Commentary: Acne Myths and Misconceptions—Setting the Record Straight
Commentary27/04/21 Jonette E. Keri, MD, PhD, University of Miami, Miller School of Medicine

It’s a cliché in countless teen movies and TV shows. On the morning of the school dance, the first date, or the big show, the main character looks in the mirror and gasps in horror to find a pimple has suddenly appeared. The teen curses the timing and wonders aloud how to get rid of it before or the evening’s event.

Thanks to celebrity doctors like Dr. Pimple Popper and evolving beauty standards, people are talking about acne more than ever these days. It’s the most common skin disease in the U.S., and eight in 10 people will have acne at some point in their lives. Yet even as people are talking more openly about their acne, many myths persist about what causes it and how it should be treated.

Here are some of the most common acne myths and key information that sets the record straight on blackheads, whiteheads, pimples, pustules, papules and cysts.

Myth: Acne Only Affects Teenagers Going Through Puberty

Fact: People can get acne at any age. Acne occurs when oil (known as sebum) clogs pores on the skin, which then becomes infected and inflamed. These infections can occur at any point in a person’s life. However, they are more common when hormone levels are increased, as is the case during puberty as well as in conjunction with a woman's menstrual cycle.

Some people are experiencing new struggles with acne due to wearing a mask in response to COVID-19. This so-called “mask acne” is actually a form of acne known as acne mechanica, which is triggered by heat and rubbing in a particular spot.

Myth: Acne Will Go Away on its Own

Fact: Acne is not some rite of passage to suffer through that will disappear over time. For some, especially males, acne does clear up by the late teens or early twenties. But around 40 percent of women will have acne well into their adult years. This can be especially frustrating for women in their 20s who feel like they should have “outgrown” their acne.

If acne is impacting your health or your happiness, talk to a doctor about next steps. Common treatment options include topicals like benzoyl peroxide or salicylic acid washes and topical antibiotics and retinoids. Moderate acne is often treated with oral antibiotics. Women with acne may also be prescribed oral contraceptives.

Myth: Acne is Caused by Eating Chocolate, Greasy Foods, or Dairy

Fact: Foods do not cause acne, but research suggests foods like chocolate and dairy products can increase the severity or frequency of acne. However, most patients don’t have to forego French fries or any other food to get their acne under control. If patients are worried about their diet, the number one thing to cut out is sugar. Patients who consume a lot of sugar can exacerbate their acne with their diet, and some studies have suggested these patients more likely to have moderate to severe acne. The best thing to do is make healthy eating choices and make sure that if you do cut out food items like dairy you are getting calcium and other essential vitamins and nutrients elsewhere.

Myth: Acne is Caused by Stress

Fact: As with some foods, researchers have found that stress does not cause acne, but it can sometimes make it worse. One study looked at students’ acne before and after exams and found that as stress levels increased, the students’ acne got worse.

Myth: Tanning Reduces Acne

Fact: When your skin appears darker, it can make the redness from acne less visible, but no dermatologist will ever recommend that a patient goes tanning. A single session in a tanning bed can increase your risk of skin cancers like melanoma.

Myth: Acne is Caused by Poor Hygiene

Fact: Although extremely poor hygiene may aggravate acne, for most people the acne is caused by something else. In some cases, washing too much can actually be the problem. Strong exfoliating and cleansing treatments can strip the skin of oils and actually exacerbate acne. In general, it’s best to wash your face twice a day (once for those with very sensitive skin) and avoid harsh products. For exfoliating, just wash with a baby washcloth once or twice a week for 15 to 30 seconds.

Myth: People Should Never Pop Their Pimples

Fact: The reality is, some people are going to pop pimples. But just because you see it on TV or social media doesn’t mean it’s safe. Popping can cause the area to become even more red and inflamed and lead to further infection. However, if you are going to touch acne, there are some steps you can take to minimize the risks. Make sure your hands and the area are clean—after a shower is often best. And stick to pimples that don’t require a lot of manipulation or aggressive squeezing.

To learn more about acne, check out the Manuals page on the topic. 
Dr Jonette Keri