By Sherrif Ibrahim, MD PhD
A quick cruise through the Internet or a beauty magazine might reveal a flurry of non-stop information about acne – who gets it, what causes it, what makes it better or worse, and how to treat it. People swear by certain facts and tinctures and these beliefs seem to spread like wildfire across various media sources until they are accepted as fact. The real truth, however, is that there are many common beliefs about acne that are simply not true.
In the United States, acne and acne-related problems rank as the #1 reason to visit a dermatologist.In fact, it is estimated that close to 85 percent of all people will suffer from some form of acne over the course of their lives – no other condition in human health, with the exception of the common cold, affects so many people. Pimples, zits, whiteheads, blackheads, cyts – these are all forms of acne and although they may look different on the skin, the underlying problem for all of them is the same. All acne, no matter what type or how severe, initiates from the same event – a clogged pore on the skin.
Pores on the skin are the openings of the tiny hair follicles and their associated oil glands on the face and anything that blocks this opening can lead to the formation of an acne lesion. Once the pore is clogged, it is known as a “comedo,” (or the plural form: comedones) a.k.a. “a blackhead or whitehead.” Once the pore is clogged, then dirt, skin cells, and oils and dirt that normally slough off to the outside world get stuck behind the plug, and the natural bacteria that inhabit all our skin has a nice protected environment to grow and multiply. Also, the follicle can get so backed up that it ruptures into the surrounding skin. Either way, the result is the same – the innocent blackhead turns into an angry and inflamed cyst or zit and this, in turn, can lead to permanent scarring. So how do we know if what we read is true and what is simply a perpetuated myth? Several common acne factoids are debunked….
TRUTH OR MYTH??
Acne is caused by bad hygiene:
MYTH. The truth is that people who get acne have pores that are prone to getting clogged. If you never washed your face in your life, then perhaps you would get more acne, but all the washing in the world won’t change the shape of your pores, change your hormones, or change the oil production in your skin.
Exfoliants and scrubbing will help reduce or prevent acne:
MYTH. Just as poor hygiene isn’t at the root of acne formation, neither will over-exuberant scrubbing or exfoliation prevent acne. In fact, harsh scrubs and washes will only irritate and inflame the delicate skin cells that line the opening of the facial pores, potentially leading to increased acne. The best choices are a gentle cleanser and your fingers.
Chocolate causes acne:
MYTH. There has been study after study that has tried to link chocolate to acne but each has failed to make the association. Not only chocolate – milk, fatty foods, sugar – none of these foods have been linked to acne. In general, these things are good to avoid for other health reasons, but enjoy your chocolate in moderation, and don’t worry about it causing those nasty breakouts.
Only teenagers can get acne:
MYTH. While teenagers are the most commonsegment of the population to get acne, anyone anywhere can start getting acne at any point in their lives. We know that the causes of acne are multi-factorial with hormones playing a large role. If it looks like acne, then it most likely is acne – even if you’re 50 or 60 years old. In fact, we see a large number of women in their 50’s who get adult acne as their bodies undergo the hormonal changes of menopause.
Never use products that contain oil:
MYTH. While it may be a good idea to select products that are for “sensitive skin” stick to products that also have the words “non-comedogenic,” which translates to “won’t clog pores” and you’ll be safe. Don’t feel that you must avoid all products just because they list a form of oil in the ingredients. A small amount of oil is okay and as long as the product is labeled as above, then it shouldn’t contain enough oil or the type of oil that clogs pores.
Acne is a cosmetic condition:
MYTH. This is a major point to understand. Acne is a medical condition that can cause permanent scarring of the skin and has been linked to other medical conditions such as depression. All acne should be treated promptly and there are a variety of very effective agents that exist in both topical and oral forms. Almost all insurance plans cover these treatments, making them affordable and easily accessible.
Hershey bar, anyone?
Sherrif Ibrahim, MD PhD is Assistant Professor of the URMC Department of Dermatology. His practice is focused on procedural and surgical dermatology including the management of skin cancer with Mohs surgery.