What Worsens Acne?

Question

Dear Skin Doctor, what worsens acne?

Answer

The following factors can worsen acne:

Hormones

Hormones can cause and worsen acne. These can be normal hormonal increases like those of androgens which rise during puberty in both boys and girls and make the oil glands in the skin produce more oil. 

The changes that occur in hormone levels in women 2 to 7 days before the monthly menstrual periods can also worsen acne.  Hormonal changes associated with pregnancy can also trigger acne. 

Abnormal hormone levels in conditions like polycystic ovary syndrome can also result in increased oil production which can clog the skin pores. Hormones which are taken into the body like oral contraceptive pills can also worsen acne though they are also used to treat it.

Oil Rich Cosmetics

Oil rich cosmetics like greasy foundations can clog the skin pores and cause a type of acne known as acne cosmetica. 

Other ingredients in cosmetics that can worsen acne include pigments like D & C red dye #3 which is used to make blush.

Oil Rich Skin Care Products

Oil rich skin care products like creams can also clog the skin pores. 

Ingredients in skin care products that can worsen acne include acetylated lanoline, etoxylated lanolin, algae extracts, coal tar derivatives, isopropyl myristate and sodium lauryl sulfate.

Oil Rich Hair Care Products

Oil rich hair care products like pomades can also clog the skin pores if they trickle down the forehead. 

Other ingredients in hair care products that can worsen acne include coconut oil and liquid paraffin.

Medications

Medications that can worsen acne include isoniazid which is used for treating TB, phenytoin used for treating convulsions, lithium used to treat the bipolar disorder and corticosteroids which are used to treat many conditions like asthma and lupus. 

Other medications that can worsen acne include iodine, barbiturates, bromides and corticosteroids. Progestin dominant birth control pills, ACTH and androgens can also do the same.   

Emotional Stress

Studies have shown that high stress levels are associated with severe acne. This happens as a result of increased levels of the stress hormone cortisol which increases the amount of oil that the skin produces. This increased oil production is what contributes to clogging the pores.

Diet

Though this is still a controversial subject, some dietary factors that have been shown by studies to possibly trigger acne. These include dairy products and carbohydrate rich foods like white bread which increase blood sugar levels. Foods that are rich in iodides have also been implicated as acne triggers.  

Excessive Cleansing

Washing the face many times during the day can also worsen acne by drying the kin since this makes the skin produce more oil which can clog the skin. This factor is worsened by hard scrubbing of the skin.

Workplace Oils

Machine oils and grease can also cause acne in workers who come in contact with them in their workplaces.

Mechanical Pressure

Mechanical pressure from tightly fitting sports helmets, bike helmets, back packs and stiff collars can also cause acne.

Environmental Factors

Environmental factors like high humidity which is found in some parts of Kenya like Mombasa as well as air pollution can also worsen acne in some people.

Picking Pimples

Squeezing and picking pimples can worsen acne by increasing inflammation.