Cheek Acne: The Causes and Treatments, According to Dermatologists

We know that breakouts on the jawline and chin are often linked to hormonal fluctuations and that breakouts in the oil-prone T-zone can be tied to stress—but what about acne on our cheeks? Though all acne results from pores clogging with excess oil, dirt, and dead skin, depending on where we're breaking out, our faces can sometimes offer clues about why the pore-clogging is happening. Cheek acne, for instance, could be caused by everything from genetics to dirty makeup brushes.

Fortunately, when it comes to acne on the cheeks, the good news is that there may be shifts we can make in our everyday lives to help get our skin back on track. We spoke to top dermatologists about what leads to cheek breakouts and how to prevent and treat them.

What Is Cheek Acne?

As the name suggests, cheek acne is any breakout that appears in the area below your eye and between your mouth and ear.

What Does It Look Like?

According to our experts, cheeks are more prone to inflammatory types of acne, such as papules, pustules, nodules, and cystic acne, rather than non-inflammatory types such as blackheads and whiteheads.

What Causes Cheek Acne?

Even though breakouts on the cheeks can be a manifestation of genetics, they are more likely to be connected to lifestyle factors and everyday habits than breakouts on other parts of our faces. “Unlike acne breakouts on the rest of your face (T-zone, nose, chin, forehead), the underlying causes of spots on the cheeks are much harder to pinpoint. It may be caused by genetics or everyday habits (touching the face, makeup, makeup brushes, etc.). For some people, it just happens to be where their skin tends to develop acne." explains board-certified dermatologist Annie Gonzalez, MD. "Everyone has different skin and oil gland tendencies. But in general, isolated breakouts on the cheeks are a byproduct of the environment and poor skincare.”

Here are a few of the causes of cheek acne.

Touching Your Face

Our cheeks, when you think about it, bear the brunt of our habits. From face touching, cradling, and leaning on hands to dirty phones and pillowcases, our cheeks put up with all of it. So it’s not so surprising that they sometimes react. Our hands are breeding grounds for germs, says Gonzalez. “The more you touch your face, the more dirt, bacteria, oil, allergens, and dead skin cells contact the skin.”

Talking on the Phone

Also a prime spot for germs? Our phones. “The hands collect allergens and pollutants throughout the day, whether from our keyboards, doors, elevator buttons, or smartphones,” notes Gonzalez.

Dirty Pillowcases

Even if our skin makes it through the day scot-free, our own beds (frustratingly) present more opportunities for germ exposure. “When it comes to breakouts on the cheek, consider the pillowcases or sheets. In just one to two weeks, your bedsheets are practically a breeding ground for bacteria, dust, dirt, fungi, pollen, and other allergens that permeate the sheets,” Gonzalez explains. 

Makeup and Makeup Brushes

Makeup and makeup brushes can also be an acne culprit, so it’s important to pay attention to the ingredients in your products. “Any skincare products or makeup with ingredients like alcohol and synthetic fragrances might be irritating or comedogenic,” Gonzalez says. 

Your Skincare Routine

While skincare is essential, there is a right and a wrong way to approach it. A lack of hydration or stripping the skin from overwashing can also lead to breakouts. What's more, you could be allergic to a product in your skincare routine, which could be causing the very breakout you're trying to combat.

Genetics

Genetics can, of course, play a role, as some people are predisposed to breakouts. As for how to tell the difference between what's genetic and what's not? While it’s best to consult a professional, your face provides some clues on its own, too. “When it's part of a chronic inflammatory condition, there usually won’t be sharp boundaries of where you’re impacted,” notes board-certified dermatologist Ranella Hirsch, MD. “When it’s not, it will be distributed more closely to whatever the trigger was—for example, the shape of your phone and connected to recent exposure."

Hormones

Hormonal imbalances can also play a role in breakouts. A board-certified dermatologist can help you pinpoint (and address) the cause. If it’s determined not to be genetics-, hormone-, or lifestyle-related, board-certified dermatologist Jeremy Brauer, MD, explains other skin conditions like rosacea, acne mechanica, folliculitis, or other rashes could be to blame.

How to Prevent Cheek Acne

The good news is that if everyday habits or lifestyle factors are contributing to breakouts on your cheeks, they’re not so hard to address—and definitely worth the extra loads of laundry and weekly makeup brush cleaning. The other key to prevention? Los Angeles–based board-certified dermatologist Onyeka Obioha, MD, says it's a well-rounded skincare routine. 

She recommends a simple but powerful routine. “End your day with an exfoliating cleanser that contains AHAs/BHAs like glycolic and salicylic acid to remove the day's debris, dead skin cells, and unclog clogged pores,” Obioha says. We like Skinceuticals LHA Cleanser ($45) and the Holifrog Shasta AHA Refining Wash ($38). Even if your skin is breakout-prone, don’t skip hydration. “Look for a soothing, oil-free, non-comedogenic moisturizer that won’t clog pores,” she says. We like La Roche Posay Toleriane Ultra Face Moisturizer for Sensitive Skin ($32). 

How to Treat It

If your breakouts are not responding to over-the-count acne treatments, Obioha recommends an evaluation in-office by a board-certified dermatologist who can help determine the best treatment plan. Common options include:

Benzoyl Peroxide

The common acne-fighting ingredient, benzoyl peroxide, treats bacteria that contribute to acne, and can, to a lesser extent, help reduce sebum production, Hirsch explains. Find it in La Roche Posay Effaclar Duo Dual Acne Treatment ($23).

Salicylic Acid

This oil-soluble beta hydroxy acid gets into the follicle where sebum is produced and exfoliates, Hirsch says. Try it in editor-favorite Paula’s Choice 2% BHA Liquid Exfoliant ($35).

Retinoids

This vitamin A derivative increases cellular turnover, which, in turn, helps keep pores clear. It can also regulate sebum production and act as an anti-inflammatory. A board-certified dermatologist can prescribe a retinoid (tretinoin) cream, but companies like Dermatica and Curology can also help you access this potent ingredient from home at an affordable price. 

Antibiotics

Antibiotics work to reduce bacteria count and inflammation. They can be prescribed by a board-certified dermatologist and taken orally or applied topically. 

The Final Takeaway

Cheek acne is characterized by the appearance of inflammatory acne types such as papules, pustules, nodules, and cystic acne in the area below the eyes and between your mouth and ear. It can be caused by a variety of factors, including hormonal changes, genetics, phone usage, skincare routines, and touching your face, as well as the use of dirty makeup brushes or pillowcases. There are many effective treatments available, including topical creams, prescription medications, and lifestyle changes. Working with a dermatologist is important to develop a treatment plan that addresses the underlying causes of your cheek acne and helps you achieve your skin goals.