Hormonal breakouts generally appear on the jaw line, chin and sometimes around the mouth. They are often cystic, red and sore but are sometimes large bumps underneath the skins surface.Digestive breakouts are usually on the cheeks and the middle of the forehead and will appear as pustules or papules.Congestion, blackheads and other small bumps on the skin’s surface generally occur from dehydration, a lack of exfoliation or incorrect product usage and are an accumulation of oil underneath the surface of the skin.