What is Acne? Everything You Need to Know 

Acne might be the most common skin condition, but it's also one of the most commonly misunderstood. From pricey, multi-part treatment systems to Pinterest-recommended at-home cures, everyone seems to have a miracle fix for those unsightly blemishes that always seem to pop up right at the wrong moment.

But what actually causes acne? And what can you really do about it? We're breaking it down into all the details so you can make the best decisions about your own acne and what treatments might be right for you.

What Causes Acne?

Factors that Aggravate Acne

• Hormone Fluctuations: The reason most people first experience acne as a teenager is because of the changes in hormones caused by puberty. This, as outlined by the Mayo Clinic affects the oil-producing glands in your skin and makes acne more likely. This is also why some women experience acne flares before their periods, or during pregnancy, and why hormonal birth control treatments can help clear up skin.
  
  
• Diet & Dehydration: Poor diet and hydration can lead to poor health overall, and that includes your skin. Some studies have suggested that a diet high in carbohydrates—like bread, cereals, pasta, and many snack foods—might worsen acne, but there's no conclusive evidence that there's a particular diet people with acne should follow to improve their skin
  
  
• Pollution & Irritants: Anything that causes irritation to your skin can worsen your acne. This includes astringent skin care products, smoke from cigarettes, vigorous scrubbing, water that's too hot—even the band of your hat! You don't necessarily need to avoid all these things to prevent acne flare ups, but if you're struggling to improve your skin, check for sources of irritants you might not have considered.
  
  
• Stress: Yes, unfortunately stress can make your acne worse. It's likely due to the hormonal changes stress causes, but whatever the reason, nothing makes stress worse like a breakout right before a big event. Try to find ways to manage your stress level— physical activity and exercise can be a big help, and no, sweating in general does not make acne worse. Just be sure to shower afterward to remove excess oil.

How Can I Treat Acne?

Over-the-Counter Treatments

• Benzoyl Peroxide
  One of the most common acne treatments, this medication is available over the counter in creams and gels, as well as in some cleansers. Benzoyl peroxide works by helping to get rid of acne-causing bacteria on your skin. Double check to make sure you aren't using both a topical medication and a medicated cleanser. Too much benzoyl peroxide can cause irritation
  
  
• Salicylic Acid
  Another common anti-acne ingredient, salicylic acid treatments work best against early pimples and pustules rather than tougher-to-treat acne cysts, according to the American Academy of Dermatology. It doesn't kill bacteria, but does remove excess oil and helps prevent pores from clogging. Salicylic acid treatments can cause stinging and mild irritation, so be careful not to overuse.
  
  
• Glycolic Acid
  Glycolic acid is what's known as an alpha hydroxy acid. This type of nonprescription medication not only helps remove dead skin cells to prevent them from clogging pores, it helps reduce inflammation and encourage the growth of healthy new skin, according to the Mayo Clinic. This means that it can help improve your skin's appearance even as your acne is still healing.
  
  
• Sulfur
  Acne medications containing sulfur are often used in combination with other medications like benzoyl peroxide, since sulfur is good at removing excess oil and helping clear away dead skin cells, but not at attacking bacteria directly. It's gentle enough to be used in these combination products, but due to sulfur's distinctive odor—think rotten eggs—some sulfur-containing products are known for their similarly unpleasant smell.

Prescription Treatments

• Topical Treatments
  There are lots of prescription-strength topical treatment options. These include antibiotic creams and lotions as well as more concentrated benzoyl peroxide creams. These might be used alone, or paired with an oral medication. Make sure not to combine your prescription topical treatments with any over-the-counter treatments without consulting your doctor first. Over-medicating your skin definitely isn't good for it!
  
  
• Oral Antibiotics
  These antibiotics work on your skin from the inside out, preventing the growth of bacteria that contribute to acne. They take some time to work, and you may need to try different types before finding the one that works best for you.
  
  
• Birth Control Pills
  For women, birth control pills can help manage acne flare ups that are made worse by hormonal changes. There are several types of birth control pills that can be prescribed specifically for treating acne (as opposed to being used "off label" for this kind of treatment). Of course, hormone-based birth control pills do have their own side effects and risks, including the potentially dangerous increased risk of blood clots. Talk to your doctor about the risks and benefits before you start treatment.
  
  
• Retinoids
  These medications are derived from Vitamin A, and are used topically. They work by preventing the pores from clogging. Some of these cause skin irritation, so your doctor may start you off with only using the medication a few times a week until your skin gets used to it. Then it can be used daily.
  
  
• Isotretinoin
  This is one of the strongest and most effective acne medications available. Marketed under names like Accutane, Claravis, and Sotret, it works well against all kinds of acne, but it has the potential for severe side effects, including liver damage. Women who use isotretinoin treatments must not become pregnant—isotretinoin is a known teratogen, which means it can cause severe birth defects. Isotretinoin treatments are typically only used for severe acne, or when other treatment options have not shown adequate improvement.

Acne Myths

Greasy Foods Cause Acne

While it's true that working in a greasy kitchen environment can worsen acne, this is due to the build up of grease on your skin, not the grease in your diet. A healthy diet overall is a good way to support your skin health, but eating greasy foods will not cause acne.

Washing Your Face More Prevents Acne

Actually, too much washing can make it worse. Stick to washing in the morning and evening with lukewarm water and a mild cleanser. In between, wash after any activities that make you sweat to remove excess oil.

Some Medications Improve Acne Overnight

Unfortunately, this one is wishful thinking. There are products that reduce inflammation, which can make your acne look better after only a day or two, as the swelling and redness will have gone down, but the underlying condition is still there. Acne treatments all take time to work, but the sooner you get started, the sooner they'll take effect.

Exfoliants Prevent Acne

It might seem satisfying to scrub away at your acne with a gritty exfoliant paste, but if you've ever been disappointed in the results, there's a good reason why. Exfoliants can help remove dead skin cells, but they also cause irritation and inflammation, which can make your existing acne look even worse. Opt for other ways of removing dead skin cells, such as a benzoyl peroxide or salicylic acid treatment.

Wearing Makeup Makes Acne Worse

It's true that some types of makeup can cause acne—according to the American Academy of Dermatology, there's even a special name for that type of acne: acne cosmetica. In general, though, makeup is fine to wear if you have acne as long as you choose products labeled "non-oily" or noncomedogenic. Use your own clean makeup brushes (wash them at least once a week) to apply your makeup, and be sure to remove all your makeup at the end of the day. Don't scrub at stubborn makeup—opt for a water-based makeup remover instead.

Popping Pimples Helps Them Heal Faster

Most of us know this one is a myth, but it's just so tempting to try and get rid of those big ugly zits by popping them! Do yourself a favor and don't do it. Popping pimples makes scarring worse, can cause further infection, and helps spread acne-causing bacteria around your face. Yuck!

There's Nothing You Can Do About Acne

One of the biggest misconceptions about acne is that it's just something you have to deal with until it goes away. Acne is highly treatable, even in its most severe forms. There are so many options and treatments available that your doctor will be able to find just the right course for you. If your acne makes you uncomfortable or anxious, don't write it off as something that will go away on its own. Take action and talk to a dermatologist.

Preventing Breakouts

• Use Noncomedogenic Products
  Check the labels on your soaps, makeup, and moisturizers to make sure that they're labeled "noncomedogenic" or "nonacnegenic." This means that they're much less likely to contribute to breakouts. It's not a total guarantee they won't cause acne; you may still be sensitive to the product, which can cause inflammation and, in turn, worsen acne, but noncomedogenic products are a much better option for acne-prone skin.
  
  
• Avoid Harsh Products
  It's tempting to try exfoliants that claim they can scrub away blemishes, or astringent liquids to dry out oily skin, but these are both examples of products that can actually make acne worse. Because they cause damage and irritation to the skin, not only can they worsen the appearance of existing acne by making it look red and inflamed, they can encourage the production of new blemishes and pimples. When it comes to skincare, harsher does not mean more effective. Stick to gentle cleansers.
  
  
• Limit Sun Exposure
  Sunlight is another one of those irritants that can cause problems for acne-prone skin. When outdoors, use a noncomedogenic sunblock and other sun protection, like a hat, to protect your skin. Avoid tanning beds and booths; not only do these cause the same kind of damage that sunlight does, they also greatly increase your risk for skin cancer. Additionally, some types of acne medication actually make light sensitivity worse, increasing your risk for sunburn. Be cautious and avoid getting burned!
  
  
• Don't Pick at Your Skin
  It's a tough urge to resist, especially when your acne is itchy or uncomfortable, but try to limit touching your face. Not only does this help prevent scarring from opening half-healed scabs, but it also helps keep you from spreading acne-causing bacteria and irritants around on your face.
  
  
• Wash Regularly, But Gently
  Regular washing can help limit oil, dirt, dead skin cells, and bacteria that contribute to acne. Excessive washing, especially with harsh soap, hot water, or vigorous scrubbing can make acne worse. Instead, wash your face and other affected areas with lukewarm water and a mild cleanser, especially after vigorous activity. Use your fingers instead of a cloth to apply the cleanser, as this will cause less irritation. Rinse thoroughly to avoid lingering sensitivity, especially if using a medicated cleanser.
  
  
• Continue Your Medication As Directed
  If you're using an acne medication and your skin starts to clear up, that's great news! It doesn't mean you can stop using your medication, however. Talk to your dermatologist about the results you're seeing and create a plan moving forward. You may continue your medication, change the dose, or stop altogether, but that's a choice you should make with guidance from your doctor.

Taking Control of Your Acne