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Acne: Types, Causes, Prevention &Treament

February 25, 2023

–  14 MIN READ


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What is Acne?

Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum—oil that helps keep skin from drying out—and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders.

Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle.  Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore. This prevents the keratinocytes from shedding and keeps the sebum from reaching the surface of the skin. The mixture of oil and cells allows bacteria that normally live on the skin to grow in the plugged follicles and cause inflammation—swelling, redness, heat, and pain. When the wall of the plugged follicle breaks down, it spills the bacteria, skin cells, and sebum into nearby skin, creating lesions or pimples.

What are the types of acne?

There are several types of acne, including:

  • Fungal acne (pityrosporum folliculitis): Fungal acne occurs when yeast builds up in your hair follicles. These can be itchy and inflamed.
  • Cystic acne: Cystic acne causes deep, pus-filled pimples and nodules. These can cause scars.
  • Hormonal acne: Hormonal acne affects adults who have an overproduction of sebum that clogs their pores.
  • Nodular acne: Nodular acne is a severe form of acne that causes pimples on the surface of your skin, and tender, nodular lumps under your skin.

What are the main causes of acne?

Four main factors cause acne:

  • Excess oil (sebum) production
  • Hair follicles clogged by oil and dead skin cells
  • Bacteria
  • Inflammation

Acne typically appears on your face, forehead, chest, upper back and shoulders because these areas of skin have the most oil (sebaceous) glands. Hair follicles are connected to oil glands.

The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air.

Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren’t usually involved in acne.

What foods cause acne?

List Of Top Foods That Cause Acne

1. Refined Grains And Sugar: A study involving 64 participants with moderate to severe acne found that those with acne consumed a greater amount of carbohydrates.

Food containing refined grains and sugar include:

  • White rice
  • Rice noodles, pasta, and noodles made of white flour
  • Bread, cereals, cakes, pastries, and cookies made of white flour
  • Sugary beverages
  • Sweeteners such as honey, maple syrup, cane sugar

2. Dairy Products: A study reviewing the high school diet of 47,355 women found a positive connection between acne and intake of whole and skimmed milk. Other dairy products, such as cream cheese and cottage cheese, were also found to worsen acne.

3. Fast Food Or Junk Food: A study evaluating the prevalence of acne in adolescents found that those with acne lacked healthy dietary habits. The researchers concluded that frequent intake of junk foods like fatty foods, burgers, sausages, cakes, pastries, and sugar might increase the risk of acne or aggravate it.

4. Foods With High Levels of Omega-6 Fats: A typical western diet contains high levels of omega-6 fatty acids and lower levels of omega-3s. Omega-6 fatty acids are found in most of the vegetable and cooking oils, and most processed foods are cooked in these oils.

You don’t have to eliminate the intake of omega-6 fats. You can control your consumption of processed foods and foods made in vegetable oils. Choose oils that are low in omega-6 fatty acids. These include olive oil, coconut oil, and palm oil. Avoid intake of oils high in omega-6 fatty acids, including sunflower, soybean, and cottonseed oils.

5. Whey Protein Powder: Whey Protein is the liquid left behind after the milk is curdled and separated during the cheese-making process. Although whey is rich in amino acids, whey protein has been linked to increased acne in gym-going adolescents who take it. Though the acne (especially on the trunk) could be caused only by perspiration, more research is warranted to establish the causes.

Milk and milk products can increase IGF-1 receptors and the production of hormones like progesterone and estrogen. It is believed that they may contribute to acne, though more research is warranted to understand the mechanism behind it.

6. Non-Organic Meat: Natural or synthetic steroid hormone drugs (including progesterone, estrogen, and testosterone) are often used to increase the growth rate of animals. This is done to get them ready faster for human consumption and has been approved by the FDA.

Consuming such meats may also trigger acne by increasing the action of androgensi  and Insulin-like Growth Factor-1 (IGF-1).

7. Caffeine And Alcohol: A study states that coffee reduces insulin sensitivity. This means your blood sugar levels stay high for a longer period than usual after you drink coffee. This may increase inflammationand worsen your acne.

Another study evaluated the diet of Kitavan people who did not have acne. Their diet involved the minimal intake of coffee, alcohol, sugar, oils, and dairy products.

Another study evaluated the diet of Kitavan people who did not have acne. Their diet involved the minimal intake of coffee, alcohol, sugar, oils, and dairy products.

8. Canned Food: Frozen, canned, and pre-cooked meals can be considered processed foods. These often contain added ingredients, such as sweeteners, oils, spices, and preservatives, which are used as flavorings. Ready-to-eat foods are usually heavily processed and can contribute to acne.

9. Fried Food: Potato chips, fries, burgers, and other fried and processed foods can also cause acne. These also include other high-glycemic foods that raise your blood sugar levels quickly, causing inflammatory conditions like acne.

10. Energy Drinks: Energy drinks contain high levels of sugar and can increase blood glucose levels. In one study, intake of sugar from soft drinks was found to increase acne risk Any sugary drink can increase your risk of acne. Hence, So avoid drinking excessive amounts of sugary energy drinks and soft drinks.

While none of the studies are conclusive, and there is a need for more research, avoiding certain foods is more likely to help reduce the risk of acne. At the same time, adding certain other foods to your diet can help make your skin clear and healthy.

Acne Statistics worldwide?

Acne vulgaris (AV) is the most common skin disease, affecting approximately 9.4% of the world’s population, with adolescents having the highest prevalence. Over 90% of males and 80% of females across all ethnic groups are affected by this condition.

How to cure acne naturally?

1. Apply apple cider :

  • Pros: affordable, easy to find, improves the appearance of acne scars
  • Cons: may irritate the skin

Apple cider vinegar is made by fermenting apple cider, or the unfiltered juice from pressed apples.

Like other vinegars, research has noted its ability to fight many types of bacteria Trusted Source and fungi Trusted Source.

Apple cider vinegar contains organic acids, such as citric acid. Research from 2016Trusted Source notes citric acid has been found to kill P. acnes in conjunction with zinc oxide.

According to research from 2017, the lactic acid in apple cider vinegar may also improve the appearance of acne scars.

While certain components of apple cider vinegar may help with acne, there’s currently no evidence to support its use for this purpose. Some dermatologists advise against using apple cider vinegar at all, as it may irritate the skin.

2. Take a zinc supplement:

  • Pros: supported by scientific studies, wide variety of benefits
  • Cons: can irritate the stomach or gut, not beneficial when applied topically

Zinc is an essential nutrient that’s important for cell growth, hormone production, metabolism, and immune function.

It’s relatively well studied compared with other natural treatments for acne.

According to a 2020 meta-analysis Trusted Source, those who were treated with zinc had significant improvements in inflamed blemish count compared with those who were not.

The recommended safe upper limit of zinc is 40 mg per day, so it’s probably best to not exceed that amount unless you’re under the supervision of a medical doctor.

Taking too much zinc may cause adverse effects, including stomach pain and gut irritation.

It’s also important to note that applying zinc to the skin has not been shown to be effective. This may be because zinc is not effectively absorbed through the skin.

3. Make a honey and cinnamon mask:

  • Pros: antibacterial, easy to make
  • Cons: not enough research to back up the claims

A 2017 study Trusted Source found that the combination of honey and cinnamon bark extract exerted antibacterial effects against P. acnes.

Research from 2020 indicated that honey on its own can block the growth of or kill P. acnes. Although, this finding doesn’t necessarily mean that honey effectively treats acne.

A 2016 study Trusted Source with 136 people with acne found that applying honey to the skin after using antibacterial soap was no more effective at treating acne than using the soap on its own.

While the anti-inflammatory and antibacterial properties of honey and cinnamon may reduce acne, more research is needed.

4. Spot treat with tea tree oil:

  • Pros: don’t need a lot of product, can be left on overnight, natural
  • Cons: drying, essential oils aren’t FDA approved

Tea tree oil is an essential oil that’s extracted from the leaves of Melaleuca alternifolia, a small tree native to Australia.

A 2018 study Trusted Source found that applying tea tree oil to the skin may reduce acne.

A small 2019 study Trusted Source found that, compared with benzoyl peroxide, participants using a tea tree oil ointment for acne experienced less dry skin and irritation. They also felt more satisfied with the treatment.

According to a 2017 study Trusted Source, tea tree oil may be an effective substitute for topical and oral antibiotics that could cause bacterial resistance if used long term.

Tea tree oil is very potent, so always dilute it before applying it to your skin.

5. Apply green tea to your skin:

  • Pros: easy to make, a variety of benefits, natural
  • Cons: not enough studies done

Green tea is very high in antioxidants, and drinking it can promote good health. It may also help reduce acne.

According to 2017 research Trusted Source, this is likely because the polyphenols in green tea help fight bacteria and reduce inflammation, which are two main causes of acne.

There isn’t much research exploring the benefits of drinking green tea when it comes to acne, and more studies are needed.

In a small 2016 study Trusted Source with 80 women, participants took 1,500 mg of green tea extract daily for 4 weeks. By the end of the study, women who took the extract had less acne on their noses, chins, and around their mouths.

Applying green tea to the skin may also be beneficial.

A 2020 study Trusted Source found that applying green tea extract to the skin significantly reduces sebum production and pimples in those with acne.

You can buy creams and lotions that contain green tea, but it’s just as easy to make your own mixture at home.

6. Apply witch hazel:

  • Pros: natural, found in many products
  • Cons: very little research to back up the claims

Witch hazel is extracted from the bark and leaves of the North American witch hazel shrub, Hamamelis virginiana. Currently, there appears to be very little research on witch hazel’s ability to treat acne specifically.

In one small 2017 study Trusted Source funded by a skin care company, 30 individuals with mild or moderate acne used a three-step facial treatment twice daily for 6 weeks.

Witch hazel was one of the ingredients in the second step of the treatment. Most participants experienced significant improvement in their acne by the end of the study.

Research from 2019Trusted Source also suggested witch hazel may fight bacteria and reduce skin irritation and inflammation, which can contribute to acne.

7. Moisturize with aloe vera:

  • Pros: natural, found in many products, can be combined with other ingredients
  • Cons: not a lot of studies to back up the claims, many products contain additives

Aloe vera is a tropical plant whose leaves produce a clear gel. The gel is often added to lotions, creams, ointments, and soaps.

According to 2018 research, it’s commonly used to treat:

  • abrasions
  • rashes
  • burns
  • wounds
  • skin inflammation

Aloe vera contains salicylic acid and sulfur, both of which are used extensively in the treatment of acne. Research from 2017Trusted Source found that applying salicylic acid to the skin reduces acne.

A 2018 study Trusted Source indicated aloe vera gel, when combined with other substances like tretinoin cream or tea tree oil, may improve acne.

While research shows promise, the anti-acne benefits of aloe vera itself require further scientific research.

8. Take a fish oil supplement:

  • Pros: easy, found in food
  • Cons: takes some time to see results

Omega-3 fatty acids are healthy fats that offer a multitude of health benefits. Fish oils contain two main types of omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

A 2019 study Trusted Source showed that high levels of EPA and DHA can decrease inflammatory factors, which may reduce the risk of acne.

You can also get omega-3 fatty acids by eating:

  • salmon
  • sardines
  • anchovies
  • walnuts
  • chia seeds
  • ground flax seeds
  • fish oil supplements

9. Exfoliate regularly:

  • Pros: easy to do at home, many products on the market, both chemical and physical options available
  • Cons: possibility to over-exfoliate

Exfoliation is the process of removing the top layer of dead skin cells. It may improve acne by removing the skin cells that clog pores.

Exfoliating may also make acne treatments for the skin more effective by allowing them to penetrate deeper, once the topmost layer of skin is removed.

Currently, the research on exfoliation and its ability to treat acne is limited.

In one small 2016 study Trusted Source, 38 patients with acne received eight microdermabrasion treatments at weekly intervals. The participants with acne scars showed some improvements following the treatments.

A small 2017 study Trusted Source found that six weekly microdermabrasion treatments helped stimulate skin repair.

While these results indicate exfoliation may improve skin health and appearance, more research is needed on acne.

There are a wide variety of exfoliation products available, but you can also make a scrub at home using sugar or salt.

Note that physical exfoliation can be irritating and may damage the skin. As such, some dermatologists recommend gentle chemical exfoliation with salicylic or glycolic-acid products.

If you choose to try mechanical exfoliation, gently rub your skin to avoid damaging it.

Try Paula’s Choice Skin Perfecting 2% BHA Liquid Exfoliant.

10. Follow a low glycemic diet:

  • Pros: reduces insulin, good for the body
  • Cons: harder to track, not enough studies to back up the claims

A food’s glycemic index (GI) is a measure of how quickly it raises your blood sugar.

Eating high GI foods causes a spike in insulin, which likely increases sebum production. As a result, high GI foods may directly affect the development and severity of acne.

In a 2018 study Trusted Source, 66 people followed either a normal or low glycemic diet. After 2 weeks, the individuals consuming a low glycemic diet had lower levels of insulin-like growth factor-1 (IGF-1), a hormone involved in acne development.

Another 2017 study Trusted Source with 64 people found that those with moderate or severe acne ate diets with more carbohydrates and a higher glycemic load than those without acne.

These small studies suggested a low glycemic diet may help those with acne-prone skin. Additional larger, longer studies are needed.

Foods with a high glycemic index include processed foods, such as:

  • white bread
  • sugary soft drinks
  • cakes
  • doughnuts
  • pastries
  • candies
  • sugary breakfast cereals

Foods with a low glycemic index include:

  • fruits
  • vegetables
  • legumes
  • nuts
  • whole or minimally processed grains

11. Cut back on dairy:

  • Pros: can reduce acne
  • Cons: controversial, needs more research

The relationship between dairy and acne is highly controversial.

A 2019 study Trusted Source with people ages 10 to 24 found that drinking whole milk three or more days each week was linked to moderate or severe acne.

In a 2018 study Trusted Source including 114 participants, those with acne were found to drink significantly more milk than people who didn’t have acne.

On the other hand, another 2018 study Trusted Source involving over 20,000 adults found no association between milk consumption and acne.

Participants self-reported the data in these studies, so more research is needed to establish a true causal relationship.

The relationship between milk and acne needs further study.

12. Reduce stress:

  • Pros: can reduce acne, good for the body
  • Cons: needs more research

The link between stress and acne is not fully understood.

When you’re stressed, you might also be more likely to pick at spots on your face. Touching or picking your skin more than necessary can increase acne by spreading bacteria.

According to 2017 research Trusted Source, the hormones released during periods of stress may increase sebum production and inflammation, making acne worse.

A 2018 study Trusted Source noted that certain relaxation and stress reduction treatments may improve acne, but more research needs to be done.

13. Exercise regularly:

  • Pros: can reduce acne, good for the body, regulates hormones
  • Cons: not washing your face after exercising could lead to more acne

There’s little research on the effects of exercise on acne. Still, exercise affects bodily functions in ways that may help improve acne.

A 2018 study Trusted Source noted that exercise also plays a role in hormone levels and regulation.

Another 2018 study Trusted Source suggested exercise can decrease stress and anxiety, both of which can contribute to the development of acne.

The CDC recommends Trusted Source adults do two types of physical activity each week for a total of 150 minutes. This can include walking, hiking, running, and lifting weights.

If you’re exercising outside, always protect your skin from ultraviolet (UV) rays with a broad spectrum sunscreen with at least SPF 30.

14. Try brewer’s yeast:

  • Pros: can take orally or topically, easy to find
  • Cons: takes a few months to work

Brewer’s or baker’s yeast is another option that may have benefits for fighting acne.

According to a 2021 publication, a strain of brewer’s yeast called Hansen CBS may help decrease acne when taken orally.

A much older 1989 study Trusted Source of 139 people with acne showed that 80 percent of those using Hansen CBS brewer’s yeast were healed or considerably improved over a 5-month period, while a placebo group showed only a 26 percent improvement.

At the same time, most recent research shows that a brewer’s yeast elimination diet is helpful for another skin condition called hidradenitis suppurativa.

With these conflicting findings and limited research, more studies are needed to confirm the role of brewer’s yeast in the treatment of acne.

15. How to prevent acne:

While there’s no completely foolproof way to get rid of acne forever, there are habits you can add to your routine that may help keep breakouts at bay. Here are some ideas:

  • Wash your face properly: To help prevent pimples, it’s important to remove excess oil, dirt, and sweat daily.
  • Use a moisturizer: Even if you have acne, keeping your skin hydrated is essential. When skin is dry, it produces oil to counterbalance, which may result in excess sebum and clogged pores.
  • Limit makeup: Using a lot of makeup may clog pores and trigger breakouts. If you do use makeup, make sure it’s noncomedogenic and fragrance-free to prevent skin irritation. Always wash makeup off, especially before bedtime.
  • Resist touching your face: Touching your face can transfer bacteria — and pore-clogging impurities — onto your skin.
  • Limit sun exposure: Frequent sun exposure dehydrates the skin, which, over time, causes it to produce more oil and block pores.
  • Don’t pop pimples: Popping pimples may cause bleeding, severe scarring, or infection. It may also increase inflammation and clog surrounding pores, making your pimple problem worse.

16. When to see a doctor:

People with moderate to severe acne should seek professional help to find relief. Prescription-strength acne treatments are available.

It may be time to seek professional help from a dermatologist if you:

  • tried everything and nothing seems to help
  • have recurring breakouts that clear up and return
  • get acne in places like your thighs or upper arms
  • have acne that’s painful and deep under the skin
  • have breakouts that have been going on for years
  • have acne that affects your confidence, self-esteem, and social life
  • think your acne may be linked to a new medication you’re on
  • have acne that leaves dark spots

Even if you have a mild case of acne, it may be helpful to visit a doctor regularly to see how your skin progresses with treatment.

Acne treatment dermatologist?

The acne treatment plan that’s right for you depends on many considerations, including:

  • What type of acne (i.e., blackheads, pimples, etc.) you have
  • Where the acne appears on your skin
  • What treatments you’ve already tried
  • When the breakouts started
  • Your age
  • Whether the acne has left you with dark spots or scars

While a treatment plan can vary from one patient to the next, even for 2 patients who have the same type of acne, treatment often follows these guidelines.

Whiteheads, blackheads, or both: If you have these breakouts, you’ll likely apply acne medication to your skin. Your treatment plan may include one of the following:

  • A retinoid
  • A retinoid + benzoyl peroxide, azelaic acid, or salicylic acid
  • Benzoyl peroxide + an antibiotic you apply to your skin

Pimples: Mild or moderate pimples can be treated with medication you apply to your skin. Treatment will often consist of applying one of the following:

  • Benzoyl peroxide
  • A Retinoid
  • Azelaic acid
  • Benzoyl peroxide + a retinoid or an antibiotic you apply to your skin

Women who continue to get breakouts may need medication, such as a birth control pill that the U.S. Food and Drug Administration (FDA) has approved to treat acne. The birth control patch may also be effective, as can some other medications.

You’ll find more information about stubborn acne that women can develop at: Stubborn acne? Hormonal therapy may help

Acne nodules and cysts: If you have deep, painful acne that often leaves a permanent acne scar, effective treatment can help you see clearer skin and prevent new scars.

Treatment may consist of:

  • Prescription medication that you apply to your skin + taking an antibiotic
  • Hormonal therapy (women only)
  • Isotretinoin (medication approved to treat severe acne)

Sometimes acne needs extra help: To help you get the best possible results from treatment, your dermatologist may also recommend adding one of the following to your treatment plan.

Laser or light therapy: Studies show that laser and light devices can help to clear acne. This type of treatment works best when combined with other acne treatment. Learn more: Lasers and lights: How well do they treat acne?

A corticosteroid injection: If you have a large, extremely painful and deep acne breakout, a dermatologist can inject it with a corticosteroid. This can rapidly relieve the pain and the size of the breakout. While effective, this treatment is reserved for treating a few severe acne breakouts. Using it more than a few times can cause side effects.

A healthy diet: Some studies suggest that what you eat can also help to give you clearer skin. If you think that what you’re eating could be causing breakouts, be sure to find out what the research shows. Learn more: Can the right diet get rid of acne?

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Published February 25, 2023

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