- Dermatologists Dr. Elyse Love and Dr. Joshua Zeichner debunk 12 myths about acne.
- Myths like greasy food causes breakouts, drinking waterclears skin, and facemapping will fix it.
- They also talk about all the places on your body that could be affected by
acne .
Following is a transcript of the
Dr. Elyse Love: "You can't pop your own pimple."
Dr. Josh Zeichner: I want you to pop your pimples thinking that you have a hot date in a half an hour.
"Acne breakouts only happen on your face."
Love: Not true.
"Face mapping can identify the cause of your acne."
Zeichner: This is not like reading your palm.
Love: Hello, everyone. My name is Dr. Love. I'm a board-certified
Zeichner: My name is Josh Zeichner. I'm a board-certified dermatologist and an associate professor of dermatology at Mount Sinai Hospital in New York City, and I specialize in the treatment of acne, rosacea, and cosmetic dermatology.
Love: And today we will be debunking myths about acne.
"Eating greasy food causes acne." So, theoretically, if you're eating very greasy food and then you're immediately, like, wiping your face with your hands, you can clog your pores. But for most people, if you're eating your food, you're washing your hands, you're having good hygiene, it's unlikely that the greasiness of the actual food that you're eating is going to have an effect on your skin.
Zeichner: Instead, it's the sugary food. We know that foods that have a high glycemic index cause acne breakouts in some people, and it's thought that raising blood sugar promotes inflammation and drives oil production. So when you go to the restaurant to go buy your milkshake and your burger, it's not the burger, but rather the bun and the milkshake that are causing the breakouts.
Love: I, in general, tell my patients that by following a general healthy diet, you're also following a healthy diet for your acne.
"If you drink eight glasses of water a day, you'll have clear skin."
Zeichner: Stay well hydrated for your overall
Love: I do think it matters what you eat, what you drink, I think it matters what your exercise routine is, and I think it matters what your topical routine and maybe even your by-mouth routine is, by your dermatologist. All of these things are factors that contribute to our acne, but there's no kind of magic cure that just drinking water will cure your acne.
Zeichner: The only time I have found that water clears up your acne is when you're using that water to swallow your prescription acne medication that your dermatologist has given you in the office.
"Acne breakouts only happen on your face."
Love: Not true. Acne breakouts are definitely more common on the face, but we also know that they can occur on the chest, the shoulder, the back, and that you can even get acne-like breakouts on the scalp.
Zeichner: Acne develops in areas where we have a high concentration of oil glands, also known as sebaceous glands.
Love: The most common reason that I see acne on the body is sweat-related acne. So, for this type of acne, making a habit of changing out of sweaty clothing and maybe even using an acne-fighting bodywash after workouts can really help.
Zeichner: Acne on the body isn't always actually true acne. I know that everybody talks about "buttne," or butt acne. Well, guess what? Butt acne usually is not even acne, it's folliculitis, which is a little infection in the hair follicle. And that happens when your skin barrier is disrupted and bacteria on the skin make its way into the hair follicles. People typically develop red bumps and pus pimples. If you don't have any big nodules, if you don't have any blackheads or whiteheads, then you may have folliculitis.
Love: "Face mapping can identify the cause of your acne."
Zeichner: Everybody loves a good story on the internet saying that, "If you have acne in one particular area, that I can tell you exactly what causes it." This is not like reading your palm. Unfortunately, there's no definitive way of mapping the cause of your acne based on where it's developing. Now, that being said, we know that adult women tend to develop acne along the lower one-third of the face and the jawline. We know that hair-care products are associated with acne breakouts along the hairline, on the upper part of the face, and sometimes if you are using a dirty phone or if you have a chin strap or a face mask, you may be developing acne in areas where those are directly coming in contact with your skin. But other than that, there's not much
Love: Acne can be asymmetric. And so I have patients who will have more acne on one side of their face than the other side, and they will drive themselves crazy trying to figure out what specifically is causing the acne, and it's just how we're made.
Zeichner: Think of your face as having thousands of pipes connecting your oil glands to the surface of the skin. In patients who have acne, all of those pipes are somewhat clogged. The problem is we can't predict which one will become clogged enough to form a full pimple. So when we treat acne, we really want to address the entire area that tends to break out to get rid of pimples that we have and to prevent new pimples from popping up.
Love: "If you don't get acne during puberty, you won't get it as an adult."
Zeichner: It's completely a myth that you're free from acne if you didn't have it during puberty. Acne most commonly develops during puberty and in adolescence. And for most people, it goes away. But there's a subset of patients who actually had clear skin as a teenager, and then sometime around the age of 25 or older start to break out. But it may have to do with changes in hormones, diet, or stress. Many adult women who are developing acne actually have dry skin, which complicates the way that we treat the acne.
Love: Sometimes adult acne, particularly that deeper acne, can be resistant to topical therapies. And that's when we consider by-mouth options. My preference is, there is a hormonally based medication called spironolactone that is highly effective for adult-onset acne, particularly the hormonal driver for the acne.
Zeichner: "Bad hygiene causes acne."
Love: There's no data to support that it's a hygiene problem that's causing acne. We know that acne is a really complicated medical disorder with a complicated pathophysiology, not at all related to hygiene. But this also can be a damaging myth because I find that a lot of my acne patients, what they try to do is they try to overcleanse their skin, and, essentially, when you start scrubbing your skin and overcleansing your skin, you increase inflammation at the level of the skin. And at the end of the day, acne is an inflammatory condition.
Zeichner: But, for the most part, the people who are most at risk are people who have oily and acne-prone skin to begin with.
"If someone else's acne treatment works for them, then it'll work for me."
Love: Some people with acne have oily skin, some people with acne have dry skin, some people with acne have sensitive skin. Some people cannot remember to use a topical for the life of them. Some people prefer by-mouth medications. And so there are a multitude of different ways to treat acne, and the one that will work is, one, the medications that are designed to treat the type of acne that you have, but also, two, the medications that will actually fit into your life and your lifestyle.
Zeichner: "Masturbation causes acne."
Love: I have no idea where this comes from. I, I, I, honestly -- no is the answer to it. But I would love to know, Dr. Zeichner, do you know where the origin of this is?
Zeichner: Yeah, I'm not really sure.
Love: Is it because of teenagers get acne?
Zeichner: But I actually would think that masturbating might help clear up your acne.
Love: Stress relief.
Zeichner: Right? But there's no data to show that masturbating will or will not affect your skin at all.
Love: "You can't pop your own pimple."
Zeichner: If you pop your pimple the right way, it's OK with me. But the problem is most people are not doing that.
Love: Patients often try to pop the super-inflamed pimples, which just sometimes don't want to be drained. And sometimes the best way to treat those is with actually an anti-inflammatory in-office. And so, don't try it. It may cause more scarring and may cause more trouble.
Zeichner: If you're going to pop something, it really needs to be blackheads. No. 1, don't do it at night. That's when you're tired and you're going to bed. I want you to pop your pimples thinking that you have a hot date in a half an hour and your face needs to look good. Because if you think about it that way, you're not gonna put too much pressure on your skin. You wanna make sure that the skin is clean and your fingers are clean. And you can take two cotton-tip applicators, like Q-tips, and just apply gentle downward and inward pressure around the pimple. And if you're trying too hard and they're not coming out, then leave it alone and abort the mission.
Love: "Putting toothpaste on your pimple will make it go away."
Zeichner: Toothpaste was formulated with a preservative known as triclosan, and this was an ingredient that helped prevent bacterial contamination. And because it has antimicrobial properties, that's where, or why toothpaste was originally used to treat pimples. But guess what? As it turns out, triclosan led to a lot of allergies in the skin, so it's been removed from toothpaste. So the reason that toothpaste was being put on the pimples isn't even there anymore. And it contains harsh ingredients with an alkaline pH, hydrogen peroxide, baking soda. And all of these things will dry out your pimple, but it's also gonna dry out your skin in general and cause a whole big mess.
Love: But the reality is that toothpaste was not designed to be used on your face, and there are much more effective acne-fighting ingredients that can be used in the same manner. My personal favorite is benzoyl peroxide as a spot treatment to both dry out the acne, decrease the inflammation, and decrease any microbial or bacterial growth.
Zeichner: "Aspirin will help get rid of breakouts."
Love: We take aspirin all the time to help treat a fever because it has anti-inflammatory properties. It's actually made up of an ingredient that's similar to salicylic acid, which is a really commonly used treatment for acne because it helps remove excess oil and dead cells from the surface of the skin to dry out the pimple. Even though they're cousins, aspirin does not have those same effects in the skin. Instead of using aspirin, I would recommend actually using salicylic acid as a spot treatment or benzoyl peroxide as a spot treatment. And if you're looking for something natural, then a cool compress is an easy option.
Zeichner: "Acne always goes away on its own."
Love: About 85% of people between the ages of 7 to 24 will develop acne to the point where we almost consider it something called physiologic. So, for the majority of those people, their acne will resolve with their teenage years. But there is a large number of people where their acne does not self-resolve.
Zeichner: Even acne that goes away within the teenage years can sometimes leave behind scars that can be permanent. I recommend treating your acne when it gets to a point where it bothers you emotionally or physically, because those emotional or physical scars are permanent and stick with you for the rest of your life. So if you're suffering from breakouts and you're trying over-the-counter products and they're not helping, make sure to visit a board-certified dermatologist like myself or Dr. Love, because that's what we're here to do, is help treat your pimples.
Love: Josh, I'm never doing a video with you again. You're, like, a superpro.
Zeichner: Oh, my God. No, you were awesome! This was great.