Cheek Acne: What Your Pillowcase, Phone and Diet Are Doing

It's actually rarely about genes. Cheek acne can usually be traced back to what you do every single day. It is exacerbated by the skin's friction, bacteria and inflammation from our pillow cases, phone and even from the food we eat. Think about it: you’re laying face into a pillowcase that has trapped eight hours of sweaty hairspray, sweat and sloughed-off dead skin from every night of your sleep or pressing a germy phone screen against your cheek as you sweat. 

Meanwhile, grabbing that sugary morning latte or snacking on high-glycemic treats spikes your blood sugar and triggers hormonal responses that show up right on your face. 

Once you identify these hidden culprits in your everyday routine you can make some simple lifestyle changes that will keep you from breaking out.

Cheek Pimples Causes

There are always certain key triggers that often contribute towards initiating the cascade. Some of them are mentioned below:

• Chronic workplace exposure to industrial oils, tars, crude compounds or greases
• Fluctuations in androgen hormones that stimulate sebaceous glands
• High-glycemic diets trigger insulin spikes and systemic inflammation
• Physical friction, pressure, heat or rubbing against the skin
• External application of comedogenic ingredients in topical products
• Systemic introduction of specific pharmaceutical compounds that alters follicular keratinization and upregulates sebum production
• Immunologically mediated systemic inflammatory response
• Systemic absorption or topical contact with halogenated aromatic hydrocarbons
• Constant, compulsive physical manipulation of the skin like picking, peeling, scratching and squeezing
• An aggressive, chronic immune hypersensitivity associated with genetic predisposition
• Stressful episodes triggering cortisol release and over production of sebum by sebaceous glands

Hyperstimulated Pilosebaceous Unit

The internal physiological cascade activates inside the pilosebaceous unit (the hair follicle and oil gland)

• Follicular Hyperkeratinization--This is when dead skin cells within the walls of the pore get plugged and don’t slough off easily. 
• Excessive Sebum--Hormonal (androgens) changes or an excessive spike of cortisol can cause the sebaceous glands to hypersecrete their natural oil.
• The Microcomedo--The combination of excess sebum and dead skin cells with the trapped impurities creates a micro-plug, which leads to a lack of oxygen.

Microbial Proliferation 

The plugged pore changes skin’s micro-environment for bacterial disruption.

• Cutibacterium acnes (C.acnes)--This native skin bacteria is anaerobic (thrives without oxygen) and lipophilic (fat loving) bacteria. 
• Overpopulation--Inside the microcomedo, C.acnes grows on an abundance of sebum to reproduce quickly. 
• By-Product Release--As C.acnes breaks down sebum, it emits free fatty acids and chemical mediators that contribute to the surrounding irritation.

Inflammatory Chain Reaction

The bacteria multiply and produce skin irritating chemicals, which the immune system of your body can identify and use as triggers to initiate its defence. 

This occurs through three phases: 

• Chemical Signaling--When a follicle becomes damaged, pro-inflammatory cytokines (such as IL-1) will begin to accumulate there. 
• Leukocyte Action--The inflammatory cytokines cause a person’s white blood cells (including neutrophils and macrophages) to reach the damaged area via bloodstream. 
• Wall Rupture--When inflammation and bacterial build-up reach a certain level in the follicle, the follicular wall will transform to form a new breakout. 

The final phase is the visible lesion as pimples on cheeks, categorised by the depth of the inflammation:

The Pillowcase Paradox

This concept is referring to how the tool for resting your face at night for reparative sleep becomes a rich source of pimple contributors. An average eight-hour sleep session that includes a woven material of any type, from polyester, to cotton, to linen, has had the chance to absorb a build up of sloughed dead skin cells, sebum (oxidized, stale sebum), moisture, your saliva and even hair care residues. It provides a warm, damp environment, perfect for the rapid multiplication of a slew of organisms. It  includes bacteria like C. Acnes. 

It gets worse with how you sleep. As you turn and toss in your slumber, the weight of your head is pushing your sensitive skin up against the matrix and this consistent friction throughout the night weakens the skin’s outer layer, causing micro-abrasions within the epidermal barrier. This form of skin damage which ends up in acne is known as ‘acne mechanica’. Then, the material reverses its function, serving up the trapped organisms back through reverse inoculation. You essentially get the bacteria, yeasts and stale oil pumped back into clean skin. 

This will then lead to the inflammatory response that forms the painful papules and cysts you see on the lower portion of your face including the cheeks. No matter how diligently you’re removing dirt and oil in the evening, an uncleaned pillowcase will have you fighting to sabotage your recovery, making laundry just as important for skin care as your anti-acne spot treatment.

Cotton vs. Silk: Choosing Your Sleep Surface

Which option would it be - a material which loves to wick moisture or one that repels it? Cotton, made up of natural fibres will absorb skin's oils, the serums and even nourishing night creams. While they get absorbed into the cotton fibres by your pillow they simultaneously create dryness of skin, thereby stimulating over production of sebum. 

Apart from absorbing essential moisture, this natural fibre comes with an unyielding, fibrous and rough texture which creates a lot of friction between skin and pillow. 

The friction caused by sleeping on a cotton pillowcase will trigger the already sensitive skin, accelerate the formation of creases and even trigger your acne. While you are the kind who sleeps like a baby you actually do a lot of damage to your skin. The same cotton can lead to 'acne mechanica' which means acne formed by friction. 

Silk, another natural protein fiber but one that is smooth in nature and its long, supple threads will let your skin slide freely across the pillowcase and your facial skin won't get damaged by the fibers of the pillowcase. It is also a natural hydrophobic (repels water) material hence it doesn't absorb skin moisture, your serums and night Creams from your face. They remain on the skin to do their job.

Your Smartphone Is a Digital Breeding Ground For Cheek Acne

The astonishing amount of bacteria resides on our smartphone screens. As we bring phones everywhere we go, they absorb the grime from everything which is the bus, restaurants and public restrooms. This grime includes microscopic species such as Staphylococcus aureus and E.coli. These microbes proliferate as they get a suitable environment to sustain like phones generate their own internal heat and are frequently kept in warm pockets or bags, creating a perfect environment for bacteria to multiply rapidly.

The real skin devastation takes place when we answer a call and apply the smartphone screen to the side of the face that touches the cheek and jaw. This action starts up what is termed “acne mechanica.” With friction, compression, heat build up and a moist skin environment, the skin’s defenses are breached and sweat, skin oils and makeup are pushed down into your skin to produce painful break-outs which typically pop up on one side of the face. You can avoid breaking this vicious reinfection cycle by treating your phone with regular cleansing. 

Quick Tech Hygiene Habits for Clearer Skin

• Wipe down your phone’s screen daily using alcohol wipe to kill accumulated germs 
• Opt to use a wireless earbud or speaker phone when speaking on the phone for an extended period. That means no more pore-clogging or skin-to-glass contact.
• Use an anti-bacterial wipe to wipe down your headphone cushions once your workout is complete. Don’t let yeast and sweat accumulate on those headphone surfaces.
• If your PC is glued to your hands at work, wipe down your keyboard and mouse once a week and keep oils and grime from migrating back to your fingers. 
• Don’t bring your phone into the restroom, thereby contaminating your screen with airborne fecal pathogens. 
• Use soap to wash your hands before commencing your morning or evening skin routine.

The Role of High Glycemic Foods in Inflammation 

In order to understand skin inflammation with high glycemic index foods, first, we must address the immediate hormonal mechanism in the pilosebaceous unit triggered by them. Once you consume high glycemic index food, anything with cake, candy, white bread, or pasta, your blood sugar rises drastically and the pancreas unleashes a burst of insulin into your system to bring it down.

In turn, excessive release of insulin also prompts the release of IGF-1, a major signal booster that drives the sebaceous gland into overproducing an abundant supply of sebum. Androgen and mTORC1 pathways lead to hyperkeratinization, an excessive production of hypersticky skin cell turnover that blocks your pore’s capacity to ventilate. This creates a vacuum for bacteria and lack of oxygen that makes it the perfect bed for the C. Acnes to flourish.

Even beyond that, high glycemic foods trigger the body’s internal inflammatory cascade, which means an increased release of inflammatory substances, such as cytokines (IL-1, IL-6, and TNF), which will exacerbate the inflammation caused by the blocked pores, causing them to turn into inflammatory papules, pustules and sometimes painful cystic lesions.

All About Cheek Irritants

• Dirty makeup brushes: Not washing your makeup brush means leftover old makeup, dead skin cells and oil are a welcome feast for pimple-causing bacteria when used repeatedly on skin.
• Leaning your face on your hand: Holding your head on your hand or doing it in between meeting rooms and classrooms will transport dirt, oil and bacteria from all surfaces onto your face. 
• Harsh laundry detergent: The chemicals in these are particularly synthetic fragrances and chemical softeners will transfer from your bed linens, causing your cheek skin to break out from contact dermatitis. 
• Airborne kitchen grease: Cooking anything with a lot of oil can mean tiny particles aerosolize and make their way into your skin, depositing on it and blocking pores around your cheeks and jawline. 
• Passive smoking: Sitting near someone who smokes exposes your facial skin barrier to small amounts of toxins that will oxidize your skin oil. 
• Harsh physical exfoliants: Rubbing your face with rough-textured scrubs essentially creates tiny cuts in your fragile cheek skin, resulting in inflammation of the skin’s immune system.

A Targeted Skincare Routine for Cheek Acne

Incorporating a consistent gentle cleansing routine can help manage the cheek breakouts effectively and improve your skin condition. Alite Anti-Acne Charcoal Face Wash And Ceramides Face Wash should be added to your skin-care regimen as it has some of the best anti-acne agents that work simultaneously to provide care to the skin on the cheeks and fight cheek breakouts. 

Alite Anti Acne Face Wash has:

• Encapsulated black charcoal milli-globules which serve as a magnet to suck up hard to reach dirt, pollutant debris and micro impurities deep into the skin. 
• Ceramides (Ceraskin P) replenish your skin's crucial lipids to prevent loss of moisture and maintain our skins’ natural protection while cleansing. 
• Active Sebum control Enzyme will penetrate sebaceous glands and reduce excessive oil production to attain a non-oily, shine free look. 
• Spiraea Ulmaria (Meadowsweet) Flower Extract dissolves old dead skin and reduces pore clogs.
• Aloe Vera leaf juice & Glycerin provide immediate calming on red and active inflammation as well as deep non-comedogenic moisture. 
• Free from Paraben, Soap and Mineral Oil (Suitable for adults and teens above 13 years of age, prone to Acne / Oily/ Combination Skin).