What Causes Acne: Myths And Reality

You’ve probably heard a lot of claims about acne remedies, but how can you know whether they’re true? We’ve come to put things right.

Since the beginning of time, people have tried to figure out what is causing their acne. This includes diet, stress, makeup, and sex.

While dermatologists and researchers aren’t 100% certain what causes acne, they have made great strides in the last decades, and most doctors agree that hormones and heredity are the main sources.

This article examines the role of diet and stress in causing or making existing acne worse. I also discuss some over-the-counter acne medications and “tripwires” that have been linked to acne-causing or worsening effects.

Let me end by examining the relationship between makeup, acne, and skin. We will also examine some historical myths about acne. You’ve likely been told not to eat too many chocolates.

These myths can be passed on from one generation to the next, shared with you by a friend, or published in beauty magazines. Myths are hard to swallow, and sometimes there’s an underlying truth that can explain how and where they originated. Other times, they’re just silly folklore.

Your blackheads may appear to be filled with dirt, but they are actually melanin. This pigment gives your skin its natural color. Contrary to what you might have heard or seen in commercials, acne doesn’t happen from the top. Most of the action that causes your pores to become blocked is inside your hair follicles.

It’s amazing, don’t you think? It’s possible that dirt is a major cause of acne in some people. We would see gazillions upon gazillions of pimples and blackheads on our faces and the faces of those who do manual labor like coal miners, ditch diggers, and construction workers. It happens that doctors, teachers, office workers, and even dermatologists get acne.

Oil is the most important aspect of acne. Although there is a correlation between the severity of the condition and how much oil the skin produces, not everyone with acne has oily skin.

A face with acne should not be rubbed. It will only irritate and worsen an already reddening complexion. The best thing for your face is to wash it twice a day. Use a mild cleanser.

The Cause Of Acne

You are not always what you eat. Despite some personal anecdotes and persistent cultural myths about acne, it is not likely to be significantly influenced by diet. There have even been studies where people were paid to eat chocolate. Yum! The acne of the chocolate-eating sub-jects didn’t get any worse.

Several substances in chocolate have been found to be mood-lifters. These chemicals are chemicals that lower pain and increase mood. Chocolate is good for your skin, and it may help reduce your stress levels.

Your waistline could get larger. There is still some debate about the relationship between diet and acne. However, many researchers believe that some dietary factors may have an impact on acne. Some dairy products and refined sugars found in Western diets are being investigated as possible acne triggers.

This is a controversial issue. If you are certain that certain foods are making your acne worse, avoid them! If your acne is being properly treated, there’s no need to worry about it. Be skeptical of any books that promote salmon as a treatment.

You may have been advised to avoid junk food in order to prevent pimples. It contains too much fat and grease, which can make your skin oily and cause you to get McPimples.

Studies have shown that it is the oil in the sebaceous glands, not the oil in French fries or in your stomach, that causes problems. It is sensible to eat healthy, which means avoiding greasy foods, but it doesn’t guarantee clear skin.

Can Beef And Milk Cause Acne?

To build muscle, many cattle are fed androgens. As you might have read, the body’s androgens can often be what causes an overproduction of oil. Researchers are investigating whether eating beef can cause androgenic stimulation or acne.

However, cooking may cause the androgens to be less effective in reaching our sensitive and acne-prone hair follicles. Some investigators, though a minority, believe that dairy products, especially skim milk, may make acne worse or even cause it.

The androgenic hormones that are injected into cows in order to increase milk production cause pimples. It is not clear if the hormones found in milk can survive high levels of stomach acidity (our stomach acid) and be absorbed into our bodies.

This debate is my take. I have seen many vegetarians choose to not eat flesh foods (fish and chicken), as well as a few vegans (pronounced “vee-guns”), people who completely avoid any animal products, including eggs and dairy. Guess what? Vegans and vegetarians both get acne just like everyone else! (And, by the way, when was the last time you saw a cow with pimples?)

Although no one knows the answer, for now, I believe you can trust your gut instincts and continue to drink your milk. (Unless you have an allergy to milk.) The same applies to eating steak. The jury is still out on the cow-androgen-acne issue.

Are Sweets A Cause Of Acne?

A study of two societies, the Kitavan Islanders in Papua New Guinea and the Ache hunter-gatherers in Paraguay, found no evidence of acne until the groups were exposed to a Western diet.

This article was published in the Archives of Dermatology’s December 2002 volume. It suggested that acne could be caused by the consumption of refined sugars in Western diets.

The bottom line: other than diet, climate, and sun exposure, many factors could be responsible for the lack of acne in these individuals.

Teenagers probably had the same amount of acne 30 years ago as they do today, even though American diets were lower in sweets.

Modern-day stress, anxiety at work, too many hormones, nuclear threats, obesity, too many hormones, too little or too many hormones—all of these things can lead to severe acne. While most investigators believe stress does not cause acne, many would disagree that stress can worsen it.

Ask college students during exam time. Teenagers are getting ready to go to prom or interview for their first job. It is well-known that the body releases excessive amounts of glucocorticoids (the body’s natural steroids) when it is under stress.

Some believe that glucocorticoids have an androgenous effect (see next section for details about glucocorticoids taken orally) and cause the sebaceous to produce more oil, which can worsen or cause acne-like eruptions.

Regular stress-reducing activities (such as knitting, yoga, and other such activities) may help to reduce the levels of glucocorticoids and their effects on the sebaceous glands. Many pundits recommend getting more sleep and meditation. These measures are not proven to reduce acne like diet and acne. But, these healthy habits may help reduce stress.

Acne-Causing Drugs

Most medication-related acne reactions are self-limiting. This means that they disappear once the drug is stopped. The same medication can be used to treat acne-like lesions if the drug is required to be taken for a prolonged period.


Oral corticosteroids are synthetic derivatives of the natural steroid cortisol (which is produced by the adrenals). These steroids are pre-prescribed for many serious inflammatory conditions. These steroids are called “systemic steroids” when they’re administered by injection or mouth. They are not as effective as topical corticosteroids, which can be applied directly to the skin.

Examples include prednisone and methylprednisolone. Sometimes, these drugs can cause inflammatory acne lesions. These are usually papules and pustules that appear on the chest or back. After the medication has been stopped, they disappear. Steroid-induced acne is generally free of comedones, which are blackheads and whiteheads.

A condition similar to acne can be caused by the excessive use of topical corticosteroids, which are used for many skin conditions. This is called steroid-induced rosacea. This sounds contradictory. Because oral corticosteroid drugs have anti-inflammatory properties, it would seem that they could be used to treat acne.

They are sometimes used to treat acne under certain circumstances. They can be used to treat acne scars and nodules by injecting them. We dermatologists may prescribe corticosteroids orally to treat acne for short, three-to five-day, low-dose “bursts”.

These are used for special occasions such as weddings, proms, and other special events. Although they can effectively eliminate acne quickly, they are only effective for short periods.

Anabolic-Androgenic Steroids

These hormones can cause acne and other serious health issues. Besides legitimate medical uses of androgens such as testosterone for hormone deficiencies, widespread use and abuse of these compounds exists, particularly the anabolic-androgenic steroids, as performance-enhancing drugs.

This type of acne is more common in males and occurs primarily on the chest, back, shoulders, and chest. However, in female athletes who use these drugs, lesions can also appear on the forehead, back, shoulders, and neck. A problem with acne might get worse, or it may be exacerbated.


Androstenedione, also known as andro, is a hormone that’s produced by the adrenal glands and ovaries. It is a precursor hormone that can be normally converted by the body into testosterone or estrogen in both men and women.

Andro was in the news after Mark McGwire, a former baseball player, admitted to taking Andro during his record-breaking home run season. Advertisements claim that andro-containing supplements increase muscle mass.

However, research has shown that andro poses similar health risks to anabolic steroids. The U.S. Food and Drug Administration (FDA) warns young people about the potential risks of taking andro. These include acne, early puberty, and stunted growth.

DHEA (dehydroepiandrosterone)

This hormone is sometimes called the “fountain of youth” hormone. It’s also a steroid hormone, which is a chemical cousin to testosterone and estrogen. DHEA can cause excessive facial and body hair, as well as acne because it is converted to testosterone.

Other oral medications

The following drugs have also been shown to be acnegenic:

  • Lithium
  • Iodine
  • Isoniazid
  • Diphenylhydantoin
  • Several androgen contraceptive pills

Can Cosmetics Cause Acne?

Acne cosmetica is mild acne caused by makeup. Although some reactions to cosmetics may look like inflammatory acne at times, it is really your skin reacting to the makeup ingredients that cause your acne to become redder or worsen.

You and I both know that cosmetics don’t play a significant role in acne development or worsening. It’s all in the title. My patients generally tell me, “If your cosmetics are making you happy, keep using them.” If your cosmetics are causing you or worsening your acne, stop using them for a few more weeks to see if they make you feel better.

There are many people who disagree with me. Some of them are dermatologists. The next sections will tell you what other dermatologists have to say. I try to include all the information and reiterate the old belief that cosmetics and makeup are important in dealing with acne.

Check Out The Ingredients

Today, cosmetic products are touted as non-pore-clogging and oil-free. Most of them also have labels that state that the product has been tested and verified to be non-comedogenic. This label is on almost every cosmetic product label.

Some skin-care products can cause blackheads or whiteheads and are therefore comedo-genic. Cosmetics can cause acne-causing problems due to excessive oil. Dermatologists believe that the most popular cosmetics can cause acne. These three ingredients are considered the most effective candidates.

  • Lanolin: This oil is extracted from the skins of sheep. It is similar to the fatty acid found in human skin.
  • Isopropyl myristate is a substance that adds “slip” to a product, making it glide on the skin more smoothly and giving it a silky smooth feel. There are many chemicals that are similar to isopropyl myristate, such as butyl stearate and octyl stearate.
  • D & C red dyes: These dyes, derived primarily from coal tar, can also be believed to be comedogenic.

Some of these ingredients may be acne-causing, according to some experts, but I personally don’t believe they cause acne. If your acne is worsening after using cosmetics, you should check the ingredients label. Try new products that don’t contain them to see if your skin conditions improve.

Oils In Cosmetics

Is it true that your cosmetic contains no oil? Chemists assume that sebum is beneficial for the skin. They have attempted to imitate it, but this claim isn’t valid. The oil substitutes used in cosmetics are synthetic and are considered more harmful than excess sebum that can block pores.

Acne may be a contributing factor.

The most likely to cause acne are:

  • Foundation makeup
  • Powders pressed
  • Thick creams
  • Blushers

Moisturizers may also contain acne-causing substances. These moisturizing products are often made with ingredients like cetyl alcohol, stearic acid, acetylated lanolin, and searing acid to smoothen the skin. These ingredients are all considered comedogenic.

Moisturizers that contain a base of mineral oil or petrolatum are recommended. Powder blushers are preferred to creams and cream/powder foundations over liquids. This is because powders “mop up” oil. A silicone-based foundation (containing dimethicone or cyclomethicone) should be used if a liquid foundation is to be chosen.

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