OVERVIEW

What is cosmetic acne?

Cosmetic acne refers to acne-like facial rashes caused by the use of cosmetics. It is the second most common cosmetic-related skin disease after contact dermatitis, primarily manifested as blackheads, papules, pustules, pigmentation, and scaling ^[1,2].

SYMPTOMS

What are the symptoms of cosmetic acne?

Typically, comedones and inflammatory follicular papules aligned with pores appear in areas exposed to cosmetics. In severe cases, dark red nodules and oval cysts may develop, usually without subjective symptoms or with mild itching at the acne sites.

If the condition persists for a long time, it may be accompanied by skin hyperpigmentation and small pitted scars.

Comedones and inflammatory papules are the most common, occurring in approximately 77.6% of cases, while hyperpigmentation and small pitted scars appear in about 13.8%, and dark red nodules or oval cysts occur in roughly 8.6% ^[3].

CAUSES

What Causes Cosmetic Acne?

Cosmetic bases such as petroleum jelly, liquid paraffin, and lanolin can clog skin pores, obstruct sebum excretion, and lead to excessive sebum accumulation in the pores, resulting in acne. The buildup of sebum in pores can also promote the overgrowth of mites, which produce toxins and worsen acne ^[1].

Additionally, some studies report that alkaline cosmetics (pH > 8) may trigger acne ^[5].

Which Cosmetics Are Most Likely to Cause Acne?

Cosmetics prone to causing acne are primarily those rich in oils, including moisturizers, essential oils, sunscreens, spot-removing creams, foundations, and whitening creams with high powder content ^[1-3].

According to surveys, moisturizers are the most common acne-inducing cosmetics, accounting for about 31.6% of cases, followed by sunscreens (20.8%) and spot-removing creams (10.8%) ^[3].

Who Is Most Susceptible to Cosmetic Acne?

• Young and middle-aged women (aged 20–35) who frequently use cosmetics ^[6].

• Individuals with oily or seborrheic skin (those prone to excessive sebum production) ^[3,7].

• Users of low-quality cosmetics ^[3].

• Overweight and obese individuals—studies show those with a BMI > 25 have a significantly higher risk of acne ^[7].

• Frequent smokers and alcohol consumers.

• People with irregular sleep schedules or insufficient rest.

• Individuals under high psychological stress.

• Those who frequently consume milk and sugary foods ^[8].

Notably, individuals with pre-existing adolescent acne may experience worsened symptoms when using acne-triggering cosmetics.

DIAGNOSIS

How to Diagnose Cosmetic Acne?

If typical acne symptoms appear after using cosmetics, you should first visit a dermatology department at a hospital for a professional diagnosis.

The diagnostic criteria doctors refer to are the Diagnostic Criteria and Management Principles for Cosmetic Acne GB17149.3-1997^[9]. Patients can also use this standard for preliminary self-assessment. The criteria are as follows:

• A clear history of cosmetic use before the onset of symptoms;

• Skin lesions are confined only to areas where cosmetics were applied;

• Clinical symptoms of cosmetic acne include comedones, inflammatory follicular papules, and pustules;

• If acne was preexisting, symptoms worsen after cosmetic use;

• After discontinuing the suspected cosmetic, acne symptoms significantly improve or disappear.

TREATMENT

Should I Go to the Hospital for Cosmetic Acne? Which Department Should I Visit?

Not necessarily.

If you notice a few pimples on the area where a cosmetic product was applied, without pain, burning, or itching, you can first stop using the product and wash the affected area immediately.

If no new pimples or blackheads appear and symptoms improve, there is no need to visit the hospital. Simply discontinue using the product and maintain facial cleanliness.

However, if a cosmetic product causes widespread or numerous pimples, inflammatory papules, or pustules on the contact area, you should seek treatment at the dermatology department immediately.

DIET & LIFESTYLE

Can cosmetic acne heal on its own?

Partially, yes.

Cosmetic acne is caused by cosmetics. If the skin damage is mild, it can heal on its own after discontinuing the use of the product.

If the skin damage is severe, with symptoms like skin ulceration, erosion, or pus discharge, it may not fully heal and can result in scar tissue formation, leaving permanent marks.

Can I wear makeup after getting cosmetic acne?

It's best to avoid makeup until the acne has fully healed.

Cosmetic acne is primarily caused by mineral oils in cosmetics clogging pores. Using makeup before the acne clears can worsen pore blockage and aggravate the condition.

After recovery, consult a doctor to choose suitable cosmetics.

PREVENTION

How to Prevent Cosmetic Acne?

• People with oily or seborrheic skin should choose cosmetics carefully, opt for water-based products, minimize makeup frequency, and avoid cream-based cosmetics as much as possible.

• Purchase cosmetics from official channels and reputable stores, and avoid using low-quality products.

• Maintain a regular sleep schedule and ensure adequate rest. Sleep deprivation can disrupt hormone levels, triggering acne.

• Exercise regularly to maintain a healthy weight. Obesity and being overweight increase the risk of acne ^[7], so overweight individuals should exercise more to improve their physique.

• Quit smoking, limit alcohol, and adopt a light diet. Studies show that frequent smoking or drinking may also raise the risk of acne ^[7,10], making early smoking cessation and alcohol moderation crucial.