Dear Derm: Why Do Recurring Zits in the Same Spots Happen?

If you’re like me, you’ve grown pretty accustomed to breaking out in the exact same spot time-and-time again. And, I’m sorry, but what gives? I cleanse, tone, moisturize, and treat my face (and body) with top-quality skin-care products, so I’d really appreciate if that silly zit could just quit it. Sound familiar? I can’t say I’m surprised. After all, it’s pretty standard, albeit unfortunate, to experience recurring breakouts. While it’s great to know that we’re not alone in this pus-filled world, it’s much more helpful (for our skin at least) to understand what’s causing the frequent pimples in the first place.

“Zits that return in the same spot are usually cysts, or inflamed pimples deep in the skin,” says New York City-based dermatologist Arielle Kauvar, MD. “Our pores are the surface of channels (or tubes) which start in the oil glands and interconnect with one main channel in a hair follicle. When the channels become blocked, excessive oil and bacteria cause inflammation and expansion of the channel into a balloon-like sac that we can feel as a bump under the skin.” When these blockages occur deep within the channel, cysts form. Over time, those channels can become narrower, and even scarred, which predisposes the corresponding pores to become clogged and infected over-and-over again.

What may seem like recurring zits could actually be the same pimple taking its sweet time to fully go away. “There is redness and inflammation that needs to get cleared away with time,” explains board-certified dermatologist Anna Guanche, MD. She says that a proper skincare routine and retin A are excellent preventative measures, but once the pore is flared, she recommends using a spot treatment—we love this medicated pimple patch from ZitSticka. Now, onto the breakouts! Keep on scrolling to figure out how to troubleshoot acne wherever it appears on your face.

Chin and jaw

The chin and jaw are known as the hormone belt around the Well+Good offices. “Generally hormonal and stress-related acne occurs on the jaw and chin,” board-certified dermatologist Lily Talakoub, MD says. “Androgens increase with stress and monthly cycles, which triggers oil production and cyst formation on the skin.” Luckily there are specific medications designed to fight these types of breakouts head on—even if just as a side effect of a different overall use. “Sometimes taking a birth control pill designed to help acne or another medication called spironolactone can help to control the hormonal breakout,” says board-certified dermatologist Marisa Garshick, MD.

Forehead

On the other hand, Talakoub explains that acne from excess oil production and bacteria generally accumulates on the forehead and nose, as that’s where the pores are the largest and most easily clogged. That’s also where comedones, blackheads, and whiteheads are most likely to appear. “These breakouts (along with hormonal breakouts) tend to be best controlled by using products that help to unclog the pores and assist with oil production, including salicylic acid washes—such as Glytone Acne Clearing Salicylic Acid Cleanser, SkinCeuticals Blemish and Age Defense, and willow bark extract,” Dr. Garshick points out. “Other treatments for these types of breakouts include retinoids, such as Differin Adapalene Gel or prescription retinoids, as this helps to regulate skin turnover to prevent the pores from getting clogged in the first place.”

Back and chest

Then, there’s the back and chest, areas prone to blemishes thanks to the sweat buildup and yeast. While showering immediately after sweating is a great preventative measure for keeping your skin healthy and clear, it helps to use the right products both in and out of the shower. We love the Pixi by Petra Glycolic Body Wash, as it helps speed up the exfoliation process which helps unclog pores. Another fave is Paula’s Choice Clear Acne Body Spray, as it, too, accelerates cell turnover and promotes a clear overall complexion.