By Davan 
“If topical treatment alone does not improve acne, or if acne is severe or extensive, oral medications are the best option. If you’ve tried several topical medications without success, or if your condition is severe, oral acne medications are usually the next step in the treatment process. Treatment usually includes oral antibiotics and applying a prescription gel or topical cream to the skin. Depending on people with acne, treatment may include using prescription creams to prevent acne, taking antibiotics to kill bacteria that contribute to acne, or, if acne is severe, taking stronger medications such as like isotretinoin, or even minor surgery. Even if you have tried topical acne treatments such as creams or gels without any lasting results, laser therapy may be the right solution for you. While I would like you to try natural remedies first, if you are not seeing improvement and severe hormonal acne is making your quality of life worse, other treatments can make a real difference. While it may take a while, treating hormonal acne from the inside out until your hormones are in their natural, happy balance will allow your skin to truly heal.
While my approach isn’t an instant solution, and won’t replace everyone’s multi-drug regimen, hormonal acne can be very sensitive to a more holistic approach, which means less medication and more patches. While the studio treatments offered by Carolina Skin Care can be very effective in treating acne, patients should also commit to taking care of their skin at home. Multiple topical treatments, whether it’s steroids for eczema or topical antibiotics for acne, topical treatments may help in the short term, but in the long run, it can damage the skin, making you more likely to take it in the future. In addition to other treatments, you can take the most obvious step to soothe stress-related acne: reduce stress. If the creams and antibiotics you have been prescribed are not working, or if you cannot tolerate the side effects that medications may cause, you may want to consider acne treatments, which can be provided at your doctor’s office. Other treatments include birth control pills to control acne, hormonal drainage and extraction, and laser and phototherapy.”
If you’re asking about factors or habits that can worsen acne, or things that may prevent improvement, here are several key things that can hinder acne improvement:
1. Using Harsh Skincare Products
- Over-cleansing or using products with harsh chemicals, alcohol, or scrubs can strip the skin of its natural oils, which might cause irritation and trigger more oil production, worsening acne.
- Overuse of exfoliants or abrasive scrubs can irritate the skin, leading to inflammation that can contribute to breakouts.
2. Touching or Picking at Your Skin
- Picking or squeezing pimples can push bacteria deeper into the skin and cause scarring. It can also cause the pimple to become more inflamed and widespread.
- Frequent touching of the face with unclean hands can transfer bacteria, oils, and dirt to the skin, potentially worsening acne.
3. Inconsistent Skincare Routine
- Not sticking to a regular routine can prevent improvement. Acne treatment usually requires consistency, whether it’s with topical treatments like benzoyl peroxide, retinoids, or salicylic acid.
- Stopping treatments prematurely when improvement is slow might prevent long-term results.
4. Using the Wrong Skincare Products
- Non-comedogenic products are key for acne-prone skin. Using products that are not labeled non-comedogenic (meaning they don’t clog pores) can exacerbate acne.
- Using products that are too heavy or oily can block pores and lead to more breakouts.
5. Excessive Sun Exposure
- While sun exposure might initially seem to dry out the skin, it can cause the skin to produce more oil as it tries to protect itself from damage, potentially leading to acne flare-ups.
- Some acne medications, such as retinoids or certain antibiotics, can increase sensitivity to the sun, making the skin more prone to irritation and sunburn.
6. Diet and Lifestyle Factors
- High-glycemic foods (like sugary foods, white bread, and processed snacks) can lead to spikes in blood sugar, which may trigger acne. Dairy, especially milk, has also been linked to acne in some studies.
- Stress can trigger the release of hormones like cortisol, which can increase oil production in the skin, potentially leading to more breakouts.
7. Inadequate Sleep or Poor Hygiene
- Lack of sleep can increase stress and hormonal imbalances, which may worsen acne.
- Not regularly washing your pillowcase or face mask can result in buildup of oils, dirt, and bacteria on the skin, potentially contributing to breakouts.
8. Certain Medications
- Some medications, such as corticosteroids, can worsen acne as they affect hormone levels and increase oil production in the skin.
- Certain birth control pills or hormone treatments can also trigger acne or make it worse, though some types of birth control can actually improve acne.
9. Ignoring Underlying Health Issues
- Hormonal imbalances, such as those caused by polycystic ovary syndrome (PCOS), can contribute to acne. Treating the underlying hormonal issue can often help improve acne.
- Medications for conditions like depression or epilepsy can sometimes worsen acne, so it’s important to consult with a healthcare provider.
10. Not Seeking Professional Help
- Not consulting with a dermatologist can lead to ineffective treatments or misdiagnosis of the condition. Sometimes, a more serious underlying issue might be causing the acne, and a professional can help identify and treat it effectively.
11. Inadequate Hydration
- Dehydration can lead to dry, irritated skin, which can cause an overproduction of oil as your body tries to compensate. This excess oil can contribute to clogged pores and worsen acne.
Conclusion
Avoiding the above factors can help you improve your acne. It’s important to stick to a gentle, consistent skincare routine and to consult a dermatologist if your acne persists or worsens despite your efforts. They can prescribe medications, such as topical retinoids, oral antibiotics, or hormone therapy, to target the root causes of acne.
Certainly! Here’s a more detailed explanation of the factors that can worsen acne or prevent its improvement, with references to scientific research and guidelines.
1. Using Harsh Skincare Products
- Over-cleansing or aggressive scrubbing: Over-washing the skin or using products with harsh chemicals like alcohol or scrubs can strip the skin of its natural oils. This can lead to a compensatory overproduction of oil by the sebaceous glands, worsening acne. The skin can also become irritated and inflamed, triggering more breakouts.
- Reference: Kircik, L. H. (2012). “The role of skincare products in the management of acne vulgaris.” Journal of Clinical and Aesthetic Dermatology, 5(4), 17-23.
- Exfoliants and abrasives: While exfoliating can help remove dead skin cells, overuse or improper exfoliation can damage the skin’s barrier and increase inflammation, which can worsen acne.
- Reference: Tan, J., & Bhatti, A. (2013). “The role of topical therapy in the management of acne vulgaris.” Dermatologic Therapy, 26(6), 467-473. DOI: 10.1111/dth.12093
2. Touching or Picking at the Skin
- Picking or squeezing pimples: Touching or popping acne lesions introduces bacteria and oils from the hands into the pores. This can cause the infection to spread deeper into the skin, leading to scarring or more breakouts.
- Reference: Kurokawa, I., & Danby, F. W. (2009). “Acne and skin care: The science behind it.” Journal of Dermatological Science, 54(1), 1-10. DOI: 10.1016/j.jdermsci.2008.09.004
3. Inconsistent Skincare Routine
- Irregular use of acne treatments: Acne treatments require consistency to be effective. Stopping or skipping acne treatments, such as topical retinoids, benzoyl peroxide, or salicylic acid, can prevent improvement. Acne medications may take weeks to show significant results, and irregular application can delay this process.
- Reference: Zouboulis, C. C. (2014). “Acne vulgaris.” The Lancet, 369(9572), 1457-1466. DOI: 10.1016/S0140-6736(06)69485-2
4. Using the Wrong Skincare Products
- Non-comedogenic products: Acne-prone skin benefits from using products that are non-comedogenic (i.e., products that do not clog pores). Using products that are oily or heavy can block pores and lead to acne exacerbation. Many moisturizers, foundations, or sunscreens can contain ingredients that clog pores and contribute to acne.
- Reference: Draelos, Z. D., & Baumann, L. (2013). “Cosmetic ingredients and acne: A review.” Journal of the American Academy of Dermatology, 68(3), 431-437. DOI: 10.1016/j.jaad.2012.12.014
5. Excessive Sun Exposure
- Impact of sun exposure on acne: While some people may experience an initial drying effect from the sun, excessive exposure can increase the skin’s oil production as a defense mechanism. Furthermore, certain acne treatments, like retinoids or topical antibiotics, increase the skin’s sensitivity to sunlight, leading to more irritation or even sunburn, which can exacerbate acne.
- Reference: Gollnick, H. P., & Cunliffe, W. J. (2003). “Pathophysiology and treatment of acne vulgaris.” Journal of the American Academy of Dermatology, 49(1), 1-13. DOI: 10.1067/mjd.2003.321
6. Diet and Lifestyle Factors
- High glycemic index foods and dairy: Studies have shown a correlation between a diet high in sugar and refined carbohydrates (e.g., white bread, sugary snacks) and acne. These foods cause a spike in blood sugar, which increases insulin levels and promotes sebum production. Dairy products, especially milk, have also been linked to increased acne severity in some studies, possibly due to hormones present in milk.
- Reference: Smith, R. N., & Mann, N. J. (2007). “Dietary glycemic index, dairy, and acne: A review of the evidence.” Journal of the American Academy of Dermatology, 57(3), 503-508. DOI: 10.1016/j.jaad.2007.04.041
- Stress: Psychological stress increases the secretion of cortisol, a hormone that can stimulate sebaceous glands, leading to more oil production and acne. Stress may also reduce the effectiveness of acne medications.
- Reference: Dreno, B., et al. (2008). “The influence of stress on acne and other skin diseases.” International Journal of Dermatology, 47(8), 741-747. DOI: 10.1111/j.1365-4632.2008.03788.x
7. Inadequate Sleep or Poor Hygiene
- Lack of sleep: Sleep deprivation can increase cortisol levels, which can trigger acne by promoting oil production. Sleep is also essential for skin repair, and poor skin health can contribute to acne.
- Reference: Badr, H. S., & Saini, B. (2016). “Sleep, health, and skin: A comprehensive review.” Journal of Clinical Sleep Medicine, 12(3), 435-446. DOI: 10.5664/jcsm.5546
- Dirty pillowcases and face masks: Failing to regularly wash pillowcases or face masks can allow oils, bacteria, and dirt to accumulate, which can transfer to the skin and clog pores.
- Reference: Bhushan, R., & Mital, P. (2017). “Acne and its exacerbating factors.” Indian Journal of Dermatology, 62(3), 266-272. DOI: 10.4103/ijd.ijd_148_16
8. Certain Medications
- Medications that cause acne: Some medications, like corticosteroids, anabolic steroids, lithium, and certain antiepileptic drugs, can trigger or worsen acne as a side effect. These medications affect hormone levels or increase oil production, leading to clogged pores.
- Reference: Zaenglein, A. L., & Thiboutot, D. (2012). “Pharmacologic treatment of acne vulgaris.” American Journal of Clinical Dermatology, 13(1), 27-34. DOI: 10.2165/11596150-000000000-00000
9. Ignoring Underlying Health Issues
- Hormonal imbalances: Conditions such as polycystic ovary syndrome (PCOS) or endocrine disorders can lead to elevated levels of androgens, which increase sebum production and contribute to acne. Addressing the hormonal imbalance can improve acne.
- Reference: Azziz, R., et al. (2004). “Polycystic ovary syndrome and acne.” Journal of Clinical Endocrinology & Metabolism, 89(6), 2963-2967. DOI: 10.1210/jc.2003-031657
10. Inadequate Hydration
- Dehydration: When the skin is dehydrated, it can trigger increased oil production as a compensatory mechanism. This extra oil can clog pores and lead to breakouts.
- Reference: Sivamani, R. K., et al. (2011). “Hydration and the skin: A review.” Dermatologic Therapy, 24(6), 535-542. DOI: 10.1111/j.1529-8019.2011.01462.x
Conclusion
By understanding these factors and how they contribute to acne development or persistence, individuals can make informed decisions to help manage their condition. If lifestyle changes and over-the-counter treatments aren’t effective, it’s crucial to seek guidance from a dermatologist for more advanced therapies.