If you struggle with controlling acne, you are not alone. Acne can have an extremely negative impact on quality of life because it is usually quite visible. While many cases of teenage acne resolve with age after hormones calm down, for some adults, acne becomes a chronic condition, causing frustration and a never-ending search for “the cure.”
While we haven’t come up with a cure for acne, we can identify a number of habits, lifestyles, or medical conditions that are quite often linked to it. While we work diligently with our patients to treat acne outbreaks and scars with medications or laser treatments, it is just as important to understand a few pertinent facts about what aggravates it.
Many people with acne think they have “dirty” or “oily” skin, so they become obsessed with washing, often several times a day. But this can actually make acne worse! Overwashing with soap can strip the skin of its natural defenses and add irritating lipids to the skin’s surface. In fact, I recommend that my acne patients never scrub their skin with rough cloths or pads. In fact, fingertips offer the most-soothing approach to cleansing.
I suggest a gentle cleansing regimen: twice a day, morning and night, using products specifically made for acne. There are a number of nonirritating choices at the drugstore, including Neutrogena® Oil-Free Acne Wash, Cetaphil® Cleansers, and CeraVe™ Hydrating Cleanser. Avoid products that are not specifically made for acne-prone skin. Read labels and choose noncomedogenic products, which don’t clog pores.
Personal Care Products
Even if acne outbreaks occur only on your face, it’s wise to take care in choosing personal care products that don’t aggravate the condition. Avoid heavy or greasy body lotions and moisturizers like cocoa butter and oils, and choose noncomedogenic makeup and moisturizers that won’t clog pores.
And think about your hair care products, too, especially if acne outbreaks occur along the hairline, forehead, jaw, and neck. Some heavy hair conditioners, gels, and pomades – and even shampoos – can leach into facial skin, making acne worse. Apply hair care products at least one inch from the hairline to protect your face.
A common myth is that fat in the diet (as in French fries, pizza, and fried chicken) prompts acne breakouts, but there is no solid scientific research that links specific foods (even chocolate!) to acne. However, current studies suggest that a diet rich in diary products and refined carbohydrates such as sugar and white flour may contribute to acne flares. For that reason, I advise my acne patients to consider the benefits of a diet based on fresh fruits, vegetables, and lean proteins.
A diet high in refined carbohydrates may set the stage for acne by triggering excess sebum production and inflammation. While definitive clinical research has yet to link certain foods with acne, I choose to err on the side of caution. And a whole foods diet has been proven to support overall health, so why not reap the benefits – which may include easing acne symptoms, too?
While it may seem logical to regard acne as purely a “skin condition,” it is more complex than that. In fact, obesity and acne are common problems for many people. Researchers are learning more about the connection, and considering the link between obesity and acne from a holistic perspective makes sense.
The diets of overweight individuals are often high in fat and refined carbohydrates, which may impact hormonal balance, resulting in excess testosterone, which is clearly identified with acne. If you are more than 20 pounds over your ideal weight and suffer with acne, a sensible weight-loss program based on fresh fruits and vegetables and lean proteins may ease your acne, as well as whittle your waistline – a win-win proposition!
Certain prescription medications may also cause acne outbreaks. For example, lithium (prescribed for mental health conditions), certain thyroid medications, and steroids (prescribed for asthma and other respiratory conditions) may spur hormone production. The result is that the body creates excess sebum, which can exacerbate acne.
In fact, any prescription that interacts with hormone production, such as birth control pills, may also be connected to acne. I advise acne patients on such prescriptions to work with their physicians to identify alternatives. In many cases, switching to a different medication will clear acne relatively quickly. However, it is very important that you do not stop taking a prescribed medication until you consult your doctor.
One thing we know for sure is that hormonal issues play a big role in causing acne. Among women in their 20s, acne can be a symptom of a fairly common hormonal condition, polycystic ovary syndrome (PCOS). Other symptoms include extra hair growth and irregular menstrual cycles. This inflammatory disorder involves complex interactions between hair, hormones, sebaceous (oil-producing) glands, and bacteria. It does not resolve with age. I refer patients with PCOS to an endocrinologist who can help manage the hormonal balance. With the right treatment, acne related to PCOS can be cleared.
If you have acne, discuss these ideas with your board-certified dermatologist – the best resource to assist you in evaluating and successfully treating your acne.