Acne Myths Facts and Tips

 

by

Michael H. Berkson, M.D.

 

 

Myths about the causes and treatment of acne abound.  Below are twelve of the most common myths that I encounter on a regular basis in the day to day practice of dermatology, along with a factual response to each misconception, and some tips.

 

 

Myth: Acne is caused by dirt and poor hygiene

 

Fact:  Acne is caused by a complex set of factors centered in and around specialized hair follicles  in genetically predisposed individuals. It is not caused by trapped dirt or other matter from the outside.   Over aggressive attempts to “clean” the skin such as scrubbing and the use of abrasives can make matters worse by traumatizing the already vulnerable follicle.

 

Tip:  Gentle skin cleansing twice daily using a medicated acne cleanser such as salicylic acid or benzoyl peroxide or a non-acne gentle skin cleanser is a more than adequate regimen for keeping the skin clean in people who have acne.

 

 

Myth:  Acne is caused by a bad diet.

 

Fact:  There is no conclusive evidence that diet affects the overall course of acne.  There is however mounting evidence that in some people excessive consumption of sugars, other high glycemic index foods, and certain dairy products such as milk might aggravate acne.

 

Tip:   If you’re a big fan of sweets and/ or dairy, try cutting back and see if the acne improves.  Also, if a whey protein shake is part of your post workout routine, you might consider switching to a casein, egg or other non- milk protein product. And, from a general health and skin point of view, you can’t go wrong with a well balanced diet that is relatively low in added sugar and fat.  For a more detailed look at the possible connection between diet and acne check out the article on this website authored by Dr. Sheila Krishna.

 

 

Myth:  Popping pimples helps them heal faster.

 

Fact:  Popping and manipulating acne lesions can impede healing and increase the chances of prolonged blemishes and scarring.

 

Tip:  A hands off approach is best.  Avoid popping, squeezing, or picking to allow faster healing and reduce the chance of long lasting marks.

 

 

Myth:  Wearing makeup makes acne worse.

 

Fact:  Most makeup has no negative effect on acne.

 

Tip:  Makeup can help conceal the pimples and blemishes of acne.  Choose an oil free, non- comedogenic/ non-acnegenic foundation and you should be fine.

 

 

Myth:  Natural sunlight and tanning beds are good treatments for acne.

 

Fact:  Ultraviolet rays from the sun and tanning beds may seem to temporarily improve the appearance of acne in some people, and in some it may worsen things. For most, it has no effect.

 

Tip:  Excessive exposure to UV rays from the sun or tanning beds increases the risk for all types of skin cancer including melanoma.  UV also accelerates photo aging ( wrinkles and permanent sunspots). It’s not worth taking that chance for a possible, slight short- term improvement  in the acne, especially with so many safe, truly effective treatments available.

 

 

Myth:  Acne automatically goes away when you stop being a teenager.

 

Fact:  It is true that, on average, acne tends to improve with age and a good share of people become acne free in their late teens and early 20’s. For many women, and some men, acne continues well into their 20’s and beyond.  Around 25% of adults with acne first start breaking out when they are in their mid 20’s, or older.

 

Tip:  All types of acne, in all age groups can be effectively managed.  Seek care from a health professional who has an interest in and is accomplished at treating acne.  Dermatologists generally best fit this role.

 

 

Myth:  People with oily skin have more severe acne.

 

Fact:  Although oil ( sebum) is a prerequisite for acne, the amount of visible oil on the skin doesn’t correlate well with the degree of acne.  People with oily skin can have mild or even no acne, and people with dry skin can have severe acne. Removing surface oil from the skin does not affect the course of acne in any given person.

 

 

Myth:  Acne is caused by an infection.

 

Fact:  Acne is a complex, inflammatory condition in which P. acnes, a bacteria that normally inhabits the skin plays a role.  Acne is not caused by an external pathogen-infection- and thus cannot be spread to other areas of the skin or to other people.

 

 

Myth:  Blackheads are dark because of trapped dirt and “Impurities.”

 

Fact:  Blackheads ( open comedones) appear dark because of the oxidation of epithelial cells and melanin-pigment-from the lining of the sebaceous follicle that has accumulated below its opening near the skin surface.

 

Tip:  Attempting to mechanically remove the dark material from blackheads at home usually results in its re-accumulation within a few days. A more comprehensive, preventive approach using topical and or/oral medications is generally required for lasting improvement.  Differin  (adapalene) gel is the most active OTC medication for the treatment of blackheads.

 

Myth:  The red and dark spots that linger after the pimple resolves are scars.

 

Fact:  Persistent red and dark spots that outlast the pimples are due to residual inflammation or hyperpigmentation that results from the immune response or over stimulation of the pigment producing cells during the inflammatory phase. It can take a long time ( sometimes many months) but these blemishes eventually fade, unlike the permanent textural changes of scars.

 

Tip:  Differin ( adapalene) Gel, which is now available over the counter, can speed up the fading of blemishes as well as help control the active acne.

 

 

Myth:  Topical treatments are best used on an as needed basis to treat active breakouts.

 

Fact:  Topicals should be used on a regular basis, usually daily, to not only treat the acne that is present in the here and now, but also to help prevent future breakouts.  Many of the leave on topicals can take a month or two to begin to work, so regular use is key.  This same principle also applies to oral medications.

 

Tip:  Leave-on topicals should be applied daily (unless otherwise directed) to the entire acne prone areas, rather than as a spot treatment for individual pimples.  In general, a pea size amount of gel or cream is enough to cover the entire face. Using this as a guideline helps to reduce the chance of irritation from over application, and also prevents waste.

 

 

Myth:  Acne can be cured.

 

Fact:  The bad news is that, with the exception of isotretinoin/Accutane, in some cases, there still is no cure for acne. The very good news is that there are a variety of highly effective treatments that can be used to manage breakouts until the acne resolves on its own.

 

Tip:   Do seek care from a health care professional who is well versed in and has an interest in helping people with skin conditions in general, and acne in particular.  Dermatologists are in the best position to serve this role as they have the most in depth training and experience treating acne of all types in all age groups.

 

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