- Excess oil production.
- Hair follicles clogged by oil and dead skin cells.
- Excess activity of a type of hormone (androgens)
These factors have little effect on acne:
- Greasy foods. Eating greasy food has little to no effect on acne. Though working in a greasy area, such as a kitchen with fry vats, does because the oil can stick to the skin and block the hair follicles. This further irritates the skin or promotes acne.
- Hygiene. Acne isn't caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.
- Cosmetics. Cosmetics don't necessarily worsen acne, especially if you use oil-free makeup that doesn't clog pores (noncomedogenics) and remove makeup regularly. Nonoily cosmetics don't interfere with the effectiveness of acne drugs.
Factors that may worsen acne
These factors can trigger or aggravate acne:
- Hormones. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. And low amounts of androgens circulate in the blood of women and can worsen acne.
- Certain medications. Examples include drugs containing corticosteroids, testosterone or lithium.
- Diet. Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods — such as bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse. A small study of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further study is needed to examine why this happens and whether people with acne would benefit from following specific dietary restrictions.
- Stress. Stress can make acne worse.
Acne treatments: Medical procedures may help clear skin
The redness and swelling that can occur with acne is caused by a type of bacteria that can be killed by exposing your skin to different types of light.
Steroid injections are most often used for the types of acne that cause painful lumps beneath the surface of the skin (nodules and cysts).
Superficial chemical peels may control some types of acne and improve the appearance of skin. This procedure has traditionally been used to lessen the appearance of fine lines, sun damage and minor facial scars.
During a chemical peel, your doctor applies a mild chemical solution to your skin. This solution helps unclog pores and remove dead skin cells, whiteheads and blackheads. A chemical peel can also generate new skin growth. You may need to repeat the process for best results.
Drainage and extraction
Your doctor may use special instruments to remove cysts, whiteheads and blackheads. This temporarily improves the appearance of your skin.
When to see a doctor
If self-care remedies don't clear your acne, see your primary care doctor. He or she can prescribe stronger medications. If acne persists or is severe, you may want to seek medical treatment from a doctor who specializes in the skin (dermatologist).
For many women, acne can persist for decades, with flares common a week before menstruation. This type of acne tends to clear up without treatment in women who use contraceptives.
In older adults, a sudden onset of severe acne may signal an underlying disease requiring medical attention.
The Food and Drug Administration (FDA) warns that some popular nonprescription acne lotions, cleansers and other skin products can cause a serious reaction. This type of reaction is quite rare, so don't confuse it with the redness, irritation or itchiness where you've applied medications or products.
Seek emergency medical help if after using a skin product you experience:
- Difficulty breathing
- Swelling of the eyes, face, lips or tongue
- Tightness of the throat
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