Acne - Myths, Misconceptions and You

Research shows that nearly 98% of the general public harbors at least one erroneous belief about acne's causes and remedies. This extends to individuals directly affected, with studies reporting that over 80% of acne patients subscribe to at least one common myth.

This misinformation about acne can lead to delayed or ineffective treatment, ultimately worsening breakouts and increase the risk of acne scarring. Beyond physical impacts, the constant struggle with acne fueled by misinformation can negatively affect mental well-being, contributing to anxiety, low self-esteem, and social isolation.
In this blog, let us expose the 7 acne myths and illuminate the path towards clearer, healthier skin.

1. Popping Pimples - Does it actually help?
2. Acne and Age - Just a teenage thing?
3. Diet and Acne - Do foods make acne worse?
4. Acne and Hygiene - You’re not dirty, hygiene rumors about acne
5. Acne and Stress - A Complex Interplay
6. Spot treating Acne - Toothpaste and Stickers?
7. Acne and Makeup - Is it making it worse, or hiding it safely?

---

Popping Pimples - Does it actually help?

Studies overwhelmingly advise against popping acne because of several reasons:

1. Increased inflammation and scarring: Popping acne can push debris deeper into the skin, leading to more inflammation, redness, and potential scarring. This inflammation can worsen the original pimple and cause new breakouts. Pimple popping impedes proper healing, thereby increasing the risk of more scarring.
2. Risk of infection: Popping a pimple can introduce bacteria from your fingers, increasing infection risk and potentially leading to painful cysts, nodules, and even cellulitis or deeper skin infection. Due to facial blood vessel connections to the brain, infections in the danger triangle may travel to your brain and can lead to serious complications like meningitis, sepsis, and in rare cases, blood clots.
   
   
   Diagram of the Danger Triangle of the Face

Individuals wanting to prevent whitehead or blackheads (comedones) from becoming full blown acne lesions can consider safer methods for extracting comedones, including:

1. Professional extraction: Dermatologists or qualified aestheticians use sterile tools and techniques to safely remove comedones. In dermatology, comedones are considered as nidus or centers of inflammation. Removing comedones safely can lead to faster resolution of acne. With the use of proper tools like the Ulcrum Professional  Comedone Extractor, comedones are extracted safely and effectively with significantly decreased risk of scarring.
2. Chemical exfoliants and sebum regulators: Products containing salicylic acid can gently penetrate pores, breaking down the skin plug and facilitating expulsion of debris. Potassium azeloyl diglycinate (PAD) can help regulate sebum secretion, reducing comedone formation over time. The Mission: Skin Acnoregulin Spray combines the salicylic acid and PAD making it an ideal acne toner for the morning routine.
   
   
3. Retinoids: Topical retinoids like Tretinoin and Retinol increases cellular turnover, pushing out deep seated comedones, helping to expel comedones over time. Pretreatment with an acid toner and retinoid loosens up comedones making them easier to extract. Retinoids help follicle skin to develop normally, preventing them from sticking to each other and this prevents clogging of pores, reducing comedone formation in the long term.

 

Acne and Age - Just a teenage thing?

For many teenagers, the transition from childhood can come with a new challenge: acne. But why is this skin condition so prevalent during puberty? Studies point to a confluence of factors:

1. Hormonal Fluctuation: Puberty initiates a surge in hormones like testosterone and other androgens, stimulating oil production in the skin. Hyperactive oil glands are at the center of acne pathology. Excess oil produced gets trapped in pores, creating the perfect breeding ground for acne-causing bacteria called Propionibacterium acnes or P.acnes.
2. Changing Skin: During puberty, skin cells around the pores develop abnormally and become very sticky, leading to the formation of a skin plug. This traps the oil and allows comedones to form and become the focus of inflammation, developing into acne with time.
3. Genetics: Unfortunately, acne can run in families. If your parents struggled with pimples, there is a higher chance you might too.

While acne is not life-threatening, its impact can be profound. Studies show that it can lead to anxiety, low self-esteem, and even social isolation during a time when self-image and social acceptance are crucial.

Unfortunately, for some, acne is not a fleeting skin condition. Studies suggest that up to 50% of adolescents experience acne well into their twenties, and persistent acne can be linked to underlying hormonal imbalances such as that seen in polycystic ovarian syndrome or PCOS. Individuals experiencing more severe acne may exhibit greater levels of depression and anxiety. Therefore, it is important to address acne as soon as it appears. 

Remember that the backbone of acne treatment is proper skincare. Start your anti-acne skincare strategically with Gentle Active Cleansing. Washing your face gently removes the layer of debris and sebum that may deactivate anti-acne ingredients in your other skincare. Maximize the cleansing stage by using a mild soap or cleanser that contains an active ingredient which targets acne, allowing you to treat acne as you cleanse. May we suggest the Azelane Soap which contains Potassium azeloyl diglycinate (PAD), a multifaceted anti-acne ingredient with anti-inflammatory, antimicrobial, and sebum-regulating properties. Do this step 20 seconds two times a day. Studies show that washing the face twice a day leads to improvement of acne. 

Build up your anti-acne skincare slowly by introducing products containing Salicylic acid, Azelaic acid, and Retinol one at a time every two weeks. If self-care measures do not suffice, consult a dermatologist for prescription medications like oral retinoids (Isotretinoin) and antibiotics (Doxycycline).

 

Diet and Acne - Do foods make acne worse?

The growing field of research on the brain-gut-skin axis suggests a potential connection of diet and acne.

The Gut Connection: It is possible that a complex network exists, connecting the gut microbiome, immune system, and nervous system, potentially influencing skin health. Studies suggest that psychological stress or mental health conditions and unhealthy diet lead to imbalanced gut microbiome and gut permeability, contributing to systemic inflammation that impacts inflammatory conditions like acne.

Potential Food Culprits: While individual responses vary, some studies associate high glycemic index foods (white bread, sugary drinks) with increased acne risk due to their impact on blood sugar and insulin levels. Dairy products, particularly skim milk, may contain insulin-like growth factors (IGFs), specifically IGF-1 and IGF-2 which can trigger acne in hypersensitive individuals.

Some approaches can help you explore potential food-acne connections:

Elimination Diet: Under the guidance of a healthcare professional, gradually remove suspected trigger foods like dairy or high-glycemic options, monitoring your skin's response for 4-6 weeks. Gradually reintroduce each food while observing any changes.

Food Diary: Track your diet and acne breakouts for several weeks to identify potential patterns. While not conclusive, it can offer initial insights.

 

Acne and Hygiene - You’re not dirty, hygiene rumors about acne

Acne is primarily caused by hormonal fluctuations, clogged pores, excess oil production, bacteria, inflammation, not dirt on your face. There is no scientific basis for linking acne to poor hygiene and assuming that people with acne have poor hygiene is harmful considering the mental health struggle that people with acne go through.  

While it is true that accumulation of debris and perspiration can increase the risk of acne eruptions, to say that poor hygiene is the cause of acne distracts us from the true enemy. The true culprit in acne are the hyperactive sebaceous glands which produce excess sebum that flood and clog the pores, creating the perfect environment for acne-causing bacteria and fungus to thrive and cause inflammation.

The most effective acne treatments are those that impact hyperactive sebaceous glands such as Isotretinoin, topical retinoids, and sebum regulators such as salicylic acid and Potassium azeloyl diglycinate (PAD). However, it is important to note that improper use of these products lead to complications. The same is true for overcleaning. Excessive washing disrupts the skin's barrier and can trigger inflammation. Wash your face regularly twice a day and avoid heavy and sticky creams or ointments to avoid clogging of pores and instead opt for light weight creams, serums, and aqueous solutions. Active skin care can be irritating and drying, use a lightweight moisturizer with skin barrier repair ingredients such as ceramides, fatty acids, and cholesterol such as the Mission: Skin HydroLock Lite Moisturizer. Apply an acne toner such as the Mission: Skin Acnoregulin Spray thinly with a single, gentle swiping motion and avoid rubbing. Avoid layering too many products, which can overwhelm your skin. Limit morning routine to 5 layers and another 3 to 5 layers in the evening. Remember that the more the layer, the higher the chances of clogging pores.

So, what does good skincare for acne-prone skin look like?

Gentle active cleansing: Accumulated sebum on the skin’s surface may deactivate some active ingredients. Choose a mild wash or soap with an active ingredient to jumpstart acne treatment early while removing excess sebum.

Targeted treatment: Use products with multiple functions, impacting hyperactive oil glands and the other causes of acne (acne, inflammation, abnormal follicle skin cells).

Moisturize wisely: Opt for oil-free, non-comedogenic moisturizers to keep your skin hydrated without clogging pores.

Apply sunscreen regularly: Protect your skin from sun damage, which can worsen inflammation and acne. Even with sunscreen it is still best to avoid sun exposure as far as possible.

Seek professional help: If over-the-counter options do not suffice, it’s time to consult your board-certified dermatologist for the big acne guns such as prescription medications like Isotretinoin.

Remember, having acne doesn't reflect your hygiene in any way. It is a common skin condition influenced by factors beyond your control. Focus on gentle skincare with effective ingredients that target specific causes of acne and it will be hard to miss your goal to clear your skin!

 

Acne and Stress - A Complex Interplay

While more studies are required to establish a direct causal relationship between stress and acne, they do reveal a complex interplay that can impact both the onset and severity of acne.

Stress and Hormones: Studies suggest that stress triggers the release of hormones like cortisol, which can stimulate oil production and increase inflammation in the skin, potentially creating an environment conducive to acne development.

The Stress-Acne Cycle: Acne itself can be a significant stressor, where breakouts trigger anxiety, further elevating stress levels and potentially worsening acne, leading to a frustrating cycle.

Beyond Teens: Adults, particularly women, can experience hormonal fluctuations and acne well into their thirties and forties therefore stress management remains relevant for all age groups dealing with breakouts.

Managing Stress for Your Skin: Fortunately, incorporating simple stress management techniques can benefit both your mind and your skin:

• Physical activity: Regular exercise, even just a brisk walk, releases endorphins, natural mood-boosters that can combat stress and potentially reduce inflammation.
• Relaxation techniques: Deep breathing, meditation, or yoga can help calm the nervous system and reduce stress hormones.
• Mindfulness: Techniques like journaling or spending time in nature can promote self-awareness and reduce stress levels.
• Healthy sleep: Aim for 7-8 hours of quality sleep each night to support your body's natural stress response and cellular regeneration.
• Seek support: Talking to a therapist or counselor can provide valuable tools and strategies for managing stress effectively.

While stress might not directly cause acne, it can play a role in its severity. Implementing simple stress management techniques along with your skincare routine can contribute to calmer skin and a calmer mind.

 

Spot treating Acne - Toothpaste and Stickers?

Spot treatments can play a valuable role in managing acne, particularly inflammatory breakouts. Studies showcase their effectiveness under specific conditions:

Targeted Action: Ingredients like salicylic acid, Potassium azeloyl diglycinate, and retinoids as spot treatments can specifically target inflamed blemishes. The Potassium azeloyl diglycinate in the Mission: Skin SpotLite Acne Spot Concentrate has moisturizing properties that enable proper healing that may decrease the risk of acne scar formation.

Anti-inflammatory Power: Salicylic acid, Potassium azeloyl diglycinate, and retinoids possess anti-inflammatory properties, soothing redness and reducing swelling.

Targeted Exfoliation: Salicylic acid gently exfoliates dead skin cells and removes excess oil, decongesting pores and preventing the spread of inflammation to involve other pores.

For severe, widespread inflammation, spot treatment alone might not be enough. Remember that acne-prone skin is inflammatory even in areas that do not have visible acne lesions. Treating the whole face in combination with spot treatment will yield better results than either alone.

Using toothpaste as a spot treatment for acne is not recommended. Toothpaste lacks ingredients that specifically target the root causes of acne and may contain ingredients that can cause allergic and irritant reactions of the skin. Some toothpastes contain fluoride, which may trigger periorificial dermatitis, a rash around the mouth.

Acne patches are hydrocolloid dressings applied directly to pimples to absorb excess oil and promote healing. Newer versions come with Salicylic acid to provide more antiacne effects, however the occlusive effects of patches can increase absorption of the acid thereby also increasing risk of irritation. Improper use, especially on broken skin, can increase the risk of infection, including cellulitis which is a deeper and more widespread skin tissue infection. If you experience any irritation, redness, warmth, swelling, pain or tenderness beyond the intended effect, discontinue use of acne patches and consult a dermatologist immediately.

Acne and Makeup - Is it making it worse, or hiding it safely?

Studies reveal that makeup does not inherently cause acne but can worsen existing breakouts under certain conditions:

• If makeup contains comedogenic ingredients, like heavy oils or waxes, it can clog pores and exacerbate existing acne.
• Friction and Irritation: Harsh application or frequent touching of the face with makeup-laden fingers can increase irritation and inflammation, worsening breakouts.
• Underlying Conditions: In sensitive skin like rosacea, even non-comedogenic makeup can trigger flare-ups. Some may be inherently allergic to makeup ingredients and some may have compromised skin barrier that makes the skin easily irritated such as in seborrheic dermatitis.

The following Steps can help you Navigate Makeup Choices with Acne-Prone Skin:

• Read Labels: Opt for "non-comedogenic" and "oil-free" formulas to minimize chances of clogging pores.
• Look for Water-Based Options: Water-based products are generally lighter and less likely to clog pores compared to oil-based ones.
• Mineral Makeup: Consider mineral makeup, often free of fragrance, dyes, and other potential irritants. You may try these brands that are known to carry mineral makeup categories: BareMinerals, ILIA, Ecco Bella, Physicians Formula, and Tarte.
• Cleansing is Key: Cleanse your face gently before applying makeup to remove dirt and oil and can get trapped under and interact with makeup.
• Never Sleep with Makeup: Never sleep with makeup on, as it can trap dirt and bacteria, worsening breakouts.
• Less is More: Opt for a minimalistic approach. Multiple layers of makeup can suffocate the skin and contribute to breakouts.

Make up is still considered safe for acne-prone skin however can trigger worsening of acne in certain conditions. Patch test make up first before fully applying to the whole face to see possible reactions.

 

Acne - The Bottom Line

Acne Science is constantly evolving, and what is considered a myth today can become a fact tomorrow and vice-versa. So, avoid the confusion and always keep updated with our blogs. One thing remains certain: effective treatment for acne exists. At DMD Skin Sciences, we can provide you with personalized advice and treatment of your acne so that you can skip the guesswork and go straight to proven steps to clear skin.