Almost everyone has had at least mild acne at some point. Acne is the most common of all skin disorders, affecting some 40-50 million Americans. A generation or so ago, it was thought that eating too many sweet or greasy foods caused acne; now doctors know much more about why breakouts happen and how to treat them.
Can what I eat cause acne breakouts?
Generally, no. The primary trigger of most cases of acne is the fluctuation of hormones. Hormones stimulate the oil glands to produce more sebum, which can block pores. Bacteria can then grow within the pores, causing them to become inflamed and break out.
That happens at times of major hormonal change, such as during the menstrual cycle, and during the teen years, no matter what you eat. So despite what your grandmother told you, eating too many potato chips won’t make you break out in pimples.
But there is some evidence that certain diets may have an effect on acne, says Macrene Alexiades-Armenakas, MD, PhD, an assistant clinical professor of dermatology at Yale School of Medicine. Studies, such as one published in the Journal of the American Academy of Dermatology, have suggested that high consumption of dairy products raises the risk of getting acne because of the hormones in milk, cheese, and yogurt. However, subsequent studies have not supported the theory.
Should I stop wearing makeup if I have acne?
You don’t have to stop wearing makeup altogether, but you might try switching brands or going with a different type. If you’re noticing breakouts along the sides of your temples, hair creams or gels might be exacerbating your acne, says Alexiades-Armenakas. Look for cosmetics and toiletries with the label “non comedogenic,” meaning that they don’t clog pores.
Does acne mean I’m not keeping my face clean enough?
Not necessarily. In fact, scrubbing too hard at your face can aggravate your acne, and using alcohol-based astringents can dry out the skin. Acne is triggered by hormones, and while gentle, regular cleansing with soap and warm water can sometimes help with mild breakouts, more significant acne requires more than just good hygiene.
Why does acne appear most often in teenagers?
The primary trigger for acne is fluctuating hormones -- specifically, the male hormone testosterone. (Women do have some levels of testosterone.) When teenagers hit puberty, their hormones start surging -- and often, so does acne.
Why do some adults have acne?
Although the hormonal fluctuations that cause acne are most common during the teen years, they can also affect adults. Women may experience hormonal swings during their menstrual cycle, pregnancy, and menopause that result in acne breakouts.
Acne can also be a side effect of certain medications, such as anticonvulsants and steroid drugs. Some people may also have a genetic predisposition to acne. One study found that 50% of adults with acne had a parent, sibling, or child with acne.
What acne treatments are best for me?
That depends on many factors: your age, whether you’re male or female, how severe your acne is, and how long you’ve had it, among others. There are several options available.
For mild to moderate acne, many dermatologists will start with a combination of a topical cream or gel containing either a retinoid or benzoyl peroxide along with a topical antibiotic. For more inflammatory acne, an oral antibiotic may be added. For more significant cases of acne, women may be placed on birth control pills or on the drug spironolactone, a water pill which also blocks male hormones. They may also prescribe the newly approved topical treatment clascoterone (Winlevi) which works a lot like spironolactone, only as an ointment.
Severe cases of acne may be treated with the drug isotretinoin, which is very effective. However, side effects and blood abnormalities must be monitored monthly and requires registration with the FDA to obtain a prescription. There are also various types of light or photodynamic therapies available.
When should I see a dermatologist for acne treatment?
If over-the-counter treatments, like a topical retinoid or products containing benzoyl peroxide or salicylic acid, along with gentle cleansing, don’t work for you (give them a chance -- it can take 4-12 weeks to improve acne), a dermatologist may be able to help. Severe acne requires aggressive treatment to prevent scarring.
Will my acne ever go away?
Most often, acne will go away on its own at the end of puberty, but some people still struggle with acne in adulthood. Almost all acne can be successfully treated, however. It’s a matter of finding the right treatment for you.