Top dermatologists reveal the 5 celebs battling 'hidden' acne...As Chris Pine says skin condition cost him lead role in The OC

With their cinched-in waists, symmetrical features and perfect hair, it can be hard to believe that celebrities ever suffer the same cosmetic ailments we do.

But experts have told DailyMail.com that there is one problem that affects far more famous faces than we realize: bad zits. 

Acne, which affects around 50 million Americans, is rife in Hollywood, dermatologists say, due to a lifestyle that is bad for skin health — namely, little sleep and eating restrictive diets.

However, many of our favorite stars have a swat team of makeup artists and cosmetic experts on hand to ensure the red, angry pimples remain hidden.

One secret acne sufferer is actor Chris Pine, who recently revealed that his bad skin cost him the leading role in the popular teen drama, The OC.

Now, Dr Christopher Chu, a dermatologist in Austin, Texas, who runs Pure Dermatology, and other skincare experts have revealed the celebs who've been battling zits all their life — not that you ever knew it.

Chris Pine, 43, pictured here in his early 20s, was rejected from a major role on The O.C. because of his terrible acne, the book reveals 

Dr Chu said acne is 'quite common' among people in the public eye. 

He added: 'Stars are probably getting expensive treatments to calm the skin as soon as flare ups emerge, or are just doing great cover up work with filters or makeup.

While some of the stars on the list have recently become more open about their skin struggles, many are rarely pictured bare-skinned and without products that cover the angry patches.

Dr Chu adds that some celebrities have visible scarring from old zits, which are easier to cover than fresh ones.

Dr Margarita Lolis, a dermatologist at Skin Laser and Surgery Specialists in New Jersey, added: 'Lack of sleep, diet habits, stress, changes in weather and humidity — and use of heavy makeup — can all clog pores and cause acne.

'For celebrities, there are several camera and video techniques that can be used to conceal acne or other skin imperfections. Soft lighting reduces shadows, while angle and framing can also hide blemishes.'

And Dr Stephen Hess, a dermatologist at Center City Dermatology in Philadelphia, added: 'I absolutely think acne is actually quite common among celebrities.

'They suffer from acne just like the rest of us. The stress of their jobs, disrupted skincare routines and broken sleep cycles, as well as sweating while wearing heavy makeup under bright lights, could make them more at risk.' 

Cameron Diaz 

Cameron Diaz, now 51, was pictured with zits on her face in her 20s and still bears some of the scars today. She only opened up about it in her 40s, saying her skin was 'terrible' 

Cameron Diaz is famous for her picture-perfect complexion in movies like The Holiday and Charlie's Angles.

But the star, now 51, secretly battled with spots breaking out all over her skin for years, but disguised them using make-up.

'It was embarrassing', she wrote in her book The Body Book. 'I had terrible skin.'

The problem eased in later in life, but she admitted it wasn't 'totally gone'.

'Looking back, I realise that I hadn't needed those prescription drugs, those vials of potions and creams... I hadn't needed to be angry at my skin or feel bad about myself. I had just needed to listen to my body.'

Dr Chu highlighted scarring on Diaz's skin from previous zits, which can be seen in more recent photos. 

Dr Hess said the zits running along Ms Diaz's lower face and jawline area suggested she had adult hormonal acne — a type of acne that appears in adulthood when shifts in hormones, possibly linked to the menstrual cycle, boost the amount of oil produced in the skin.

'She definitely has more of that adult female pattern of acne,' he said, 'which makes sense as she is not a teenager at this point'.

'For some people, acne may not start until they reach their 20s and 30s — more than half of women over 25 still have acne.

'It can flare up at this time, with stress being a big trigger, as well as hormone shifts.' 

Rihanna 

Rihanna has scarring on her face and zits that are hidden under makeup, Dr Chu said. The marks are visible here on the sides of her cheeks

Those looking at Rihanna's album covers may have assumed the singer has enviable, picture-perfect skin.

Yet, glance a little closer at photos of the now 36-year-old out and about, and a different image begins to emerge.

Dr Chu said Rihanna had marks on her face from acne, revealed in the above photos as small bumps beneath the foundation.

Dr Hess added that the bumps on Rihanna's cheeks suggested she had comedonal acne, or when pores or hair follicles have gotten blocked by bacteria, oil and dead skin — causing the formation of bumps, or white heads.

'This can sometimes be triggered by things like heavier occlusive makeup,' he said — a type of skincare product that forms a protective barrier over the skin to keep it hydrated. 

Rihanna opened up about her skin troubles in 2020 amid the launch of her skincare brand Fenty to help those with acne.

She said at the time: 'It was a tough journey to get me back [to clear skin].'

Lorde

Images of Lorde have been edited previously to cover up her skin (top), although the singer has urged people not to do this (bottom image). She shared these two snaps in 2018

Those watching Lorde on screen may have been left with the perception that she has smooth and texture-free skin.

But the singer, 27, has since revealed this isn't the case — and even asked photo editors to stop tweaking pictures of herself.

Opening up about her battle with her skin in 2018, she posted a picture of herself at a concert compared to one put out on the screens.

'For real though, acne sucks,' she said.

'You know what also sucks? When you've had acne for years and years and years... and people are still like, "You know what worked for me? It's moisturizing!'

 Kendall Jenner

Kendall Jenner reportedly struggled with bad acne early in her career, leading photo editors to often blur her skin to hide imperfections. She is shown above with marks on her skin from acne

Kendall Jenner struggled with acne early in her career. Pictured above in 2017 with zits on her cheeks

Kendall Jenner, 28, is a former Victoria's Secret model who is well-known for her flawless appearence.

But sources say that early in her career she was struggling with 'terrible' acne which often made photoshoots challenging.

Cassandra Brankson, a former model who works with dermatologists, said  that in a previous interview that photo editors used to blur images of her skin to hide blemishes.

More recently, Kendall opened up about the acne she struggled with in her youth, after partnering with a brand that sells acne-fighting medication. 

She said previously: 'I get hormonal acne and will get little breakouts when I'm around my period and stuff like that.'

Dr Lolis said Kendall Jenner was among those to suffer from acne, and had recently been vocal about her struggles. 

Cristiano Ronaldo 

Cristiano Ronaldo has clear scarring on his cheeks from acne, said Dr Chu. He is pictured above early in his career in 2005 (left) and 2004

Not only is Ronaldo one of the most famous soccer players, he is also a budding wellness influencer who recently launched a fitness and nutrition app.

But images of the star taken between his teenage years and early 20s show that he once suffered with acne.

Painful-looking blemishes can be seen beneath his cheekbones.

Dr Hess said that Ronaldo's acne looked like that he has seen on a lot of athletes, which he said was likely linked to sweating from sporting activity. 

'This could also be aggravated by shaving,' he added. 'Which can cause acne in the cheek by irritating the skin and causing pores to clog.'

Ronaldo previously said he adopted a healthy lifestyle in order to appear younger, but has not mentioned any role acne may have played.

He has not commented publicly on his struggle with the condition. 

Justin Bieber 

Justin Bieber is normally clear-skinned on the red carpet, but he, too, suffers from zits

Justin Bieber may appear clear skinned whenever he appears on the red carpet, but this isn't always the case.

The star, 30, has been struggling with his zits for some time — and has previously said he is a victim of adult-onset acne.

Dr Hess said this was possible, although typically it would be less common in men.

'Perhaps the stress of a busy schedule and inadequate sleep, inconsistent skincare, and all the travel — that would certainly contribute to acne,' he said.

'It could also be from attempts to make his acne go away. 

'I see patients who have mild acne and then start using products, but one thing I tell them not to do is excessive scrubbig or try to manually exfoliate the skin. This can actually make it worse.'

Bieber has also been pictured wearing small star stickers on his face in an attempt to cover up and heal the zits.