Green’s Dictionary of Slang

suffering from a severe case of acne.

1960		E. De Roo Big Rumble 95: Listen, before that pizza-faced clown gets back.
1986		T. Ardizzone Heart of the Order 40: ‘Honest,’ I said as the pizza-faced girl kicked me, ‘it’s not a joke, I’m not pulling your leg.’.
1993		T. Blacker Homebird 27: Maybe living seventeen years with a pizza-faced psycho has driven them away from home.
1996		P. Howard The Joy (2015) [ebook] The manager and his pizza-faced assistant were down me gaff [...] asking questions.
2005		J. Rosen Waiter, There’s a Horse in My Wine xviii: Then along comes this hulking, pizza-faced creep, claiming you’re related and embarrassing you in front of your friends.