Clear Up Your Misconceptions About Acne

By Rosalyn George, MD | Apr 09, 2019

How We Get Acne

Acne happens when a hair follicle - or pore - in our skin gets clogged with dead skin cells. Normally, our bodies are very good about getting rid of these cells so that new, healthy skin can take their place.

But, sometimes the body overproduces an oil called sebum, so the cells start to stick together and attract bacteria. If the irritated area becomes inflamed, then it often turns into what we know as a pimple.

We’re not quite sure what causes the overproduction of sebum, but scientists and doctors have been researching it for years. What we’ve found is that acne could possibly be related to the foods we eat, our daily habits, and even our genetic makeup.

But what we DO know for certain is that one of the biggest culprits is our hormones, and specifically, the hormone testosterone.

You’re probably familiar with testosterone as a male sex hormone that produces sperm. But it’s responsible for so much more. Among other roles, it plays a part in our bone and muscle mass, fat metabolizing, and producing red blood cells. You may not be aware that women also produce testosterone, though in smaller amounts.

And can you guess what else testosterone is responsible for?

That’s right: the production of sebum.

Remember when you hit puberty? Your hormones probably felt like they were all over the place, right? In addition, that’s probably when you had your first real run-in with acne, which is no coincidence.

When we hit puberty, our testosterone levels increase, which results in an increase of sebum, which results in clogged pores, which results in acne.

And while for most of us, puberty is but a distant memory, that doesn’t mean that our hormones still can’t affect our skin, especially in women. Things like stress, pregnancy, and menstrual cycles can all cause hormonal changes and, in turn, acne.

Treating and Preventing Acne

The first step is simply cleansing. A lot of people have the misconception that the more they wash their faces, the cleaner it’ll be. But actually, washing twice a day - with a cleanser formulated to fit your skin type - is more than enough. Doing more than that can actually make acne worse by increasing oil production and inflammation, both of which we now know cause breakouts.

Once your skin is clean, it’s important to remember to moisturize! Many people are afraid that moisturizers will clog their pores, but that’s just another misconception. Dry skin tends to be more prone to irritation, which puts it at risk for inflammation and more breakouts.

Even your makeup can play a role in keeping your skin acne-free. Look for products that are water or mineral-based and labeled “oil free” or “non-comedogenic.” These tend to be lighter and won’t clog pores. Also, use a light hand when applying; packing on the foundation or concealer on top of your skin might hid your acne temporarily, but it’s almost sure to cause future breakouts.

And a reminder if you use makeup brushes or sponges: wash them! Regular cleaning with warm water and a bit of soap or shampoo will keep your brushes free of germs and bacteria. Think of it this way: when we wash our face, we get rid of the oil and bacteria on our skin; why would we want that to go to waste by using brushes that aren’t as clean as our faces?

Remember, patience is key when it comes to acne treatment. One of the biggest mistakes I see people make is changing products too frequently. Since acne can come and go, people tend to start a new product and think they’ve found a miracle cure. But, when they break out the next week, they immediately go back to the store in search of the next “miracle.”

Unfortunately, acne is a chronic condition that requires maintenance, treatment, and patience. It will typically take two to three months on any treatment to know if it is effective. I always tell my patients to stick with the treatment plan - even if it flares a little at first - for at least a couple of months.  Don’t forget, while your acne may not disappear immediately, with the right routine, you can improve your skin’s appearance, leaving you confident and ready for anything!