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There are some breakouts so predictable that you feel like you pretty much have a standing date. They show up at regular intervals and in pretty much the same place: your chin and jawline. What’s behind this clockwork breakout pattern?

Is it hormonal or just regular acne?

Breakouts that are localized to the chin and jawline are related to hormones. And, though any hormonal activity can be triggering breakouts, if it’s happening at regular intervals (like every month before you get your period), that’s a sure sign it’s hormonal.

Why does hormonal acne concentrate on the chin and jawline?

The chin and jawline have more hair follicles than the rest of your face (think beards). Follicles are the pathways for sebum. Whether related to puberty, menstrual cycles, pregnancy, menopause, or stress, hormones cause an increase in oil production. That means more oil on the chin and jawline. The excess oil mixes with dead skin cells clogging pores and leading to breakouts.

Why are chin pimples often so painful?

The hormonal stimulation of oil glands induces inflammation, which creates oxidative stress in the follicle. Oxidized or damaged sebum boosts the proliferation of keratinocytes, dead skin cells. This keratolytic over-abundance leads to an impaction that allows acne bacteria to thrive and produce still more inflammation. It’s the perfect storm that results in the raised, tender red bumps of cystic acne or painful subdermal nodules.

The recurrent nature of hormonal acne can mean the follicles become damaged, and the intensity of the breakout may worsen with each subsequent event.