Of American-English origin, the derogatory expression pizza face denotes a person with facial acne.
This expression occurs, for example, in The Pill is a great liberator—but it’s not risk-free, by Rosamund Urwin, published in the London Evening Standard (London, England) of Thursday 28th May 2015:
THE Pill is often treated like a wonder drug. Fifty-five years old, its many fans proclaims that it has given women sexual freedom […].
Yet when you ask women about side-effects of the Pill, you’ll find plenty of anecdotes. “Voldemort with breasts”, is how one friend describes her “artificially-hormoned” self. Another went on Microgynon, and after three months her blood pressure had risen dangerously. Another friend with no history of mental health problems became “almost suicidal” a week into trying a new pill; she came off it immediately and has had no further issues. More common reactions include weight gain (“three quarters of a stone in one month!”), developing brown patches on the skin and acne (“my brother called me Pizza Face”). Oh, and then there’s the zero libido effect—a cruel joke that one, making the whole pill-popping redundant.
In the expression pizza face, the pimples caused by facial acne are likened to slices of pepperoni on a pizza—as illustrated by the following from Medical woes? Ask Dr. Wannafee, by David Grimes, published in the Johnson City Press (Johnson City, Tennessee, USA) of Sunday 9th July 1989:
Dear Dr Wannafee: I’m a 17-year-old girl and it really took me a long time to get up the nerve to write to you because I’m very sensitive about my problem and it’s caused me a lot of embarrassment. My social life has been devastated and I’ve lost all of my self-respect. As you can see by the picture I’ve enclosed, I have very bad acne. Can you help? Please?—Z.T.
Dear Z.T.: You call that acne? When I was in high school, we used to call people like you “pizza face.” Pizza face! Pizza face! Hey, Z.T., looks like you got some new pepperonis on that pizza face! Hold the anchovies, OK? Pizza face! Pizza face! Hah-hah-hah!
The earliest occurrences of the expression pizza face that I have found are as follows, in chronological order—it seems that this expression originated in Californian high-school slang:
1-: From What a “Z”! The astonishing private language of Bay Area teen-agers, about “the dense verbal undergrowth that flourishes in the high schools of the Bay area”, by Dilys Jones, published in the San Francisco Examiner (San Francisco, California, USA) of Sunday 27th October 1963:
At nearby Redwood High we picked up a few more:
Out to lunch—Out of the swing of things.
Bugging the tube—Watching TV endlessly.
Pizza face—Pimply face.
2-: From Helen Help Us! Youth Asked for It, “dedicated to young people, their problems and pleasures, their troubles and fun”, by the U.S. columnist Helen Bottel (1914-1999), published in several U.S. newspapers on Tuesday 11th August 1964—for example in The Bastrop Daily Enterprise (Bastrop, Louisiana, USA):
Now that you’ve got “Youth Asked for It” going, here’s some slang that is “gear” with teenagers. Did you know that:
“Hang a lippy” means “kiss?” Also—
“Fine Bod”—good shape.
“Grease”—food, and when you eat it you “chow down.”
“You’re really happening!”—You’re somewhere else!” (Translation from H. for benefit of tint-age mothers: “super-dooper.”)
“Fig” or “Kiss”—sissy or teacher’s pet.
“Pizza face”—pimply face.
“Wipe out”—drop dead.
“Aced”—scored high. As “I aced a test.”
“Tubed”—flunked. (People who don’t ace an exam sometimes tube it.)
“Hodad”—not too swift.” Not “cherry.” Not “turned on.” (Okay, you squares—“not a swinger” then.)—CALIFORNIA TEEN
3-: From Ball Four: My Life and Hard Times Throwing the Knuckleball in the Big Leagues (New York: The World Publishing Company, 1970), by the U.S. baseball player Jim Bouton (1939-2019), edited by the U.S. journalist and author Leonard Shecter (1926-1974):
Baseball players are, of course, very gentle people. If we happen to see some fellow who is blessed with a bad complexion we immediately call him something nice, like “pizza face.” Or other sweet little things like:
“His face looks like a bag of melted caramels.”
“He looks like he lost an acid fight.”
“He looks like his face caught on fire and somebody put it out with a track shoe.”
The U.S. author, columnist, journalist and presidential speechwriter William Safire (William Lewis Safir – 1929-2009) mentioned the expression pizza face in his column On Language, published in The New York Times (New York City, New York, USA) of Sunday 7th August 1983:
Hickey? People who call knots on their noggins hickeys don’t know the way to the mill. I looked up hickey in several dictionaries, and discovered, to my horror, that this word (probably derived from doohickey , a doodad or gizmo) is still most frequently defined as “a pimple.” That’s last generation’s lingo; a pimple has for the last 20 years been called a zit, and a person with a proliferation of zits is called by his kind playmates a crater-face or pizza-face . Anybody who calls a zit a hickey doesn’t know how to write his name and certainly doesn’t have both oars in the water.