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What was in your Pre-workout?
Maybe I'll stop taking a pre-workout and see what happens. I noticed the Beta Alanine, which gives a "tingly" effect on the skin, caused my acne to worsen since my face was "tingly" and irritated by it. The pre-workout I take now doesn't have that, but maybe it's that ingredient or some other one. Hard to find that out since there's probably a lot of ingredients in your pre-workout.
When you WEREN'T sick, how much caffeine were you taking? Like the person above me, were you washing your face differently? Taking any presciptions? vitamins? wearing certain makeup? sleeping more?? drinking less water? Think of all the things you have been doing differently