What Causes Jawline Acne? Best Treatments and Prevention

• Jawline acne can present as noninflamed comedones and/or inflamed lesions
• The jawline is susceptible to acne as it has a high number of sebaceous glands that secrete skin-lubricating oils which can lead to clogged pores
• Acne on the jawline can be a result of several causes including shifting hormones, genetics, diet and stress
• A number of over-the-counter and prescription acne medications are available to effectively control and treat jawline acne 

Acne is a chronic skin disease that occurs when a combination of dead skin cells, sebum (oil) and debris block pores and create blackheads and whiteheads, a form of noninflammatory acne. If bacteria becomes trapped, it can multiply and cause inflamed pustules, cysts and nodules. As with elsewhere on the face and body, jawline acne can take the form of one or the other type or be a combination of both.

Types of Jawline Acne

All acne stems from overactive sebaceous glands, as excess oil is a necessary component for acne pimples and lesions to form. 

The jaw is susceptible to acne as it is home to a large number of sebaceous glands. As well, the jawline is exposed to comedogenic cosmetics and hair styling products which can contribute to blocked pores.

Acne that develops along the jawline can be mild, moderate or severe, and result from a number of causes. It can take the form of mild pimples and comedones but typically, it is inflamed and can lead to the development of moderate to severe cystic and nodular acne.

Cystic acne is characterized by large pus-filled lesions that are red, swollen and painful. These form deep beneath the skin and are an accumulation of sebum, dead skin cells and Cutibacterium acnes bacteria. These lesions are visible on the skin’s surface as boils. 

Nodular acne is characterized by extensive inflammation, and cysts and large nodules that form deep within skin tissue. These are hardened masses that do not release pus. Raised red bumps are visible on the skin’s surface and can be disfiguring. 

Both cystic and nodular acne require professional treatment in the form of combined therapy to treat and manage symptoms, and minimize scarring and tissue damage.

What Causes Acne on the Jawline? 

Several causes can influence oil production and increase the likelihood of acne on the jawline. These include hormonal imbalances, diet, genetics and stress. 

Hormonal fluctuations 

Areas that are more susceptible to the effects of fluctuating hormones include the lower portion of the face, especially the cheeks, chin and jawline.

Hormonal fluctuations and imbalances play a key role in acne flare-ups. A number of hormones are implicated, such as estrogens, progesterone and insulin but androgens, male hormones, are the most important of hormones in regulating sebum production. 

Fluctuations in hormones commonly occur during puberty, the menstrual cycle, pregnancy and menopause, which results in excessive oil production. This oil accumulates with dead skin cells and grime, resulting in mild pimples called comedones, or inflamed lesions if bacteria proliferates.

Jawline acne can also be a symptom of polycystic ovary syndrome, (PCOS) a condition where the ovaries overproduce androgen hormones. This stimulates oil production and increases the likelihood of acne on the jawline.

Postadolescent females therefore have the greatest burden compared to males due to these hormonal fluctuations that occur over the course of their lives.

Diet

While research is still ongoing, the latest studies do implicate diet as another driver of acne development. 

Studies show that people with acne who consume diets with a low glycemic load have reduced acne lesions compared to those with a high glycemic load. Consumption of dairy and especially whey proteins can increase your level of insulin-like growth factor 1 (IGF-1), a hormone that boosts testosterone, which causes breakouts.

Foods high in fat, sugar-laden products and sugary drinks, and refined carbohydrates such as white bread and pasta all have a high glycemic index which causes blood sugar to spike and triggers the body’s immune response. This response causes widespread inflammation throughout the body and enhances sebum production.

Genetics

Genetics can also play a key role in acne development through various pathways. Genes influence risk, sebaceous gland activity as well as the inflammatory response and acne severity.   

One large twin study of acne in women used genetic modeling to show that 81% of acne scores were attributable to the combined effects of multiple genes which spurred acne development. Family history of acne was also a strong indicator of increased risk.

Stress

Stress can have a far-reaching effect, not only on the mind, but on the body and skin. It can cause acne to form and exacerbate symptoms.    

Anxiety and stress release cortisol and androgen stress hormones. These hormones cause acne flare-ups by increasing inflammation and stimulating sebum production.

Chronic or long-term stress can cause dryness, oiliness, sensitivity, swelling and acne flare-us.  One study examining the effects of stress found that the greater the stress the worse the acne.

Best Ways to Treat Jawline Acne

Cystic and nodular acne are both severe types of acne that can lead to extensive tissue damage and scarring; and both can be difficult to treat. 

As such, dermatologists apply a multimodal approach that includes retinoids, antibiotics and hormonal treatments that all work in synergy to alleviate symptoms and manage the disease.

A typical first-line treatment strategy would be an oral antibiotic + combination of adapalene or tretinoin, a vitamin A derivative; or benzoyl peroxide + a retinoid; or an oral antibiotic + retinoid + benzoyl peroxide.    

Your dermatologist will examine your skin, take your history and determine which medications would be best for you.

Antibiotics 

The most commonly prescribed oral antibiotics for moderate-to-severe acne fall within the tetracycline class of antibiotics (doxycycline, minocycline and sarecycline). These are mainstay acne treatments that have an established safety and efficacy profile. 

Antibiotics are a mainstay of inflammatory acne treatment because they kill C. acnes bacteria, and reduce inflammation, redness and pain. Targeting the infection halts the progression of damage and any associated scarring.

Benzoyl peroxide is another tried-and-true medication that is commonly included alongside a course of antibiotics. Not only does it enhance the effects of antibiotics, it works to decrease antibiotic resistance. 

Hormonal treatments

Two systemic agents have demonstrated efficacy against moderate-to-severe forms of jawline acne; taken together they produce greater results.

Birth control 

For females with jawline acne seeking contraception, combination (estrogen and progestin) birth control pills can regulate androgen activity which in turn lowers sebum production. Studies show that these pills lead to significant reductions in lesion counts across all lesion types.

On the negative side, taking oral contraceptives has been linked to increased risk of venous thromboembolism and a potential increase in breast cancer risk. Cardiovascular risks can also be elevated based on risk factors such as smoking and diabetes.  

Spironolactone

Spironolactone is an oral diuretic medication that is used as a second-line therapy to treat hormonal acne in women with difficult-to-treat acne or severe acne. It works by inhibiting the production of androgens to suppress and regulate sebum production.  

While this medication has been shown to be effective with some to significant improvement, additional studies are needed before it can be considered a mainstay treatment. One recent 7-month study of spironolactone in adolescent females found 80% had an improvement with 22.5% having a complete response. 

Some side effects associated with this medication include dizziness, nausea, fatigue, muscle cramps and breast tenderness. Severe side effects include reduced kidney function and  low blood pressure.

Isotretinoin

Isotretinoin is a systemic retinoid sold under a variety of brand names and is prescribed for moderate-to-severe acne such as cystic and nodular acne, as well as for treatment-resistant cases. It is an option that is used when other conventional acne medications have failed.

This medication is currently the most effective treatment on the market; most patients who take oral isotretinoin will be free of acne by the end of 4–6 months of treatment depending on the dose. 

Isotretinoin reduces the size of sebaceous glands to dramatically lower sebum production, encourages skin cell turnover, lowers the amount of acne bacteria on skin and has anti-inflammatory effects.

However, this medication has a long list of potential serious adverse effects and must therefore be monitored throughout treatment.

Over the counter topicals

For acne on the jawline that is comedonal—noninflamed blackheads and whiteheads—there are several effective over-the-counter (OTC) skin care products that contain active agents to clear and prevent future pimples from forming:

• Benzoyl peroxide can kill bacteria to prevent inflammation and penetrate pores to clear away dead skin cells, oil and debris 
• Salicylic acid is a powerful oil-soluble beta-hydroxy acid (BHA) that deeply penetrates skin to dissolve clogged pores and slough off dead skin cells and debris from the skin’s surface; it also lightens hyperpigmented spots
• Retinol is a gentler version of retinoid and can exfoliate pores, regulate oil production and fade dark spots

Preventing Jawline Acne

There are several steps you can take to prevent or reduce the frequency of jawline acne:

• Choose skin care products and cosmetics that are oil-free and labeled noncomedogenic
• Use a gentle cleanser formulated for your skin type and follow with a moisturizer to hydrate and protect skin
• Include a chemical exfoliant such as salicylic acid twice a week to maintain clear pores 
• Avoid touching your face or picking at blemishes as this can introduce bacteria, spread the infection and worsen symptoms
• Wash your pillowcase regularly and keep hair off your face to avoid transferring oils to your skin
• Follow a whole-foods diet that emphasizes fruits, vegetables, whole grains and legumes, and limits processed foods; this will have a positive impact on skin’s appearance and health

Other Spots that Appear on the Jawline 

Acne on the jawline can easily be confused with other skin conditions:

• Boils are large red pus-filled bumps that form in hair follicles and are caused by bacterial infections
• Cellulitis is another bacterial infection that develops around a skin injury and causes discolored skin, swelling and pain 
• Folliculitis is a skin infection that develops in hair follicles, resulting in itchy, pus-filled bumps 
• Rosacea is a chronic skin condition that is characterized by pus-filled blemishes and red swollen bumps

Takeaway

Jawline acne can take the form of noninflamed blackheads and whiteheads or more commonly, as inflamed acne. Symptoms can be moderate to severe and fall within the category of cystic or nodular acne; both can present with a high degree of inflammation and can therefore cause significant damage if not treated quickly.

Acne breakouts on the jawline develop for the same reasons it develops elsewhere on the body — due to a high number of sebaceous glands which can overproduce sebum and prompt acne lesions. 

Increased sebum production can be initiated by hormonal fluctuations, genetics, stress and diet. Hormonal imbalances are a frequent instigator of jawline acne and therefore predominantly affects women.

Treatment typically consists of combination therapy including topical antibiotics, benzoyl peroxide, hormonal treatments, isotretinoin and spironolactone. These target and kill acne-causing bacteria, reduce inflammation, clear pores and regulate and reduce oil secretions.  

Jawline acne that consists of blackheads and whiteheads can be effectively treated using OTC solutions: benzoyl peroxide kills bacteria, salicylic acid sloughs off dead skin cells and debris; and retinol deeply exfoliates pores and regulates oil production.