Let’s start with the bad news: Like a temperamental teenager, acne can be fickle. It can flare at any moment, for any number of reasons. And a lot of the time, you may not know or be able to determine what’s triggering your breakouts.
As a physician who treats hundreds of acne patients a year—and who also suffered from acne for years—I understand that feeling like you’re not in control of your skin can be scary.
But take heart: I’m here to tell you that while that may be true sometimes, there are plenty of things that are within your control that can profoundly affect the clarity of your complexion. The first step is to avoid some of these common pitfalls that can actually make your acne worse.
First, don’t blame yourself for your acne
Acne is not your fault. Blaming yourself for your breakouts will only cause you more stress—and we know that acute stress can play a significant role in the formation of acne. Most people experience some amount of stress regularly and their skin is just fine, so what I’m really talking about here is an increased level that exceeds the normal amount of stress you’d likely experience on a day-to-day basis. For example, one study found that college students had an increase in breakouts during exam periods.  It’s hard to tell exactly how soon after a stressful event your skin will react, but it’s likely relatively quickly, within a few days to a few weeks of when you’re feeling tense. Try not to get worked up about a breakout, since worrying about why your acne is getting worse could cause you additional unneeded stress. I know it can be emotionally difficult to deal with, but we dermatologists are here to help you. You don’t have to go it alone. Make an appointment with a doctor so that the two of you can come up with a management strategy.
Never underestimate the role of a proper diet in preventing acne
While there’s no hard data on the correlation between diet and acne, I think it’s important to have an open mind about this connection. In my own practice, I’m talking with patients more and more about their diet and how it may be affecting their acne. Some individuals might notice that their skin gets worse when they’re eating a high amount of dairy, others may notice a connection with sugar or fast food. Whatever it is, keep a food journal that tracks how certain dietary choices may be affecting your skin and bring it to your next appointment with your dermatologist so you can track when and why your acne is getting worse.
Don’t fall victim to frictional acne
Sudden breakouts, especially if they’re concentrated in one spot, may also be the result of what’s called frictional acne. This refers to blemishes that occur due to constant friction or rubbing of the skin in a particular area. The relatively new phenomena of ‘maskne’ is a great example of this—constant mask-wearing has led to breakouts around the mouth and chin. Other things we see are breakouts around the hairline in people who are always wearing hats, blemishes along the top of the shoulders where backpack straps rub, even issues along the sides of the chin and jawline in violin players from resting this area on the instrument. Pay close attention to the spots where your acne is cropping up to see if what you’re wearing could be causing your acne to get worse.
Sometimes skincare products are to blame for worsening acne
And we can’t forget to talk about the breakouts that occur when you use topical products. Sometimes people will start to notice problems when they’re using lots of different products, or after they apply a lot of sunscreen. That’s a common one. The good news here is that these types of breakouts are generally very short-lived and timed to just one incident of exposure, rather than being more of a chronic issue.
Avoid this obvious pitfall
What I see most often—and this may seem pretty self-evident—is that people’s skin gets worse when they stop using their treatment products, whether they’re topical or oral. This happens quite often in my practice: Patients get on a treatment protocol, see significant improvement, and eventually their skin is in such good shape, they stop using their products. Then their acne comes back with vengeance and they come in wondering why they’re breaking out. Keep in mind that acne treatment products do more than just stop breakouts from getting worse; they also work to prevent new ones from forming.
James Del Rosso, D.O.
Dr. Jim Del Rosso is an internationally renowned dermatologist who has been practicing dermatology since 1986 and a member of the Acne Store Board of Dermatologists. He is Clinical Editor-in-Chief of the Journal of Clinical and Aesthetic Dermatology, has published multiple peer-reviewed articles and textbook chapters, and was President of the American Acne & Rosacea Society, American Society of Mohs Surgery, and the American Osteopathic College of Dermatology. He is Adjunct Clinical Professor of Dermatology at the Touro University Nevada in Henderson, Nevada. Currently, Dr. Del Rosso is Research Director of JDR Dermatology Research and practices at Thomas Dermatology in Las Vegas, Nevada and also serves as Senior Vice President of Clinical Research and Strategic Development at Advanced Dermatology and Cosmetic Surgery in Maitland, Florida. He served as Head of the Section of Dermatology at the Ohio University College of Osteopathic Medicine after receiving his D.O. degree from the same medical school in Athens, Ohio, interning at Doctors Hospital in Columbus, completing a dermatology residency at Atlantic Skin Disease and Skin Surgery in Fort Lauderdale, Florida, and completing a fellowship in Mohs micrographic surgery and cutaneous oncology at OSU.
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