Although often thought of as a condition of adolescence, acne affects both teenagers and adults of all ages. An estimated 40 to 50 million people in the United States experience acne breakouts every year. Many go through their teen years relatively unaffected by acne, and only begin to experience breakouts in adulthood. Others may suffer with acne throughout the years.
What Causes Acne
The ultimate cause of acne is clogged pores, inflammation, and bacterial infection. Oil and dead skin cells combine to clog pores, allowing the bacteria that are normally present on the skin to multiple and produce an inflamed skin lesion. Common contributing factors are hormonal changes during adolescence and fluctuations in adulthood as well, and an inherited predisposition to acne. However, lifestyle factors have been linked to acne breakouts as well. Each patient is different and is affected by different factors to varying degrees. One patient’s acne may be completely driven by hormones and another, almost all diet-related. A dermatologist like Dr. Steele can help determine the causes and triggers in your particular case.
What Causes Acne Breakouts?
High Glycemic Index Foods
Eating high glycemic index foods has been shown to trigger acne breakouts in many people. High glycemic index foods are foods made out of simple, quickly digested carbohydrates, such as white bread, pasta, cakes, cookies, soda, and candy. When consumed, these foods are rapidly converted into sugar which is absorbed into the body, caused a spike in blood sugar levels quickly followed by a spike in insulin levels. It’s not quite clear how this leads to acne, but some researchers speculate that high insulin levels induce the production of excessive skin oils. Others speculate that the inflammatory state induced by blood sugar and insulin spikes induces inflammation of the skin, making it more prone to developing acne. Since high glycemic index foods are not part of a healthy diet, it’s a good idea to not consume them. Eliminating these foods from the diet will improve both overall health and skin health by eliminating acne triggers.
In some people, consumption of dairy triggers acne. Since dairy is not an essential component of the diet as long as sufficient calcium is obtained from other sources, it is easy enough to perform a test elimination diet followed by a challenge to see if dairy is an acne trigger. A test elimination diet consists of not eating any dairy for several weeks. This may require carefully reading labels and using caution at restaurants. If the skin clears up during the elimination period, that strongly suggests dairy is the culprit. However, since acne can have multiple causes, failure to clear up during the elimination period doesn’t prove dairy isn’t making the acne worse. The final test is the challenge: eat some dairy and see if an acne breakout occurs. Researchers speculate that dairy may be triggering acne in two ways. First, dairy induces chronic inflammation in some people, and as mentioned above, inflammation plays an important role in acne. And second, dairy products contain a number of growth factors that may be mimicking the action of testosterone on the skin. Surges in testosterone during adolescence are a primary cause of acne in teenagers.
Most modern diets contain primarily omega-6 fatty acids and insufficient omega-3 fatty acids. Omega-3 fatty acids are anti-inflammatory and omega-6 fatty acids are pro-inflammatory. Consuming excessive amounts of omega-6 fatty acids can induce a chronic inflammatory state, contributing to acne breakouts. Omega-6 fatty acids are found in vegetable oils and grains, and are also high in meat and eggs from animals fed primarily grain. Omega-3 fatty acids are found in fish and seafood, eggs and meat from free-range forage-fed animals, flaxseed, and nuts. Avoiding vegetable oils and taking a fish-oil supplement may help to soothe inflamed skin and reduce acne breakouts.
Chronic stress can take a big toll on health, including skin health. Stress increases cortisol levels in the body and has downstream effects on the pores and oil glands associated with acne. Many, even those who don’t typically have acne, will notice a breakout when they are really stressed out. Although it is difficult to avoid the stresses of life, the impact of stress on health can be minimized by using stress-reducing strategies. Daily exercise is a very effective way to relieve the effects of stress. Other strategies include yoga, meditation, or simply setting aside time every day to enjoy a special relaxing activity, such as a long bath, reading a book, or engaging in a hobby. No matter how hectic life becomes, it is important to get sufficient sleep at regular hours and to find time to decompress.
Many women only suffer from acne breakouts at particular times in their menstrual cycles due to hormonal fluctuations. Oral contraceptives containing estrogen are often very effective in preventing this type of acne. Conversely, progesterone only contraceptives can induce acne breakouts. Women who have hormonal issues like polycystic ovarian syndrome (PCOS) may have a particularly hard time with persistent acne. There may need to be discussions between your dermatologist and your gynecologist to figure out the optimal way to control breakouts if hormones are a contributing factor.
Sunscreen, Moisturizers, and Hair Products
In many cases, acne can be caused by certain products that get on your face, even if inadvertently. They may be sunscreens, some moisturizers, or hair care products. It may even be from products that you you are putting on other areas of the body, but even a small amount of residue from the product on the fingers that may touch your face can cause an issue. These products are considered “comedogenic” if they contain oils or other substances that clog pores. Acne-prone individuals should look for products advertised as “non-comedogenic” and oil-free. Many claim that some oils can be helpful in controlling acne, but most oils will cause acne and any oil has at least some risk of causing acne in an acne-prone person.
How to Treat an Acne Breakout
Individuals with chronic or moderate to severe acne should consult a dermatologist immediately for treatment in order to minimize the risk of scarring. However, those afflicted with only occasional, mild breakouts can try home treatment first. If a few weeks of home treatment is not effective, consulting a dermatologist is wise.
Affected areas should be gently cleansed with a non-irritating cleanser twice a day. Do not scrub vigorously, do not use an exfoliating agent, and do not use astringent or disinfecting agents; all of these can damage and inflame the skin, making the acne worse.
Applying over-the-counter products that contain benzyl peroxide or salicyclic acid can quickly clear up an outbreak. However, be careful to follow the instructions and do not apply the product too frequently or it may irritate and dry out the skin, making the acne worse. Also, do not just apply the product to existing lesions-treat the entire face in order to stop lesions that are about to develop. These products will not work overnight but can clear up an outbreak within a few days to a week.
See your dermatologist!
Chronic acne breakouts can be a nuisance, but they can be managed. Contact Dr. Steele for a consultation and a custom treatment plan that’s right for you.