No two people living with acne have the same experience—some see minor breakouts occasionally; others can count on pimples at least once a month (if not more). And some may have deep, cystic acne on a consistent basis. Acne symptoms can also be regional and only appear in specific spots, like the forehead. If you struggle with breakouts above the brows, specifically, treating them is usually made far easier when you know what kinds of acne symptoms you’re dealing with, and why they pop up there.
We spoke with two board certified dermatologists about what causes forehead acne, and how to get rid of it for good.
Meet the Expert
- Dr. Purvisha Patel is a board-certified dermatologist and founder of Visha Skincare.
- Dr. Craig Kraffert is a board-certified dermatologist and President of Amarte Skincare.
Types of Forehead Acne
Because acne is the result of clogged pores, acne symptoms can show up anywhere on the face where a pore can be found. "During adolescence, the forehead is often one of the first areas to develop acne,"says Kraffert. "It is also often one of the first areas to clear up as adolescence progresses too." Some types of symptoms, however, tend to appear on the forehead more often than others.
- Comedones: Read: those small spots known as blackheads and whiteheads. “Acne comes in many flavors, and the type of acne you see depends on the person’s ability to produce oil," says Patel. "Usually the type seen on the forehead is caused by occluded pores, so more whiteheads are seen there."
- Pustules and papules: While whiteheads are by far the most common acne symptom seen on the forehead, raised red pimples are also know to pop up in the area. "Inflammatory papules (which are red bumps) and pustules (which are red bumps with white centers) are less frequent than comedones," says Kraffert.
- Milia: Not technically acne although often mistaken for it, milia can sometimes take shape on the forehead as well. The difference between acne and milia? Acne forms when excess oil and dead skin cells clog a pore and create bacteria. Milia is seen when keratin becomes trapped under the surface of the skin to create little bumps that resemble whiteheads.
According to Kraffert, certain types of acne aren’t so commonly found so high up on the face. "Inflammatory acne tends to be less severe on the forehead than elsewhere on the face including temples, cheeks, jawline and chin," he explains. "Nodules and cysts are also less frequent and severe on the forehead."
Causes and Prevention
No matter where it pops up, acne symptoms all start the same way. “Breakouts are caused by four things: follicular occlusion, bacteria or fungus in the follicle, oil or sebum (or edible product) accumulation in the clogged follicle, and inflammation," explains Patel. "When these four things happen, breakouts happen—anywhere on the skin." Area-specific breakouts, however, may be exacerbated when something near that skin makes frequent contact with it.
- Excess oil production. “Acne on the forehead shares its pathogenesis with facial acne, namely hormones, heredity, and environment,” says Kraffert. Forehead acne, like all acne symptoms, starts with excess oil produced by the sebaceous glands. This extra oil, which is sent through the pores to protect and hydrate the skin, can sometimes become clogged on their way to the skin’s surface, creating a breeding ground for acne-causing bacteria.
- Tight clothing. Sure, not much clothing is worn on the forehead, but this refers to anything that may come in contact with it, like headbands, scarves, or even hair. "Think baseball caps, headbands, and hair products that leak down on the forehead skin to cause breakouts," says Patel. "Wearing hats or bandanas or headbands, and even touching your forehead a lot can manually occlude the forehead skin and cause forehead acne." The same goes for anyone who might hit the gym a lot, or enjoy activities that involve a helmet, like riding a bike. "Mechanical acne can occur on the forehead from hats and helmets," Kraffert adds. “This is particularly problematic with protective headgear such as football and cycle helmets, and is one tradeoff for [those with acne] engaged in these sports.”
What Is Mechanical Acne?
Mechanical acne (also known by its technical term, acne mechanica) are acne lesions caused by the heat and friction from an object (like bra straps or a helmet) rubbing up against the skin. The friction irritates the skin and disrupts the surface, which can clog the pores with dead skin cells and lead to inflammation.
- Food-grade oils: Here's an interesting tidbit. According to Patel, food-grade products are actually problematic for acne-prone skin. “Using products such as coconut oil and olive oil on your scalp and hair can cause forehead acne as edible products such as these tend to increase the growth of microorganisms on the skin,” he explains. “If you can eat a product, bacteria and fungus can eat a product as well."
- Certain hair products: What kind of hair products might make their way from your tresses and onto your forehead? Anything oily or sticky. "Pomade acne is caused by hair products, particularly thick or greasy ones," says Kraffert. "It is important to keep in mind that hair products can sometimes worsen acne, so take protective steps if a hair care product seems to be tied to worse acne manifestations."
- Sweat: Sweating is known to be great for the skin as it detoxes the body, but that only improves the condition of acne-prone skin when it’s rinsed away ASAP, and not left to linger on top of pores. “Sweating a lot increases oil in the follicles and if not washed off soon after sweating, can make forehead acne worse,” says Patel. Even a quick facial rinse after a sweat session can remove impurities on the surface of the skin, so don’t skip splashing your skin after a workout, especially if you’re noticing breakouts.
- Dead skin cells: While you may think to place primary blame on oil for causing acne, the fact remains—debris, like dead skin cells, contribute to acne-causing bacteria in clogged pores, which is why exfoliating is so crucial to proper skin health. "Exfoliating the skin regularly with an exfoliating wash helps unclog the pores,” says Dr. Patel. “Visha Skincare Top 2 Toe shampoo, face wash and body wash has bakuchiol (a natural exfoliant as well as zinc and tea tree oil to decrease microbial growth).” Even if your clogged pore doesn’t result in a pimple, sloughing your skin of dead skin cells can prevent unwanted buildup in your pores and rough skin texture. “When the pores get clogged and there is no bacterial or fungal growth, there is no pustule,” explains Patel. “Instead, a milial cyst forms, which is a clogged pore of just oil, like a small ball of oil under the skin. Milial cysts are also treated by exfoliating the skin.”
How to Treat Forehead Acne
Now that we know what we’re getting and why we’re probably getting it, let’s get rid of it, and keep it from coming back.
- Exfoliate. If you get little bumps on the forehead, regular cleansing and exfoliating with a non-irritating chemical exfoliant will go a long way in keeping pores clean and free of clogs. (Physical exfoliants, like face scrubs, can further exacerbate the situation.)
- Moisturize. What’s an easy way to tell your body to stop producing more oil? Replace any moisture that was washed or treated away with a gentle moisturizer to keep the skin hydrated. CeraVe is a classic choice that won’t clog pores, and can be found in most drugstores.
- Try a retinoid. "Differin is an over-the-counter acne medication that promotes the unclogging of pores," says Patel. "A prescription variant would be Retin-A, which helps open the clogged pore and the hardened oil come to the surface."
- Seek prescriptions for stubborn symptoms. "For more moderate acne with inflammatory papules and pustules, adding the oral antibiotic Seysara, which is FDA approved for acne, to your regimen provides nice additional benefit," Kraffert says. “In severe nodulocystic acne, isotretinoin is my preferred approach, particularly if the above program is not providing the desired improvement.”
- Try combination therapy. For chronic or stubborn acne symptoms, sometimes the best course of action is to combine three solutions in one regimen—cleansing, exfoliating, and treating with a prescription topical. "For mild forehead acne, I have seen nice results with Daily ExfoliPowder twice daily along with either Aklief Gel or EpiDuo Forte gel once daily," Dr. Kraffert recommends.
- See a pro for in-office treatments. When nothing else seems to be working, don’t give up—consult a pro for effective treatments tailored to your skin. "If over-the-counter methods do not work with the treatment of forehead acne, seeing a board certified dermatologist is recommended to prevent scarring," says Dr. Patel. "In-office treatment of milial cysts consists of extraction and chemical peels."