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Hormones

Hormones can provide a good explanation as to why acne commonly affects teenagers (hormonal acne). Particularly during puberty, the androgen hormones cause the sebaceous glands to enlarge and produce more oil. This oil can clog pores, leading to the build-up of dirt and acne-causing bacteria that cause pimples and hormonal acne outbreaks.

In addition to the rising hormone levels during puberty, other changes to the body can also cause hormonal acne, including:

• A woman’s menstrual cycle

• Pregnancy

Medications

Certain medications can cause or worsen acne. Some known examples are:

• Corticosteroids - Acne due to corticosteroids is also called steroid acne. Steroid acne can happen to bodybuilders who use high-dose anabolic steroids and also in patients who were prescribed corticosteroids.

• Lithium - This medication has been prescribed for the treatment of depression and bipolar disorder. However, a common side effect of lithium is inflammatory acne.

• Barbiturates - This group of sedatives is used for the treatment of seizure disorder, insomnia, and anxiety. Acne breakouts are a side effect of barbiturates.

If you are concerned about acne outbreaks, ask your doctor about possible alternative treatments.

Diet

Diet is not a well-understood factor. It is not easy to directly attribute acne to a single food source, as people eat different food at each meal every day. However, according to the American Academy of Dermatology Association, findings from some studies indicate that cow's milk and food high in carbohydrates (high glycemic food) may worsen acne.

A few small studies have found that switching to a low glycemic diet from a high glycemic one can reduce acne outbreaks. Fresh vegetables, fruits, and beans are examples of low glycemic foods. Potato, bread, rice, and sugary drinks are examples of high glycemic foods. When you consume high amounts of high glycemic food, your blood sugar spikes, causing inflammation throughout your body. As your blood sugar spikes, it also triggers your body to increase oil production in your skin. A combination of inflammation and increased oil production can lead to acne. However, note that no studies have established a connection between a high-glycemic diet and acne.

While it is not known why, some studies have shown cow's milk (whole, low-fat, and skim) consumption to be related to acne.

Contrary to popular belief, greasy foods have little to no effect on acne. However, handling greasy foods in environments like a kitchen increases your chances of getting some oil stuck to your skin which can cause irritation and acne.

Family history

Genetics are known to influence acne, and if your parents had acne, it is likely that you will too.

Pressure on skin

The use of phones, helmets, collars, backpacks, or sports equipment can all worsen acne.

Acne mechanica is a type of acne that occurs due to friction and pressure on the skin, and typically affects athletes. When an athlete's sports equipment or clothing constantly rubs against heated and sweaty skin, the skin becomes irritated. For athletes with existing acne or acne-prone skin, the skin irritation can trigger acne breakouts. Below are a few examples:

• Cycling equipment, such as the helmet

• Golf equipment, specifically the golf bag strap

• Football equipment, including the helmet, chin strap, shoulder pads, or other protective gear

Acne can appear as the following on your skin:

• Pimples without abscesses

• Pus-filled cysts

While these can appear anywhere on the body. they tend to appear in the following areas with a high concentration of oil glands:

• Face

• Neck

• Shoulder

• Chest

• Upper back

When you have acne, you can develop any (or a combination) of these breakouts on your skin:

• Whiteheads - pimples with a small white pus-filled top

• Blackheads - pimples with black top

• Nodules - large pimples that are deep and painful

• Cysts - pus-filled pimples that are deep and painful

Acne can also cause the following long-lasting effects:

• Acne scars - Sometimes after an acne outbreak clears, it can leave acne scars on the skin.

• Dark spots - After an acne outbreak clears, dark spots can remain in places where the acne once was.

Oral antibiotics

These prescription tetracycline antibiotics can be taken orally to treat moderate acne to severe acne:

• Doxycycline

• Minocin (minocycline)
  
  

Topical treatments

• Benzoyl peroxide - Common brand names of topical benzoyl peroxide include Clearasil, Stridex, and PanOxyl. This topical medication targets surface bacteria. A common side effect people have reported is irritation and dry skin in the application areas.

• Salicylic acid face wash - Salicylic acid removes dead skin cells and prevents clogged hair follicles. This topical medication is available over-the-counter.

• Tretinoin (Retin-A) - Topical retinoid (vitamin A derivatives) works by breaking up blackheads and whiteheads and preventing the formation of new pimples. A common side effect of this topical retinoid is irritation and dry skin in the application areas.

• Antibiotics - Topical antibiotics work by controlling bacteria growth on the skin surface. Examples include clindamycin and erythromycin. Topical antibiotics together with topical benzoyl peroxide are effective acne treatments.

Birth control pills

For women, birth control pills can be an effective form of prescription acne treatment. Particularly, a few FDA-approved birth control pills (for acne patients) have been shown to be effective in controlling breakouts associated with menstrual cycles. A few examples are Estrostep, Beyaz, Yaz, and Ortho Tri-Cyclen.

Eczema (atopic dermatitis)

Eczema is a skin condition that has symptoms such dry skin, severe itching, red or gray-brown scaly patches/rashes on the: hands, feet, ankles, wrists, neck, chest. Though acne causes pimples, sometimes it is difficult to tell eczema rash and pimples apart. Do note that eczema and acne are completely different skin conditions.

Folliculitis

Folliculitis is a skin condition that can look like acne, often starting out as small red bumps on your face, arms, back and legs. Folliculitis is caused by inflammation/infection of hair follicles while acne is caused by blocked pores.

Rosacea

Rosacea is a skin condition that presents itself as small, red, pus-filled bumps on the face, and can be accompanied by visible blood vessels on skin, blood shot eyes, red and swollen eyelids. Unlike acne, which tends to affect people in their teenage years, rosacea tends to affect people age 30 years and older.

Staph

The staph bacteria Staphylococcus aureus can be commonly found on our skin. Staph infections can present as large, painful bumps that look like acne, and are relatively minor and treatable with antibiotics.

Skin cancer

Another skin condition that can be mistaken as acne is skin cancer, which can start out like acne: as small pink or red pearly bumps. They can progress in pinkish growths with raised edges or even open sores. That is why it is always a good idea to get a professional diagnosis from a board-certified dermatologist.