The Truth About Acne

Male chin and nose showing acne


Acne usually starts in puberty, but it affects adults too. Most teenagers get some form of acne, and there are many myths about what causes it. Here are the facts and details of treatments.

Acne consists of spots and painful bumps on the skin. It’s most noticeable on the face, but can also appear on the back, shoulders and buttocks. Severe acne can cause scarring.

What causes acne?

The causes of acne continue to be investigated by scientists, but even after decades of research there are no definite answers. It appears that a person’s genes have the strongest influence on whether they get acne or not. This could be due to the way skin reacts to hormonal changes. The skin contains sebaceous (oil) glands that naturally release sebum, an oily substance that helps protect it. During puberty, changes in levels of the hormone testosterone can cause changes in the sebum produced. This happens in both boys and girls.

The sebum can block hair follicles. When dead skin cells mix with the blockage, it can lead to the formation of spots. Bacteria in the skin multiply, which can cause pain and swelling (inflammation) beneath the blockages.

There isn’t any evidence that conclusively shows acne is caused by what you eat. Restricting certain food types may be a big struggle that has little or no effect on acne formation.

There are different kinds of spots:

There isn’t any evidence that acne is caused by what you eat.

  • Blackheads are small, blocked pores.
  • Whiteheads are small, hard bumps with a white centre.
  • Pustules are spots with a lot of pus visible.
  • Nodules are hard, painful lumps under the skin.

Inflammatory acne is when the skin is also red and swollen. This needs to be treated early to prevent scarring, and should be discussed with your doctor.

Try not to pick or squeeze spots as this can cause inflammation and lead to scarring. Spots will eventually go away on their own, but they might leave redness in the skin for some weeks or months afterwards.

It is possible that acne can become worse during times of stress, because of the effects on hormones, or because of behavioural changes accompanying the stressful period. In women, it can be affected by the menstrual cycle. Sometimes, acne can occur during pregnancy.

If you have acne, wash your skin gently with a mild cleanser and use an oil-free moisturiser. Scrubbing or exfoliating can irritate the skin, making it look and feel sore.

Myths about acne

Several myths about what causes acne are described below.


Many people say that eating chocolate or greasy food causes acne, but when this is studied carefully it may not be true. There is not much strong evidence that acne is caused by what you eat. However, eating a balanced diet is good for your general health so aim to eat as healthily as you can. Healthy eating, rather than diet restrictions, may have a positive effect on your hormones, and this can help manage your risk of acne.

Bad hygiene

Some people believe that acne is caused by bad personal hygiene, but this is not true. If you are going to get acne, you will get it no matter how much you clean your skin. Too much cleaning can make the condition worse by removing the protective oils in your skin.


There is also a myth that wearing make-up can cause spots, but there is no evidence that this is the case. The less you touch your skin, the fewer bacteria will be spread to your skin. If you wear make-up, wash your hands before putting your make-up on and always remove it before going to bed.

If acne is severe, your doctor can refer you to a dermatologist who may prescribe medication. Some light and laser therapies also claim to help get rid of acne.

Sources: Magin, P. et al (A systematic review of the evidence for ‘myths and misconceptions’ in acne management: diet, face-washing and sunlight (2005)),NHS Choices (Dealing with acne),Smith E., Grindlay, D., Williams, H., (What’s new in acne? An analysis of systematic reviews published in 2009–2010 (2011))