What Causes Acne On Cheeks?

Acne is the commonest chronic skin condition affecting millions of people worldwide. It is also the most commonly diagnosed dermatological disorder worldwide. Besides its effects upon the skin like scarring and hyper-pigmentation, acne also tends to impact the lives of people negatively on a mental level bringing on a feeling of inferiority or making them conscious about their looks. Before knowing what causes acne on cheeks, it is necessary to understand a little about the normal structure and layers of skin.

The normal skin has 3 layers;

1. The outermost layer – Epidermis contains specialized cells of skin called keratinocytes which form and secrete keratin, secretes vitamin D.
2. Middle layer – The dermis containing collagen, sebaceous glands, sweat glands, and hair follicles
3. Innermost layer – Subcutaneous layer

What Is Acne?

Acne is also called as acne vulgaris in medical terms. It is a chronic inflammatory condition affecting the sebaceous glands, hair follicle or hair shaft present in the dermis of the skin.

According to statistics, about 2/3rd visits to a dermatologist for acne are made by women. The mean age of patients seeking treatment for acne is about 15 – 25 years, probably owing to the several hormonal changes that take place during this age group.

However, acne may continue to occur in persons even beyond the age of 25 years. Appropriate treatment is possible only when we know what causes pimples on the cheeks.

Acne can be of the following types;

1. Acne Conglobata

It is a severe form of acne where multiple pores are infected resulting in the formation of the abscess filled with pus. This type of acne takes a lot of time to heal and may also leave behind scars or pigmentation on healing.

2. Cosmetic Acne

Seen commonly in women from the overuse of cosmetics. This type of acne is seen mostly on cheeks, chin, and forehead.

3. Drug-Induced Acne

This type of acne occurs from the use of medications and can be seen commonly on the back or abdomen.

4. Acne Fulminans

This form of acne is of a short duration wherein the lesions are crusted and ulcerated and is often associated with fever.

Acne can be graded as follows based on the type and severity

Grade 1	Comedones, occasional papules
Grade 2	papules, comedones, few pustules
Grade 3	predominant pustules, nodules, abscess
Grade 4	cysts, abscess, scarring acne

Signs And Symptoms Of Acne

Acne presents typically like the following;

1. Oily skin from excess production and secretion of sebum
2. Presence of whiteheads or blackheads on cheeks and forehead or chin
3. Acne may be simply papules or pus-filled
4. Lesions begin with redness

What Causes Acne On Cheeks, Chin, And Forehead?

Acne develops when the hair follicle, hair shaft or the sebaceous glands present in the dermal layer of skin gets infected.

Some of the basic underlying cause for acne on cheeks, chin, and forehead is disturbed activity of the sebaceous glands due to causes like;

• Excess production of sebum from sebaceous glands which may cause pores to clog and form blackheads or whiteheads and eventually get infected
• Alteration in the composition of fatty acids present in the sebum – a major factor influencing this is what we eat
• Hormonal irregularity or imbalance
• Excess secretion or formation of keratin by the epidermis
• Dysfunction of the immune system resulting in inflammation of the skin
• Apart from a disturbed sebaceous gland activity, some additional factors which can trigger or cause acne are;

1. Genetics

Genetics Have found to be associated with an increased risk of having acne. It can be a presenting feature of rare genetic diseases like Apert’s syndrome and also XXY syndrome.

2. Hormonal activity

It can trigger acne as is seen in women before or during menses, during pregnancy and during puberty in both boys and girls. The secretion of androgens causes the pores on the skin to enlarge. Due to this, the skin becomes oily due to excess sebum.

Some medical conditions associated with hormonal irregularity and acne are polycystic ovarian syndrome and androgen-secreting tumors.

Frequent acne is also associated with hormone replacement therapy or from the consumption of hormonal supplements.

3. Infections

Staphylococcus aureus, bacteria found on the skin is mostly responsible for infecting hair follicles or sebaceous glands. Bacteria Cutibacterium Acnes has also been found responsible for excess sebum production and inflammation.

4. Stress

This is a major contributing factor to most of the infectious and non-infectious medical conditions. Constant stress often results in inappropriate diet, lack of sleep and release of stress hormones which may worsen acne.

5. Diet

A strong relationship has been established between acne and what we eat. While the foods rich in vitamins, minerals, antioxidants, and omega-3 fatty acids improve skin texture and prevent acne breakouts, sugary foods like chocolates and candies, oily or greasy foods may aggravate acne.

6. Other lifestyle factors

some lifestyle factors which may worsen acne are;

• Excess alcohol consumption
• Cigarette smoking
• Lack of proper sleep
• Inadequate hydration
• Little or no physical activity or sedentary lifestyle
• Excess use of cosmetics or harsh products on the skin

7. Medicines

Some prescription medicines like anti-epileptic drugs, antibiotics, anti-tubercular drugs, oral contraceptives, hormone replacement therapy, and chemotherapeutic drugs may aggravate or trigger acne.

When To See A Doctor For Acne?

You need to see a doctor for acne under the following conditions;

1. There has been no improvement in your skin condition despite the use of the best home remedies.
2. When acne is associated with fever.
3. Acne rapidly developing into a puss-filled, painful abscess.
4. Acne producing scarring or hyper-pigmentation needs proper treatment from a dermatologist.

Acne specifically does not require any treatment unless it is of a severe form. What causes pimples on cheeks generally helps in guiding the line of treatment so that the root cause can be addressed.

Grade 1 and 2 acne can be treated by simply taking better care of the skin by regular cleansing, dietary and lifestyle modifications.

Grade 3 and 4 cystic acne requires dermatological assistance as these are severe forms of acne and can produce severe scarring if left untreated or if managed poorly.