Acne Cosmetica: Is This The Cause Of Your Bumps And Breakouts?

acne on a womans face

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?
Kristen: No.

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.

Read: Dermatologist Vs. Esthetician: Who Has The Best Approach For Treating Acne?

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!

Read: 8 Tips To Prevent Chin And Jawline Breakouts
Read: Struggling With Acne? Keep Track With A Calendar To Find The Cause
Read: How To Look 24 Percent Younger

Which skin care products are best for you? See our nine skin types or take the Skin Type Quiz and get products recommended.

Need expert advice from a licensed esthetician? Schedule a virtual consultation to get customized advice in person, over the phone or online via Skype or FaceTime.

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Disclaimer: Content found on and, including text, images, audio, or other formats were created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website or blog.


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  1. Dear Renee,
    Thanks a lot for your all the effort you give to help us ! I have been experiencing a similar situation like the one posted but it has been like this for almost 7 months; tried azaelic acid and it did actually make me breakout more, then dr prescribed me doxcy 100mg for a month along with duac; when i strated duac my skin broke out as well.. my hormones are perfect, do you think its acne cosmetica?
    Your answer is much appreiciated
    thanks a lot

    Posted By: al  | 

    • If you’re getting these kind of small bumps on the face, and prescriptions aren’t making it any better than you very well may want to look into trying another type of makeup. It could be helpful for you to get a professional facial to clean out the pores.

      Posted By: Renée Rouleau  | 

  2. Hello, I have cystic acne, I cant go outside without make up,which foundation and power can you suggest me?

    Posted By: Elene  | 

    • I don’t have any suggestions for which makeup is best. You’ll just have to experiment. Every skin will respond differently so there just isn’t one that will work for every type of acne-prone skin. I do have a recommendation for cystic acne. See our spot treatment.

      Posted By: Renée Rouleau  | 

  3. I had cystic acne when younger, and took 2 courses of Accutane. Now at 59 with whacko hormones, it is back. Without using topical creams and a oral antibiotic it would be even worse. What can I do? and when will this end? Help!

    Posted By: Carol Morris  | 

    • Since you’re having a lot of hormonal breakouts, I suggest you schedule a consultation with one of our estheticians. We will be able to learn more about your skin so we can help you make a plan. We can do this via video or over the phone. See for more information.

      Posted By: Renée Rouleau  | 

  4. Hey Renee! I’m 17 now and I’ve been getting acne since I was 13. I have tried what seems to be everything and my face just won’t budge. I recently started on Mary Kay but that only worked for the first few weeks then it just stopped working. I have oily/combination skin that is somewhat sensitive. Please please please help me.

    Posted By: Erica  | 

  5. Thank u so much for ur reply Mrs, Renee. I have wondered that I’m not seeing what my skin really is. I don’t see oil or need to blot but I do have a problem with whiteheads and blackheads in my tzone and they are constant. So from what u said above I looked thru those typs and I’m thinking 3 or 4.
    3 being that I have constant breakouts but 4 being that I deal with redness a lot. My face is darker then my neck. One dr said rosacea and one said sensitive skin. So would the products for skin type 3 and 4 be safe for rosacea/red skin? Again, thank you for taking the time out to answer my questions and hope u had a great weekend 🙂

    Posted By: S  | 

  6. Hi Renee! 🙂
    I am very interested in trying your products but even with the info on your 9 skin types I’m having difficulty determining what I am. Obviously I haven’t been able to determine what my skin likes or needs.(ex.. am I truly dry or is it products making me dry?) I have been struggling with my skin for the last 4ish years and for the life of me I can’t get it balanced or consistently breakout free. Could you please help with product recommendations?

    Posted By: S  | 

    • Customer Service can definitely help you if you need assistance. Email us here and we’ll get you all set up with the right recommendations. But based on what you have said, you are probably in skin types 1, 2, 3 or 4. If you get breakouts, it means you have oil in your skin so if you’re feeling dry, it’s surface dry from using products that are drying out your skin.

      Posted By: Renée Rouleau  | 


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