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Frequently Asked Acne Questions

There are many conceptions (and misconceptions) about what causes acne vulgaris and what treatments are effective for improving acne symptoms. In this FAQs section we address acne related questions on topics such as diet, hygiene, bacteria, hormones and more. If you have a question that isn’t covered in this section, feel free to post it as a comment at the bottom of the page, and we will address it as soon as possible.

The Basics

What Causes Acne Vulgaris?

There are many types of acne and different factors influence the disease.  Generally spearking, acne is caused by hyperactive sebaceous glands, a bacterial infection and the resulting immune response.

The structure of your pores, the composition of your sebum, the amount of sebum your body produces, and how your body’s immune system responds to certain bacteria contribute to whether or not you are likely suffer from acne. Hormones can trigger elevated sebum production, contributing to acne. Stress and diet can enhance or inhibit immune functions. Climate can effect your immune system, sebum composition, and facilitate or inhibit bacterial growth and reproduction.

Popular Topics

Does chocolate, greasy food, or milk cause acne?

Individual foods are unlikely to trigger acne outbreaks.  The fats and oils that you eat are not the same substances that make your skin oily.  Skin oil, called sebum, is produced by specialized glands in the skin called sebaceous glands.  The production of sebum by sebaceous glands is only indirectly affected by what you eat.

However, diet as a whole does effect acne. Particularly, patients with high glycemic index diets – diets with lots of sugar and simple carbohydrates, tend to suffer from acne more frequently. For a more thorough investigation of the relationship between food and acne, continue reading here.

Is acne caused by dirt or not washing my face enough?

The plugs that clog follicles and contribute to acne are not formed by dirt or grime on the surface of the skin, but from sebum, keratin, and cell debris produced deep within the follicle. In most acne, the site where the infection and inflammation occurs is physically separated from the surface of the skin.

It is important to only use gentle cleansers – and to not overdo it.  Topical face washes are limited in their effectiveness for the treatment of acne.  Topical washes are not capable of penetrating deeply into the pore (despite what the commercials for acne cleaners say).  Washing your face is an important part of a daily hygiene plan, but is unlikely to be effective for people who have moderate to severe acne symptoms.    For further information, continue reading here.

Should I pop it?


It depends.  Sometimes it is OK to pop a pimple, but other times it can be a bad idea.  If done in an improper or unsterile fashion, or attempted on an unsuitable lesion, popping a pimple can exacerbate  the problem. Some pimples, however, should be popped – to remove the pus and pressure, and accelerate healing. For more information on popping and lancing pimples, continue reading here.

Can stress cause acne?

Stress inhibits functionality of the immune system.  Under persistent stress a person is more susceptible to infection, including infection by acne-causing bacteria within the follicle. For more information concerning the impact of stress on the immune system and acne, click here.

What does non-comedogenic mean?

Comedogenic means that a substance is likely to induce the formation of comedos ( blocked follicles ).
Some common substances encourage the formation of comedos, cause allergic inflammation or even serve as a nutrient source for bacteria.  Acne sufferers should avoid comedogenic substances. For more information on comedogenic substances, and non-comedogenic alternatives, as well as a chart of the relative comedogenic potential of common substances, click here.

Living with Acne

What is the relationship between pregnancy and acne?

Pregnancy causes changes in hormone balance and immune function. Many women experience dramatic changes in their acne both during and after pregnancy. Hormones that control the natural processes of menstruation and pregnancy have wide ranging effects throughout the body. These changes impact both the activity of the sebaceous glands and immune system. These changes can lead to a change in acne symptoms. For more information about the relationship between pregnancy and acne, click here.

Is acne different between men and women?

Yes. There are differences in the rates of acne between men and women of different age groups. Adolescent men tend to have much higher rates of acne then their female counterparts, while older women tend to suffer acne at higher rates then men of the same age. Underneath these differences are the stark contrasts between the hormonal profiles of men and women. For more information on how acne differs between men and women, click here.

Acne Science

What is Propionibacterium acnes?

Propionibacterium acnes (P. acnes) is a bacteria that is the causative agent of most acne. P. acnes resides within the hair follicle and feeds off of sebum produced by your sebaceous glands. Excessive production of sebum and blocked follicles can lead to an overgrowth of  P. acnes, causing an immune reaction, inflammation and the development of acne symptoms. For an in-depth look at P. acnes and its relationship to acne vulgaris, click here.

How Do Bacteria Become Resistant To Antibiotics?

While overuse of antibiotics does contribute to increasing bacterial resistance, there are actually a number of factors that play a role in the spread of antibiotic resistant bacteria.  In addition to high levels of antibiotic use, particularly in industrial animal farming, certain types of environments also play a role.  Places like hospitals and nursing homes can serve as the focal point for the acquisition and dissemination of antibiotic resistant infections.  Diseases like HIV/AIDs also play a role by suppressing normal immune function in affected individuals, making them more susceptible to bacterial infection.  In this post we discuss in detail what antibiotic resistance is, how it happens and what factors contribute to the spread of antibiotic resistant bacterial infections.  For the in-depth discussion on how bacteria become resistant to antibiotics, click here.

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