12 common myths about acne

Learn about 12 common myths surrounding acne and what the scientific evidence tells us about this very common skin condition.

Acne is one of the most common dermatological conditions, particularly during adolescence and early adulthood. Because it affects so many people, numerous misconceptions have developed around its causes, prevention and treatment.

Common myths about acne

1. Acne is caused by poor hygiene

False. Acne is not caused by inadequate hygiene. Its development involves several factors, including increased sebum production, follicular blockage, inflammation, hormonal activity and the bacterium Cutibacterium acnes. Regular cleansing is important, but excessive washing or using harsh products will not cure acne and may irritate the skin barrier. In most cases, washing the face once or twice daily with a mild cleanser is sufficient.

2. If your parents had acne as teenagers, will you have it too?

There is a genetic component to acne. Studies suggest that people with a family history of acne, particularly severe acne, may have a greater likelihood of developing the condition themselves. Genetic factors may influence characteristics such as sebaceous gland activity and the tendency to develop follicular obstruction and inflammation. However, heredity is only one factor and does not determine with certainty whether someone will develop acne or how severe it will be.

3. Smoking does not affect acne

The relationship between smoking and acne is complex. Some studies have found an association between smoking and certain forms of adult acne, particularly in women, while other research has produced less consistent results. Smoking has numerous well-established adverse effects on the skin and general health, but it should not be considered a universal or direct cause of acne in every patient.

4. Stress has no effect on acne

Stress can influence acne in some people. Psychological stress activates hormonal and inflammatory pathways that may affect sebaceous gland activity and inflammation. Many patients report flare-ups during periods of increased stress, although stress is not the sole cause of acne. Its effect varies from person to person.

5. If acne appears or worsens before menstruation, there must be a hormonal disorder

Not necessarily. Acne can worsen in the days before menstruation as a result of normal hormonal fluctuations. This alone does not mean that an underlying hormonal disorder is present. Further investigation may be appropriate in women who develop sudden-onset or persistent adult acne alongside other signs of androgen excess, such as increased facial or body hair, irregular menstrual cycles or certain patterns of hair loss. In these cases, conditions associated with increased androgen activity may need to be ruled out.

6. Masturbation causes acne

False. There is no scientific evidence that masturbation or sexual activity causes acne or makes it persist. This is a longstanding myth with no established biological basis.

7. Cosmetics have no effect on acne

Some cosmetic products can contribute to acne. Products containing ingredients that promote follicular blockage may cause or aggravate what is sometimes referred to as acne cosmetica. Lesions may be particularly noticeable around the mouth, jawline or other areas where products are applied. People with acne-prone skin may benefit from products labelled non-comedogenic or oil-free, although these labels do not guarantee that a particular formulation will be suitable for every person. Individual tolerance remains important.

8. Medicines cannot cause acne

False. A number of medicines have been associated with acneiform eruptions, which may resemble acne but can have a somewhat different clinical presentation. Examples include lithium, corticosteroids, some antiepileptic medicines, isoniazid and high doses of certain B vitamins. If acne-like lesions appear after starting a medicine, the treatment should not be stopped without medical advice. A dermatologist can assess whether the medication may be contributing to the eruption.

9. Oral isotretinoin causes acne scars

It does not. Acne scars are primarily caused by inflammatory acne lesions that damage the deeper layers of the skin. Effective acne treatment can reduce the development of new inflammatory lesions and therefore help lower the risk of future scarring. Oral isotretinoin is one of the treatments that may be prescribed for severe acne, acne at high risk of scarring or selected cases that have not responded adequately to other treatments. It requires appropriate medical supervision and does not remove scars that are already present.

10. Eating chocolate causes spots

The relationship between diet and acne is more complex than blaming a single food. There is no good evidence that eating a particular chocolate bar or another isolated food directly causes acne in everyone. However, research suggests that certain dietary patterns — particularly those with a high glycaemic load — may influence acne in some individuals. Some studies have also investigated a possible association with dairy products, although the evidence is not uniform. Diet should therefore be considered as one potential contributing factor rather than the main cause of acne.

11. Sun exposure clears acne

False. Sun exposure may temporarily dry the skin or make redness less noticeable because of tanning, creating the impression that acne has improved. However, ultraviolet radiation does not treat the underlying mechanisms of acne. Unprotected sun exposure increases the risk of sunburn, photoageing and skin cancer and may worsen post-inflammatory hyperpigmentation. Some acne treatments can also make the skin more sensitive to sunlight. For these reasons, people with acne should use an appropriate non-comedogenic broad-spectrum sunscreen.

12. Squeezing spots is harmless

False. Squeezing or picking acne lesions can increase inflammation, damage surrounding tissue and raise the risk of post-inflammatory pigmentation and permanent scarring. It can also introduce bacteria into damaged skin.

The safest approach is to avoid manipulating inflammatory lesions and use treatment recommended by a dermatologist. Closed comedones can often be managed with topical treatments that help normalise follicular keratinisation and gradually clear the obstruction.

Open comedones, or blackheads, may sometimes be extracted professionally when appropriate.

In patients with more extensive comedonal acne, a dermatologist may recommend topical treatment, chemical peels or other procedures depending on the characteristics of the skin and the severity of the condition.

Using needles, pins, fingernails or other objects to open or squeeze acne lesions is not recommended because it increases the risk of tissue damage, infection and scarring.

We invite you to share this article about common acne myths with family and friends who may find it useful.