form of acne due to hormones, stress, food, or medication, there’s little evidence to connect your breakout site to your internal organs.
Now, this isn’t to say that the acne face map should be dismissed entirely. In fact, “we do see certain trends that may create patterns of acne breakout on specific areas of the face,” says dermatologist Rachel Nazarian, MD. This means that because some acne can be caused by measurable, real internal and lifestyle factors, we can use a revised, modernized face map in some cases to pinpoint acne patterns and treat accordingly. Sound complicated? That’s because it is. Our bodies are complex, and acne, equally so. That’s why I broke down everything there is to know about localized acne with the facts, courtesy of a board-certified dermatologist.
What is face mapping?
Put simply, face mapping is the process of connecting the location of your skin condition—in this scenario, acne—to your body’s organs or internal systems. However, face mapping is not a standard practice in Western medicine, explains Dr. Nazarian. Not only is there little scientific evidence to back these claims, but she adds that “because acne is nearly always multifactorial, dermatologists don’t typically treat solely based on location.”
Instead, acne is typically diagnosed and treated based on the type of acne lesion itself (whiteheads, blackheads, cystic acne, etc.), the severity of the breakout, factors such as lifestyle changes and medical history, and, yes, sometimes location. For example, “female hormonal acne often presents as lower face and neck pimples,” Dr. Nazarian says. She adds, that said, diagnosing acne isn’t straightforward—even though the causes may be the same, each person can experience acne differently. The consensus? All acne treatment is individualized, although location and lifestyle factors that are measurable can be one stepping stone in determining the root cause.
Cosmo’s Acne Face Map:
With expertise from board-certified dermatologists and scientific studies, we put together our very own modern acne face map that suggests which lifestyle factors, potential triggers, or internal happenings *may* contribute to your acne on a location basis.
Hairline breakouts:
⮕ What it *may* mean: Buildup of hair products, sweat, or sebum
Ah, the dreaded hair and scalp pimple that sometimes goes unnoticed until you get that really painful throbbing feeling. Or maybe you’ve noticed a cluster of small bumps along your hairline, the back of your neck, and even your forehead. Whichever way it presents itself, one thing is possible: You may be dealing with pomade acne—i.e., a type of acne that is caused by using haircare products high in oil.
As the American Academy of Dermatology puts it simply, when your haircare products contain oil, that oil can build up on your skin, in turn leading to acne. The solution? Stop using the product. Sounds easy enough, but a lot of times, you may not even know a product is high in oil. If that’s the case, check the ingredients, use the process of elimination, and invest in haircare that’s labeled oil-free. Begin incorporating a shampoo in your routine once in a while that removes buildup—my favorites have an added chemical exfoliant.
Scalp Shampoo
AHA+ACV Pre-Shampoo Scalp Clarifying Treatment
T/Sal Scalp Build-Up Control Therapeutic Shampoo
Cheek breakouts:
⮕ What it *may* mean: Bacteria from hands, phone, or pillowcase
Cheek acne is notoriously difficult to cover up, IMO. No matter how many acne-friendly concealers I pack on, I find that when I’m dealing with this type of breakout, my face looks cakey, my blush and bronzer don’t sit right, and I’m really freaking annoyed. Though traditional face mapping calls on your liver for being the cause of cheek acne, it actually may be a whole lot simpler. Hi, lemme introduce you to something called bacteria—i.e., one of acne’s favorite things to feed on, that lives on literally everything you come in contact with daily.
Think about how many times you hold your phone up to your ear, how many doorknobs, railings, and surfaces you touch. Think about how much germs, dirt, and debris live on your pillowcase. Then think about how all that can be easily transferred to your face with one touch. The easiest way to treat cheek acne is to keep your hands and phone clean, change your pillowcase often, and treat with retinols or chemical exfoliants.
Queen Pillowcases —12 Pack
SOS Daily Rescue Facial Spray
Screen Wipes
Chin, jawline, and neck breakouts:
⮕ What it *may* mean: Fluctuating hormones or a hormonal imbalance
While it may be hard to pinpoint the root cause of acne on other areas of the face, breakouts on the lower face, jawline, and neck are almost always hormonal acne, says Dr. Nazarian. (But keep in mind hormonal acne may also appear elsewhere.) Hormones cause an increase in oil production, leading to breakouts that can appear as whiteheads, blackheads, inflammatory acne, or, if you’re like me and a lot of others, cystic acne. While chemical exfoliants or retinol may be able to treat on-the-surface acne (hi, whiteheads and blackheads), hormonal acne is a beast, and—I can’t repeat this enough—you’ll need to see a professional who can prescribe you the right treatments.
This includes anything from birth control, topical or oral antibiotics, or my favorite hormonal acne solution, spironolactone. Cystic acne is too deep below the surface to treat with topicals, and a steroid injection may be necessary to relieve pain and speed up the healing process. In the meantime, don’t poke or prod, and soothe your skin with noninvasive, gentle alternatives like LED lights, pimple patches that protect against bacteria, and even cold compresses.
Spironolactone Rx
Hero Cosmetics Mighty Patch™ Chin Patch
Light Therapy Acne Patch
T-Zone breakouts:
⮕ What it *may* mean: Excess oil production
Having skin that turns into an oil slick by noon is not ideal if you’re prone to acne, take it from me. There are not enough setting powders or mattifying lotions to keep my oil at bay, which I’m sure a lot of you can relate to. The T-zone is a naturally oilier place on your face, resulting in—you guessed it—grease, shine, and acne.
The oily sebum your skin makes to lubricate itself collects and forms sebaceous filaments, and when mixed with dead skin and dirt, can create clogged pores, blackheads, whiteheads, and even cysts, Dr. Nazarian says. The fix? Chemical exfoliants. The goal is to unclog those pores, and chemical exfoliants work by breaking down the “glue” that holds these dead skin cells together, as well as dissolving excess oil. The result is smoother, more noticeably clearer pores if used consistently over time.
2% BHA Liquid Exfoliant
T. L.C. Sukari Babyfacial AHA + BHA Mask
T. L.C. Sukari Babyfacial AHA + BHA Mask
2% BHA Liquid Exfoliant
Acne Resurfacing Retinol Face Serum
The bottom line:
Traditional face mapping may be a helpful tool for treating acne, but it’s by no means the end all. So as tempting as it may be to jump down a Reddit/Google/TikTok self-diagnosis rabbit hole, seek out the help of a dermatologist. They’ll be able to properly address your unique acne pattern and type so that you can be equipped with the right tools and treatments to get rid of your acne for good. That’s why they exist, after all!
Meet the expert:
Rachel Nazarian, MD, is a board-certified dermatologist at Schweiger Dermatology Group in New York, New York.
Why trust Cosmopolitan?
Siena Gagliano is an associate editor at Cosmopolitan with more than four years of experience writing in the makeup, skin, and hair spaces. She constantly speaks with cosmetic chemists and dermatologists about the newest and greatest in the beauty world, with a particular interest and expertise in acne. Her stories include the best salicylic acid cleansers and blue light therapy for acne treatment.
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