Why Am I Breaking Out? 8 Sneaky Causes of Acne (Plus How to Treat It)


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Breakouts may not be that big of a deal in the grand scheme of things, but for some, they can ruin an otherwise good day. They seem to come from nowhere and pop up when you really want to look your best, like for a work presentation, date, or family gathering. Worse, they can be painful and even feel like they’re throbbing.

Plus, attempts to camouflage them only make them stand out even more — as if they’re carrying a neon sign saying, “Look at me!” And that may only increase the embarrassment.

But there are ways to prevent breakouts without prescription medication. Keep in mind, however, that one product alone likely won’t treat your acne, but a combination of treatments and lifestyle habits may help you see clearer skin.

Whether it’s a tried-and-true skin care regimen, how often you wash your hair, or the cosmetics you’re curious about, beauty is personal.

That’s why we rely on a diverse group of writers, educators, and other experts to share their tips on everything from the way product application varies to the best sheet mask for your individual needs.

We only recommend something we genuinely love, so if you see a shop link to a specific product or brand, know that it’s been thoroughly researched by our team.

Healthline

What is a breakout?

Breakouts most often appear where our skin has the most oil glands. That means on the face, chest, and even upper back and shoulders.

During a breakout or an acne flare, the hair follicle fills with dead skin cells, sebum (oil), and sometimes bacteria. This leads to swelling, redness, and inflammation. Eventually, the pores become clogged and push their contents to the skin’s surface.

If only the pore is clogged and there’s no inflammation, this is called a comedone. But if the comedone is closed, it’s considered a whitehead (the pimple or zit looks whitish or yellowish). If the comedone is open and has a black plug, it’s a blackhead. This coloring comes from the bacteria and oil in the pore, which turns black when exposed to air.

Pimples are different from whiteheads and blackheads. Pimples form when a plugged hair follicle contains bacteria, which leads to inflammation and red pimples.

Lastly, when skin cells, oil, and bacteria are trapped deep inside the pore, this can form painful cystic acne underneath the surface of the skin.

Causes of breakouts

A lot of things can cause breakouts. But the good news is there are a few ways to prevent them from happening. If you have acne, consider if the following causes may be contributing to your skin issues.

Stress

Stress in and of itself doesn’t cause breakouts. However, stress is linked to an increase in acne severity.

When we’re stressed, our bodies release corticotrophin-releasing hormone (CRH). CRH triggers the release of inflammatory cytokines and promotes the production of oil. Excess oil can clog pores and, when combined with inflammation, lead to breakouts.

Skin care products

The lotions and creams you’re using may be to blame for breakouts. “Oil-based makeup, some silicones, and some liquid foundations clog pores,” says Sharleen St. Surin-Lord, MD, a board certified dermatologist in Washington, D.C. She recommends using noncomedogenic products, which don’t clog pores.

Acne treatments

Sometimes, too much of what we think is a good thing can be a bad thing. Going overboard on acne-fighting products can lead to skin irritation, inflammation, and dry skin. Overly dry skin will react by producing more oil — and that oil can clog pores, St. Surin-Lord explains.

Diet

More research is needed to determine exactly which foods are better and worse for skin. However, high glycemic foods may make acne worse. These foods are often highly processed and cause blood sugar levels to rise quickly.

High glycemic foods include:

  • white bread, white rice, and white pasta
  • bagels
  • baked goods and pastries
  • sugary beverages such as soda, sports drinks, and fruit juice
  • chips and pretzels
  • potatoes and fries
  • breakfast cereal

When blood sugar levels spike, the body produces more insulin and more insulin-like growth factor 1 (IGF-1). Increased insulin increases the production of sebum. And IGF-1 increases levels of androgen (natural steroid hormones), which also increases the production and secretion of sebum. All that oil can then overwhelm the pores, resulting in acne.

Dehydration

Our bodies need water to maintain their physiological balance. Water is also believed to help reduce acne by keeping skin hydrated.

When our skin is dehydrated, it can increase the production of oil — and too much oil can trigger a breakout of acne.

When combined with a skin care regimen that includes applying moisturizer, drinking more water may help support soft skin, according to some studies.

In a 2015 study, 49 women drank an extra 68 ounces (2 liters) of water every day for 30 days. The results showed that their skin became more hydrated.

Research from 2018 also found evidence that drinking more water increases deep skin hydration and elasticity and decreases signs of dryness and roughness. This may be even more effective for people who don’t drink enough water.

Smoking

Cigarette smoke is harmful to the lungs and skin, plus several studies suggest that smoking contributes to acne.

An older 2009 study of 1,046 women found that 82 percent of those with severe acne smoked.

Researchers in this study also believe that smoking may alter the composition and production of sebum, in turn leading to acne.

In a 2001 study of almost 900 adults, acne was significantly more prevalent in smokers than in nonsmokers. The number of cigarettes smoked daily was also linked to acne severity.

Contact with the skin

Touching your face or pressing a phone against your skin can transfer bacteria to the skin, increasing the chances of breakouts, St. Surin-Lord says.

Not washing your pillowcase at least every week can also transfer bacteria, makeup, dirt, and hair care products onto your face. This can clog pores and lead to acne flares, she adds.

Insufficient sleep

When we sleep, our body heals. Energy is restored, cells regenerate, blood supply increases to the muscles, bones and tissues grow and repair, and our immune system strengthens.

On the other hand, lack of sleep can lead to stress, and stress increases the production of skin oils. We also may be more prone to eat unhealthy foods that can cause or worsen acne when we’re stressed.

How to soothe a breakout

If you do experience a breakout, here are some ways to calm your skin:

Wash your face

When you wake up and before you go to bed, properly wash your face to remove excess oils, dirt, and makeup. St. Surin-Lord recommends using a foaming cleanser. If this causes your skin to feel dry, follow up with a noncomedogenic facial moisturizer.

Also, wash your face and body after a workout to remove sweat.

Eat more whole foods

Processed foods such as white bread, baked goods, and chips are considered high glycemic foods. These cause blood sugar levels to spike. When this happens, the body ramps up the production of insulin and, in turn, oil. This increases the chance of breaking out.

Try to minimize your intake of processed high glycemic foods. Instead, focus on eating more low glycemic foods, which cause blood sugar to rise more slowly. Low glycemic foods include:

  • whole grains (whole-grain bread and pasta, as well as brown rice, quinoa, farro, steel cut oats)
  • legumes (lentils and all kinds of beans)
  • vegetables
  • fruit

You may also want to incorporate the following foods into your diet:

  • lean meat and seafood
  • nuts and seeds
  • oils
  • avocado
  • herbs and spices

These foods contain beneficial nutrients, including antioxidants, vitamins, minerals, and fiber. The nutrients support healthy skin and a healthy gut, and gut health is linked to skin health.

Drink water

Dehydration can cause the body to produce excess oil and lead to breakouts.

Aim to drink at least eight 8-ounce glasses of water each day to stay hydrated. If you don’t like drinking plain water, add a squeeze of citrus juice.

Avoid touching your face

Frequently putting your hands or phone on your face can transfer acne-causing bacteria to the skin. Instead, try using earbuds or speakerphone when making calls.

If you find yourself touching your face often, first, make sure to wash your hands frequently. Then try to be mindful about keeping your hands away from your face. If you’re having difficulty, try these tips:

  1. Observe when you touch your face. For example, do you tap your chin when working on your laptop? Or do you rub your eyes while on the couch at night?
  2. Once you know when and how you touch your face, identify an alternative habit you can do instead. Can you drum your fingers on your desk or play with the throw pillow?
  3. Then, each time you find yourself tempted to touch your face, do the alternative habit instead. This is called habit reversal training.

Another trick is to keep your hands busy. Keep a stress ball, small toy, or another gadget on hand to play with. Or, if you can, sit on your hands.

Manage stress

Stress increases inflammation in the body and also ramps up the production of oil. These two things combined can lead to acne or make acne more severe.

Consider doing the following to help relieve stress:

  • exercising
  • doing deep breathing exercises
  • meditating
  • journaling
  • spending time in nature

Get plenty of sleep

Poor or limited sleep can increase stress. Sleep is also when your body restores itself and when all kinds of cells regenerate.

Aim for 7 to 9 hours of sleep every night. Also, try to wake and go to bed at the same time every day so that your body gets into a rhythm.

Try OTC medication

Over-the-counter (OTC) treatments can be very effective at clearing up acne. These products often contain benzoyl peroxide, salicylic acid, or adapalene.

Some OTC options can spot-treat pimples. Others help prevent or manage breakouts when used regularly.

Follow the manufacturer’s directions, as some of these products can cause dryness or irritation. If you’re concerned about any negative side effects, talk with a dermatologist. They can help you select a treatment that’s more appropriate for your skin.

Level up to prescription treatments

In some cases, OTC treatments aren’t enough to remedy acne. For those with more severe acne, a prescription medication may be needed. Prescription acne treatments are more potent than OTC ones.

Prescription acne treatments include:

  • Topical retinoids. These creams, gels, and liquids are derived from vitamin A and help prevent clogged pores.
  • Oral contraceptives. The hormones in combination birth control pills can help decrease how much oil the glands produce.
  • Anti-androgen agents. These reduce hormones that increase the production of sebum.
  • Oral antibiotics. These help reduce excess skin bacteria.
  • Oral isotretinoin. This retinoid helps prevent clogged pores and reduce excess oil production, acne-causing bacteria, and inflammation.

Each of these treatments can have side effects. Talk with your dermatologist to discuss which options are best for you and your acne.

Products to try for different types of breakouts

Most OTC acne treatments contain either benzoyl peroxide, salicylic acid, or sulfur. There’s also one retinoid OTC acne treatment available. Dermatologists suggest trying the below products to treat acne. Try one product at a time — using too many things at once may aggravate your skin.

Pricing guide

  • $ = under $10
  • $$ = $10–$30
  • $$$ = over $30

Aveeno Clear Complexion Foaming Cleanser

Price: $

Salicylic acid can help clear up current breakouts and prevent future ones. Users of this product report that it doesn’t dry out their skin.

Shop for Aveeno Clear Complexion Foaming Cleanser online.

Differin Gel Adapalene Gel 0.1% Acne Treatment

Price: $$

This is the only OTC retinoid to treat acne. It can take some time to see changes in your skin, but users rave about its effects. You may want to avoid Differin if you have dry skin, though.

Shop for Differin Gel Adapalene Gel 0.1% Acne Treatment online.

La Roche-Posay Effaclar Duo Dual Action Acne Treatment Cream

Price: $$$

This heavy hitter combines benzoyl peroxide and lipo hydroxy acid (LHA), a chemical exfoliant that helps with breakouts and acne. You may want to use this product as a spot treatment.

Shop for La Roche-Posay Effaclar Duo Dual Action Acne Treatment Cream online.

Proactiv 3-Step Acne Treatment

Price: $$$

Proactiv contains micronized benzoyl peroxide. “This means that the benzoyl peroxide is broken down into much tinier molecules, so it penetrates better, works faster, and creates a more dramatic result,” St. Surin-Lord says.

Shop for Proactive 3-Step Acne Treatment online.

Dermalogica Daily Microfoliant

Price: $$$

This skin smoother contains salicylic acid to fight acne, plus rice bran to gently exfoliate. The phytic acid found in rice bran also helps remove dead skin cells.

Shop for Dermalogica Daily Microfoliant online.

The bottom line

Breakouts may seem like a fact of life, but there are a few remedies you can try to prevent and treat them.

Take stock of your skin care routine and daily habits. You may want to switch to noncomedogenic makeup and skin care products, as well as cut back on the use of OTC acne treatments. Too many treatments can dry out your skin — and dry skin leads to excess oil production.

Then, consider your diet, sleep, and stress levels. Eating more whole foods and less processed ones, getting 7 to 9 hours of sleep every night, and finding ways to manage stress may all help reduce breakouts.

You don’t have to change everything all at once — a few small changes may lead to your best, clearest skin.



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