Many things can cause acne. While it’s easy to treat it as though it were a disease, it’s usually a symptom of a deeper issue. If you’re currently struggling with acne, check this list to see if any of these culprits might be triggering yours. But as always, speak with your doctor first before treating it! It’s never a good idea to jump to conclusions, especially when it comes to the internet. This is just general information that can help to guide you along the way.

Hormones

Our first brushes with acne tend to happen when we’re teenagers. That’s because most cases of acne are tied to hormones, which, during our early years, are in a tailspin as our body enters puberty. However, acne can still rear its ugly head even into adulthood. Again, it may have to do with hormones. Statistics show that 50% of women have acne between the ages of 20 to 29, with 25% of women having it between 40 to 49. [1] When hormones start to fluctuate, our skin will often reflect the changes. In the case of acne, it’s usually the result of a rise in male hormones (androgens), like testosterone. Once androgens rise, our skin produces more oil (sebum), and a type of bacteria known as Propionibacterium acnes (P. acnes) start to spread. As a result, we experience the all-too-familiar blackheads, whiteheads, and cysts. [2]

OK, if you know there’s a hormonal imbalance, what can be done about it? First, you need to know what’s causing it. There are many possibilities, including:

• Puberty
• Menstruation
• Menopause
• Hormone Replacement Therapy (HRT)
• Oral contraceptives
• Pregnancy
• PCOS (polycystic ovarian syndrome)
• Increased androgen levels

[3]

Gut Health

Surprise! It turns out that gut health plays a role in healthy skin (and acne). While your gut does not directly cause acne, it plays a role in its development. When invasive bacteria, yeast, or viruses try to enter the body, our immune system fights back and tries to keep them out. Since a large part of our immunity takes place in the gut, we must keep it healthy to prevent the overgrowth of these invaders. Can you guess what may happen if our gut isn’t healthy? The bad guys move in, our immune system kicks into overdrive, and we find ourselves stuck with a lot of inflammation. According to microbial specialist Garage Al-Ghazzewi, Ph.D., “There are inflammatory markers in the skin called cytokines. We know that these are involved in the formation of acne lesions and that their numbers are higher in people with acne.” [4]  

(Want to know if your acne is tied to your gut? First, check out this post here to see if it’s out of whack. Then, head over to this post here to see if dysbiosis (aka, bacterial imbalance) is to blame, along with what to do about it.) 

Sugar

Even though I’ve never been a fan of sugar, the more I learn about its effects on the body, the more I grow to stand against it. A few years ago, I made a post about sugars ties to acne and wrinkles and how it causes inflammation. Many experts (doctors included) believe that this inflammation is what triggers breakouts. And the sugar from processed foods like candy are often the culprits. Think about it. How many times growing up did you hear about chocolate causing acne? Well, there may be some truth to that. Not that chocolate by itself is terrible. It’s a potent antioxidant! But that chocolate is accompanied by sugar. After all, who eats 100% pure, raw chocolate these days? It’s always in the form of a candy bar or dessert, which contain (drumroll please) sugar! [5]

(Need help taming your inner sugar beast? Check out this post– you don’t have to be keto to follow these tips!)

Diet

Sugar isn’t the only thing you’ve got to worry about. There’s also the combination of high blood sugar and insulin. When insulin levels are high, they spike the activity of androgens (male hormones) and increase insulin-like growth factor 1 (IGF-1), both of which contribute to acne by causing skin cells to grow faster and produce more oil. Outside of straight-up processed sugar, there are also simple carbs from things like soda and white bread you need to watch out for. Milk is also notorious for increasing IGF-1, which is why many experts believe it may cause acne. But remember, milk is not a low carb food; it’s moderately high in both carbs and sugars, giving more credibility to the theory that sugar and high-carb spikes that spike insulin are the culprits behind acne. [6]

Stress

Stress, it’s not just a head game. It’s not unusual to experience breakouts during stress. While science is still scratching its head as to how (and why) this happens, they do know that it’s no coincidence. Back in 2003, researchers from Stanford University found that college students suffered more breakouts around stressful periods (like exams) compared to ones when they weren’t under any stress. Furthermore, it’s been shown that skin cells contain special “receptors” for stress hormones. Receptors that, when activated, produce more oil. [7]

(Need to do more than take a chill-pill? Use this post as your go-to guide for handling stress!)  

There you have it, everyone! The top causes for why you may be experiencing acne. For more on this topic, you can check it a similar post I made about it here. It includes other things like poor sleep and exercise, makeup, and food intolerances.

Sources: 

[1] https://www.aad.org/media/news-releases/hormonal-factors-key-to-understanding-acne-in-women
[2] https://flo.health/menstrual-cycle/health/symptoms-and-diseases/hormonal-acne
[3] https://www.healthline.com/health/beauty-skin-care/hormonal-acne#symptoms-and-causes
[4] https://www.womenshealthmag.com/beauty/a19984618/the-skin-gut-connection/
[5] https://www.ncbi.nlm.nih.gov/pubmed/25738848
[6] https://www.healthline.com/nutrition/foods-that-cause-acne#section3
[7] https://www.webmd.com/skin-problems-and-treatments/acne/features/stress-and-acne#1