Acne Evidence · Knowledge base

Zones

Read live from Airtable. Every zone is exposure-first: what is touching this area, what the pattern suggests, and when it may not be acne at all.

1. 01

   Hairline

   Investigate first

   Hair products — pomades, waxes, oils, leave-ins, hair masks, styling creams, dry shampoo, heat protectants. Sweat. Hats, headbands, helmets. Bangs and hair sitting against the forehead. Shampoo and conditioner residue that isn't fully rinsed.

   Tiny uniform bumps here are worth considering as folliculitis rather than assuming acne.

   Ask the client

   “What products do you put in your hair, and where does your hair sit when you sleep?”

2. 02

   Upper Forehead

   Investigate first

   Hair products, sweat, sunscreen, heavy moisturizer, hats and headbands, bangs, occlusive products, and how many products are being layered in the routine.

   Tiny uniform bumps — consider folliculitis before assuming acne.

   Ask the client

   “What goes on your forehead in a day — hair products, sunscreen, moisturizer, a hat — and in what order?”

3. 03

   Central Forehead

   Investigate first

   Look at the overall skin environment rather than assigning one cause: sebum, sweat, routine layering, occlusion, picking and touching, stress-related behaviors, and hair or product transfer.

   Ask the client

   “Has anything changed in your routine, stress level, or sleep in the last 2–8 weeks?”

4. 04

   Glabella (Between Brows)

   Investigate first

   Brow products, brow gels and pencils, concealer, sunscreen, incomplete makeup removal, picking, exfoliation, friction.

   Ask the client

   “What do you put on or near your brows, and how do you take it off?”

5. 05

   Temples

   Investigate first

   Dry shampoo, hair products and oils, hats, glasses, sweat, headphones, pillow contact.

   Ask the client

   “Do you use dry shampoo, and do you regularly wear glasses, a hat, or headphones?”

6. 06

   Upper Cheek

   Investigate first

   Sunscreen, foundation, primer, makeup, masks, glasses, sweat, environmental exposure.

   Ask the client

   “What's on your face during the day — sunscreen, makeup, a mask — and how long does it stay on?”

7. 07

   Mid Cheek

   Investigate first

   Phone, pillowcase, makeup brushes, hands, cosmetics, skincare products.

   Ask the client

   “How often do you wash your pillowcase and your makeup brushes, and which side do you hold your phone on?”

8. 08

   Lower Cheek

   Investigate first

   Hair removal, shaving, waxing, friction, occlusive moisturizers, makeup, picking.

   Ask the client

   “Do you shave, wax, or thread this area, and how soon afterward do the bumps show up?”

9. 09

   Cheeks — One-Sided Pattern

   Investigate first

   Anything that repeatedly contacts one side of the face: phone, hand, pillow, hair, helmet, mask, work equipment.

   Ask the client

   “What repeatedly touches this side of your face?”

10. 10

    Nose / T-Zone

    Investigate first

    Sebum and follicular congestion — open comedones, closed comedones, enlarged pores, sebaceous filaments, excess sebum.

    Ask the client

    “Has this always been here, or did it change recently?”

11. 11

    Sides of Nose

    Referral consideration

    Investigate first

    Skincare products, sunscreen, over-exfoliation, tissues and friction, barrier-disrupting routines.

    Don't auto-call this acne. Redness, scaling, burning, small uniform bumps, or persistent irritation here — consider ruling out irritant dermatitis, seborrheic dermatitis, periorificial dermatitis, over-exfoliation, or barrier disruption. Refer out if suspected.

    Ask the client

    “Does this area burn, itch, flake, or sting — or is it just bumpy?”

12. 12

    Around the Mouth

    Referral consideration

    Investigate first

    Lip balm, lip oils, gloss, lipstick, toothpaste, mouthwash, lip licking, heavy moisturizers, occlusive products, topical steroids.

    Consider ruling out periorificial (perioral) dermatitis. Topical steroid use is a meaningful part of that history. Refer out if suspected — do not treat as acne.

    Ask the client

    “What touches your lips and the area around your mouth — balm, toothpaste, mouthwash — and have you used any prescription cream here?”

13. 13

    Chin / Jawline / Under Jaw

    Referral consideration

    Investigate first

    Hair removal (shaving, waxing, threading), chin straps and masks, resting the hand or chin on something, occlusive products. Then, where the presentation supports it, hormonal influence.

    Nodular or cystic lesions here carry scarring risk — referral consideration.

    Ask the client

    “Do these recur in the same spots on a predictable cycle, are they deep and painful, and did anything change with medication or hormones around the time they started?”

14. 14

    Neck

    Investigate first

    Hair products, fragrance and perfume, sunscreen, collars, jewelry, sweat, exercise, hair lying against the skin, shaving.

    Don't assume acne here. Itchy or post-sweat uniform bumps — consider folliculitis or contact irritation.

    Ask the client

    “Do these show up after workouts, and do they itch?”

Acne Evidence investigates and, when warranted, refers. It does not diagnose.