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Types of Jawline Acne
While there are a few different causes of acne that forms along the jawline, such as wearing makeup that clogs up the pores, taking certain medications, or shaving with old, bacteria-laden razor blades, far and away the most common reason for jawline acne is hormonal.
Unfortunately, the blemishes stemming from hormonal acne like this tend to by cystic, meaning they’re bigger, severe, and deeply rooted in the skin, making them the most visible yet difficult type of acne inflammations to treat. Plus, they typically don’t dissipate for at least one or two weeks, and are the acne blemishes most likely to leave scars or post-inflammatory hyperpigmentation marks once they finally do dry out and fade away.
What Causes Acne on the Jawline?
Acne is the most common skin condition in the United States, affecting some 50 million people a year, according to the American Academy of Dermatology (AAD). It results when hair follicles in the skin become blocked with dead skin or excess oil, trapping dirt that leads to inflammation. Bacteria on the skin infects blocked follicles, which results in pimples, cysts, and nodules.
While hormonal changes are the most frequent cause of jawline acne, the condition is not exclusive to hormonal fluctuations and can also be caused by:
- Sports equipment: with chinstraps that trap moisture, heat, and sweat around the jaw, leaving the area vulnerable to inflammation.
- Cosmetics: containing heavy oils that clog skin pores. Non-comedogenic skin care products are recommended as they are specifically formulated not to block pores for this very reason.
- Medications: Acne is listed as a potential side effect for a variety of pharmaceuticals, most commonly steroids along with anti-depressants and anti-psychotic drugs designed to treat bipolar disorder and schizophrenia.
- Shaving: can irritate the skin even at the best of times. But when razor blades are older they can break the skin and lead to infection, which in turn stimulates acne breakouts.
- It’s believed people with a parent or parents who have suffered severe cystic acne are more prone to the condition themselves.
Hormonal fluctuations
Young, post-adolescent women between age 20 and 40 tend to be the most vulnerable to hormonal jawline acne. According to a study commissioned by the American Academy of Dermatology, approximately half of all women in their twenties and over a quarter of women in their forties are affected by the condition.
Fluctuating hormone levels are the most common reason why jawline acne develops, so outbreaks tend to appear just prior to menstruation, during pregnancy, after stopping or starting a regimen of birth control pills, and during perimenopause. These are times when an increase in male hormones called androgens are produced, which stimulates the skin’s oil glands, producing the excess oil that leads to inflammation.
Jawline acne can also be a symptom of polycystic ovary syndrome, a condition that creates cysts in the ovaries and is accompanied by an increase in the production of male hormones.
Diet
There’s still no consensus among dermatologists about the role diet plays in the development of acne. For example, the American Academy of Dermatology (AAD) does not support the contention that certain dietary adjustments will affect acne either positively or negatively, citing the lack of data on the subject as being too substantial to arrive at any firm conclusions. Nevertheless, while more study is required, there is still a fair body of research to indicate some foods and/or food groups can either curb or stimulate the incidence of acne outbreaks.
As a general rule of thumb, cutting out sugar and dairy, particularly whey protein-heavy skim milk, and simply avoiding any food that causes blood sugar to spike (white bread, potato’s, candy, soda, juice, processed food) could have a positive effect on hormonal jawline acne, as it will with any kind of acne. A gluten-free, dairy-free diet with few refined carbs and an emphasis on natural, real food like fruit and vegetables is a good place to start.
Some foods believed to spur acne include:
- Dairy products and whey protein: skim milk in particular
- Refined carbohydrates: white bread, pastries, pasta
- Sugar and sugary drinks: like soda and fruit juice
Some foods believed to curb acne are those rich in:
- Zinc: sunflower and pumpkin seeds, whole grains, nuts, beans.
- Omega-3: tofu, eggs, fish, soy products, kale, flax seeds, walnuts, almonds, spinach
Best Ways to Treat Jawline Acne
Cystic acne is most typically brought on by hormonal fluctuations, is the most severe and longest lasting form of the acne vulgaris, and the most difficult to treat. Unlike whiteheads or pimples, cystic acne is characterized by large, red, and painful breakouts that originate deep in the epidermis. Consequently, topical applications that serve to treat superficial blackheads and pimples on the top layers of skin have little effect on cystic acne blemishes. Dermatologists will usually recommend one of the following treatments to address this type of acne.
- Oral antibiotics
- RX creams, gels or lotions with retinoids that help antibiotics better treat inflammation by unclogging the pores
- Accutane (Isotretinoin)
- Steroid injections
- Spironolactone
- Birth control pills
Antibiotics and topical treatments
Because cystic acne tends to be severe and not easily rectified, dermatologists will often start treatment with a combination of oral antibiotics and strong topical creams or lotions to see how well they perform before moving on to more dramatic treatments like side-effect heavy Isotretinoin or using hormonal drugs like Spironolactone.
The antibiotic usually prescribed for this purpose is tetracycline, or a tetracycline derivative like doxycycline, while a hydrocortisone topical cream, often prescribed in combination with a retinoid, will have benzoyl peroxide and/or salicylic acid as their active ingredients. This is usually the first line of defense. If it proves ineffective, dermatologists usually move on to the following more complicated drugs to treat hormonal cystic acne.
Isotretinoin
Isotretinoin is an RX medication sold under a variety of brand names and is a particularly effective treatment for cystic, or any severe variation of acne. It’s exact mechanism of action is unknown but it’s been shown to induce cell death, in particular cells responsible for acne, such as those found in sebaceous gland cells. This reduces sebum production in sebaceous gland cells while simultaneously exhibiting an antimicrobial effect on the bacteria responsible for acne inflammations.
Unfortunately, while effective, isotretinoin also comes with some significant side effects, particularly if taken during pregnancy, where it’s been known to cause congenital deformities and even death to unborn infants. As a result, it’s widely considered to be a treatment of last resort for those with moderate acne, usually only implemented after oral antibiotics have been shown to be ineffective for a particular individual. It is, however, often a first line treatment for cystic acne due to the severity of the condition.
Steroids
Dermatologists will sometimes inject a corticosteroid medication called triamcinolone directly into a cystic acne inflammation. Again, however, there are side effects to consider with triamcinolone as well, so this therapy is usually only employed with severe cases of acne.
Spironolactone
Spironolactone was originally designed to treat high blood pressure and heart failure. However, the drug also inhibits the production of androgens, the male hormones that lead to hormonal acne in women. By reducing these hormones, the drug reduces oil production on the skin, which by extension lowers the frequency of clogged pores. While the treatment can be effective after 6 – 12 weeks of use, it too has potentially serious side effects, including dizziness, headaches, nausea, vomiting, breast tenderness, hair loss and can potentially increase potassium levels to a dangerous extent.
As with Isotretinoin and steroid therapies, while Spironolactone can lead to promising results, there are several considerations to take into account before beginning this therapy. It is sometimes prescribed in combination with birth control pills containing estrogen and progesterone to amplify it’s acne-reducing effects.
Birth Control Pills
Oral contraceptives are also used to treat hormonal jawline acne because they target androgens and other hormones that lead to the condition. Birth control pills prescribed for this purpose have ethinylestradiol in combination with drospirenone, norgestimate or norethindrone as their active acne-fighting ingredients. It’s a long term treatment which suppresses the production of sebum, which can lead to inflammations of this type.
Preventing Jawline Acne
There are many things you can do to guard against acne from forming along the chin and jaw in the first place. While following these tips can’t guarantee you’ll never have to deal with cystic acne again, they should at least reduce the frequency of breakouts.
- Wash your face twice a day using a gentle cleanser, rinse with warm water, and pat yourself dry. Remember not to scrub as that can actually worsen the condition.
- Try not to touch your face too many times over the course of a day. Touching your face introduces bacteria that can get into your pores and result in a breakout.
- If you’re using sports equipment that requires a chinstrap, be sure to wash your face immediately after you take it off.
- Only use skin care products that are oil-free and labeled non-comedogenic
- Don’t use any products that can irritate the skin (astringents, toners, exfoliants)
- Resist the urge to pick at or pop your acne blemishes. This only worsens the condition, makes them last longer, and can easily result in acne scars or hyperpigmentation long after the original blemish has dissipated.
- Avoid spending too much time under direct sunlight and always wear sunscreen when you do
- Shampoo your hair on a regular basis, even once a day if you have oily hair.
Other Spots that Appear on the Jawline
Cystic acne blemishes are not the only kind of inflammation that can develop along the chin and jawline. Others include:
- Folliculitis: develops from ingrown hairs that become infected, leaving pus-filled inflammations on the skin that can sometimes appear similar to cystic acne.
- Rosacea: leaves red spots on the skin that are typically swollen and bumpy.
- Boils: are infections that spawn large, painful, pus-filled, red bumps on the skin.
- Cellulitis: is another common bacterial infection that leaves swollen red inflammations on the skin, often along the jawline and lower face area.
Takeaway
While there are several reasons why acne can form around the chin and jawline areas, more often than not, particularly among young post-adolescent women, it’s the result of hormonal fluctuations that stimulate excess production of androgens, which in turn leads to excess oil production which can then become infected and leave large, painful, red inflammations on the skin.
Jawline acne caused by hormonal fluctuations usually results in cystic acne, which is fortunately the least common type of acne people suffer, but unfortunately the longest lasting, most painful, and difficult variation of the condition to treat. Consequently, therapies that help with more moderate cases of acne are largely ineffective with cystic acne inflammations and professional treatments are invariably required to address the problem. Most of these treatments are ultimately effective in curbing the incidence and severity of jawline cystic acne inflammations, but are slow to work and require medications that also come with potentially significant side effects.
For those prone to hormonal acne that forms along the chin and jawline, the best approach to dealing with the condition is to take measures that discourage acne from forming in the first place. Sometimes the answer can be as simple as beginning a regimen of birth control pills, although this can only be determined by your dermatologist. However, paying close attention to one’s diet and taking a low-glycemic approach with limited blood sugar spikes and no dairy or refined carbs while replacing those foods with others understood to curb acne inflammations, is one proactive measure you can take to address the condition.
Sources
- Dréno, B. (2015), Treatment of adult female acne: a new challenge. J Eur Acad Dermatol Venereol, 29: 14-19. doi:10.1111/jdv.13188
- Kucharska, A., Szmurło, A., & Sińska, B. (2016). Significance of diet in treated and untreated acne vulgaris. Postepy dermatologii i alergologii, 33(2), 81–86. doi:10.5114/ada.2016.59146
- Charny, J. W., Choi, J. K., & James, W. D. (2017). Spironolactone for the treatment of acne in women, a retrospective study of 110 patients. International journal of women’s dermatology, 3(2), 111–115. doi:10.1016/j.ijwd.2016.12.002