What is cosmetic acne (acne cosmetica)?
Cosmetic acne occurs when makeup such as liquid foundation, makeup primers, cream blushes and cream bronzers cause a blockage in the pores resulting in bacteria growth that can lead to breakouts. Cosmetic acne can be exacerbated during the summer due to increased oil production from heat and humidity.
A cosmetic acne story
Throughout the years, I have friends (and friends of friends!) who will text me photos of their face during a skin emergency in need of my expert help. One such friend, who I’ll call Kristen, sent me the above picture of these rash-like bumps that she has been experiencing. If you look closely, you can see not only redness, but little whiteheads everywhere. So, as an esthetician with 27 years of hands-on experience with a specialty for problem-solving my client’s skin issues, I started by asking her some questions to get some insight so I can get it figured out for her.
Me: Did this just occur (if so, when?) or has this consistently been like this?
Kristen: This only happens when I come home from spending the weekend outdoors in Palm Desert, CA. I was out at Coachella and the weather was very hot.
Me: Have you introduced anything new to your skin recently?
Kristen: No, I haven’t changed anything.
Me: Is this on other areas of the face other than this left side?
Kristen: Yes, but it’s worse on the left side.
Me: Does it itch?
Me: Does this ever happen when you workout and sweat?
Kristen: I do workout regularly at home, but no. This doesn’t happen normally.
Me: When in Palm Desert, were you wearing a lot of foundation makeup? If so, was it a liquid or powder? Also, do you wear powder blush or cream blush?
Kristen: Yes, I did have heavy makeup on for long periods of time because I was doing some filming there. And yes, I do always wear a cream blush.
Easy! I determined the problem and the solution.
Me: The fact that it only happens in Palm Desert clearly shows that it’s something weather related. If this was happening every day, wherever you are, then we would have to explore much further but I don’t see this as being the case. What you appear to have is a condition called acne cosmetica which is essentially comedones, pustules and papules caused from a blockage in the pores resulting in bacteria growth. It’s a combination of your foundation makeup, cream blush and increased oil secretion from the heat and humidity. This is simply not a good combination for your skin type.
Hormonal breakouts would be more pustular or cystic, not these small ones, so it’s definitely not hormone related. As for why you would have more bumps on the left side of your face than the right, my guess is that you’re using more foundation on the left side. Why? Assuming you are right handed, this would mean that you’ll first squeeze or pump out your foundation onto the fingers of your left hand. Even if you then rub your right fingers together before you apply, you’ll usually still have more makeup on your left fingers resulting in a heavier application on the left side. An even application is important, especially with skin care products. Read more about what can also happen when you don’t apply your skin products correctly.
In the future, I would suggest only use a powder blush (since creams can be very problematic), as well as to start experimenting with other brands of liquid foundations, since the one you are currently using clearly isn’t a good fit—or at least when you’re outdoors in the heat.
Kristen: I went to a dermatologist for this and she has given me a bunch of topical antibiotics as well as an oral antibiotic, Minocycline (Soldoyn) to treat this. Should I use it?
Me: I am not a doctor and so I can’t tell you if you should or should not take or apply prescription medication, but if it were me, I would let this clear up on its own (which it will) and start experimenting with different makeup options since we have found the problem. Your doctor might also agree that medication isn’t necessary at this point, so you may want to ask her.
Kristen: Renée, this all makes perfect sense and is putting me at ease! I was getting worried that this was a bigger issue. Thank you for this assessment!
So there you have it. I quickly saved another client from going down a long, and often expensive, road of trying to figure out the cause of her breakouts. This usually consists of using prescription medications and topical treatments that will dry out the skin leaving it red and irritated, only to find that the root of the problem was never discovered.
Not all skin types will respond negatively to makeup, but for Kristen, this unique combination of heat, humidity and makeup were problematic for her. Luckily, I don’t see this condition nearly as often as I did when I started my esthetics career in the late 80s. The reason for this is because makeup formulations have improved greatly over the past 30 years with formulas that are more agreeable with acne-prone skin types.
She did also send me a picture of her nose that had a red streak going down the center. She asked if it was rosacea. I knew it immediately when I saw it. No, it wasn’t rosacea but rather that her skin’s natural oils wore off her sunscreen throughout the day in Palm Desert and caused a mild sunburn in this area. And/or, she didn’t apply it on the center of the nose as well as she thought. Most people apply sunscreen in downward strokes from the sides of the nose and can often not apply it on the top. Yet, another example of proper application.
Kristen: Yes, my nose could be sunburn now that I think of it. It is sore!
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Celebrity Esthetician & Skincare Expert
As an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Her hands-on experience as an esthetician and trusted skin care expert has created a real-world solution — products that are formulated for nine different types of skin so your face will get exactly what it needs to look and feel its best. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”