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4 acne myths, and your guide to the facts

Author Allison Milionis

Don’t eat greasy foods. Stay away from chocolate. Don’t scrub your face, but do wash it twice a day. Just use over-the-counter acne medicines. No, try lemon juice.

Teenagers hear it all. During those tender adolescent years when they’re most concerned about appearance, many teens contend with skin issues. Desperate to regain their perfect prepubescent skin, they look for answers.

And answers are abundant. But which ones are accurate? Is there something (anything!) that will make acne disappear and keep it away?

The myths

  • Greasy foods cause acne.  Good news for french fry lovers: Eating greasy food has little to no effect on acne. However, working in a greasy area, such as a kitchen with fry vats, can irritate skin or promote acne. How? The oil can stick to the skin and block hair follicles.
  • Chocolate causes acne. A recent study (unfortunately) concluded that chocolate contributed to acne in the male study participants. However, the researchers did note that “further investigation is warranted.” (Some studies show that it’s actually the dairy and sugar in chocolate that’s the problem.)
  • Dirty skin causes acne. Acne isn't caused by dirt. Period.
  • Only teens get acne. If only it were true. Adults also struggle with acne, especially if they had it during adolescence. Pregnant women or women starting or stopping birth control pills are susceptible because of an increase in hormones called androgens.

Acne 101

To get a grip on acne, it helps to understand what it is and what contributes to it. Here’s a crash course: 

When tiny oil glands around hair follicles on the face, chest and back are stimulated by hormonal changes, they produce an oily sebum. In acne, the opening of the follicle gets blocked and the sebum builds without a way to escape. The result is a plugged pore, commonly called a whitehead. (Blackheads are whiteheads that have been exposed to air.) If bacteria grow in the plugged pores, they cause inflammation, which in turn creates pimples. In more severe cases, painful cysts develop, and often leave scarring.

In spite of what we do know about acne, we don’t know the exact cause. According to the National Institutes of Health, experts believe it may be caused by an increase in androgens, or male sex hormones. These hormones increase in boys and girls during puberty causing the sebaceous glands to enlarge and make more sebum.

Heredity or genetics also play a role in the cause of acne, as well as certain drugs, such as lithium. Even some cosmetics cause acne by altering the cells of the follicles, causing them to stick together like a plug.

Here are other factors that contribute to acne:

  • Stress
  • Changes in hormone levels in adolescent girls and adult women two to seven days before their menstrual period starts
  • Oil from skin products, such as moisturizers or makeup
  • Pressure from sports helmets or equipment, backpacks, tight collars or tight sports uniforms
  • Environmental irritants, such as pollution and high humidity
  • Squeezing or picking at blemishes
  • Hard scrubbing of the skin

Caring for your skin

  • Be gentle with your skin. Wash your face with a soft, cool cloth and mild cleanser, once in the morning and once in the evening, and after any kind of heavy exercise. You might want to ask a professional about the best type of cleanser to use. Using strong soaps or rough scrub pads is not helpful and can actually make the problem worse. Astringents are not recommended unless the skin is very oily, and then they should be used only on oily spots.
  • If you have oily hair, you may want to wash it every day.
  • Avoid the temptation to squeeze, pinch or pick at your blemishes. The end result may be scars or dark blotches.
  • Shave carefully. Make sure the blade is sharp, and soften the hair thoroughly with soap and water before applying shaving cream. Shave gently and only when necessary to reduce the risk of nicking blemishes.
  • Protect your skin from the sun. A suntan may make blemishes less visible and make the skin feel drier, but these benefits are only temporary. Excessive sun exposure ages the skin and puts you at risk of developing skin cancer.
  • Use oil-free cosmetics and hair-care products. Choose products labeled noncomedogenic (meaning they don’t promote the formation of closed pores). In some people, however, even these products may make acne worse.

Treating acne

If you have a mild case of acne, an over-the-counter topical medicine may be the best way to treat it. There are several OTC options, and they come as gels, lotions, creams, soaps or pads. Each works differently so it’s important to choose one that’s right for your skin type. Here are the most common topical medicines:

  • Benzoyl peroxide – Kills P. acne (acne-causing bacteria) and may also reduce oil production
  • Resorcinol – Helps break down blackheads and whiteheads
  • Salicylic acid – Helps break down blackheads and whiteheads, and cut down the shedding of cells lining the hair follicles
  • Sulfur – Helps break down blackheads and whiteheads

Be aware that OTC acne medicines can cause skin irritation, burning or redness, which can get better or go away by continuing to use the medicine. However, if you experience severe or prolonged side effects, you should talk to your provider.

If mild acne becomes more severe, a doctor or dermatologist may prescribe a topical or oral medication (or a combination of both) to help. These could include antibiotics to help stop or slow the growth of bacteria and reduce inflammation, or a vitamin A derivative, such as Retin-A.

Like OTC topical medicines, prescription topical medicines come as creams, lotions, solutions, gels or pads. Your doctor or dermatologist will prescribe a product based on your skin type.

Don’t hide – ask for help

An estimated 85 percent of all teens deal with acne during adolescence, and many adults do as well. If you have acne, don’t be embarrassed or think there’s nothing that can be done about it. Talk to your provider for advice.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases, or NIAMS, website is also an excellence resource for science-based information on acne.