Getting Breakouts Out of Nowhere? Here Are 12 Possible Reasons Why
Ever looked at your reflection in the mirror and asked yourself, “Why am I breaking out?” We all have. Whether you’ve been breakout-prone your whole life or you’re new to dealing with acne, one thing we can almost all agree on is that breakouts can be total day ruiners (if not weeks, months, or even longer). Like unwelcome guests, they pop up at what seems like the most inconvenient times and overstay their welcome—not to mention the more you mess with them the worse they get. Even if you’re on top of your skincare routine and use the best skincare products that you can buy, acne happens and the reasons you’re experiencing adult acne can vary. Since dealing with acne has a lot to do with finding out its root causes, we decided to take a closer look at some of the reasons (some common and some not so obvious), that you could be breaking out. We talked to dermatologist Hadley King, MD, for some insight into what causes breakouts and what we can do to treat them.
First, let’s start with a little background on how acne happens. “All acne lesions start with a microcomedo, which is a tiny clog in a pore. This is so small that it's not visible, but it can evolve into a larger comedonal lesion (a blackhead or a whitehead), or if there are bacteria and pro-inflammatory molecules, it can evolve into an inflammatory acne lesion like a pimple or a cyst,” says Dr. King.
So, what’s the difference between a blackhead, a whitehead, a pimple, and a cyst? If you’re experiencing acne breakouts, it’s not uncommon to see some or a combination of all of the above. “Blackheads and whiteheads occur when pores become clogged with dead skin cells, sebum and bacteria. These plugs are called sebaceous plugs and they form comedones. Open comedones are blackheads and closed comedones are whiteheads. Blackheads are "black" because the open pore allows for the oxidation of the plug, which turns it dark in color. Pimples are inflamed acne lesions that show up as red bumps (called papules) or pus bumps (called pustules). Acne cysts are deep acne lesions that are inflamed. Deep bumps under the skin that are often tender, red, and warm,” Dr. King tells us.
Meet the Expert
Hadley King, MD, is a board-certified dermatologist in New York City
12 Reasons Your Skin Might Be Breaking Out
1. It’s Stress
When it comes to factors that cause acne, stress plays a big part. “Stress triggers adrenaline, cortisol, and other stress hormones, and these can trigger the production of sebum and sweat, which can contribute to the formation of acne,” Dr. King tells us. Studies show that higher levels of stress even correlate to more severe acne. When you’re stressed (even if you’re so busy you aren’t aware of it), this increased production of cortisol can make acne worse if you already have acne-prone skin, or cause new breakouts in otherwise clear skin. While we know managing stress is easier said than done, trying to identify your stressors, trying to get enough sleep, and trying to exercise regularly is always a good start.
2. It’s Hormones
Ah, hormones. They were responsible for pimples in our pre-teen years and they still are a cause for clogged pores in our adult years. Hormonal changes related to your cycle are another big reason that you’re breaking out. “The mid-cycle rise in progesterone stimulates increased production of sebum and a higher relative testosterone level around menstruation also stimulates more sebum production. This results in oily skin, clogged pores, and inflammatory acne,’ says Dr. King. Some signs that your acne is hormonal acne? If you’re breaking out around the same time every month, it’s a sign. Breakouts around the chin and jawline, neck, back, chest, and shoulders also tend to be hormonally related and can appear as blackheads, whiteheads, cystic acne, and pimples.
3. It’s Sweat
It's no secret that sweat and acne go hand in hand. “Sweat and oil can provide a breeding ground for bacteria that can contribute to acne,” says Dr. King. Sweat causes an increase in oil production and this buildup of excess oil can clog pores, trapping dirt and bacteria. If you’re seeing blemishes around your hairline, t-zone, and back and you’re someone who sweats often, be sure to shower immediately after exercising and stick to using products on your body that are non-comedogenic (we love lathering NEUTROGENA Body Clear Body Acne Wash Pink Grapefruit post workout).The American Academy of Dermatology also recommends removing your makeup before working out, using a clean towel to wipe down, avoiding sharing equipment like helmets with others, and using oil-free sunscreen.
4. It’s Your Environment
Heat, humidity, pollution like smog and cigarette smoke are all common causes of acne. While these can be hard to escape (especially if you live in a big city), be sure to wash your face twice a day to rinse away dirt that can settle into your pores and trigger breakouts.
5. You’re Diet Has Too Much Sugar
“Studies have shown that foods (or beverages!) with a high glycemic index (high amounts of sugar) may contribute to acne. We think this is probably because of the blood sugar spike that results and how this affects our insulin levels and other hormones. Artificial sweeteners have been shown to be able to affect our hormones in the same way as sugar so therefore they may also contribute to acne,” according to Dr. King. Does that mean you should never have a sweet treat again? Of course you can! But if you’re seeing more acne and tend to have a high sugar diet, it could be one of your causes.
6. It’s Dairy Products
Gotta have milk in your coffee? Dairy products like milk and certain types of cheeses and creams have been shown to trigger inflammation and an overproduction of oil, in turn triggering different types of acne.
7. It’s Your Skincare Products
Skincare products that aren’t non-comedogenic are heavily responsible for causing pimples. Whether it's your cleanser, your moisturizer, serum, or sunscreen, ensuring your products are oil-free and not oil-based is essential to preventing acne from worsening. Look for ingredients like salicylic acid, or benzoyl peroxide when it comes to over-the-counter acne treatments. “Benzoyl peroxide is helpful for treating acne because it not only kills bacteria that contribute to acne, but also helps to prevent and clear out clogged pores. This makes it helpful for both inflammatory and non-inflammatory acne. Salicylic acid is an excellent pore-clearing ingredient because it exfoliates the surface of the skin and penetrates into pores to remove oil. This helps to prevent pores from becoming clogged and can help remove clogs that have already formed. This is a great ingredient for people with oily and acne-prone skin, and particularly for treating and preventing comedonal acne (blackheads and whiteheads),” Dr. King advises.
8. It’s Your Hair Care Products and Hats
Acne along your forehead and hairline usually have something to do with products that you’re putting in your hair. Certain hairsprays, thick gels, hair oils, and hairsprays can clog pores and cause build up, eventually causing breakouts. Fan of headbands or hats? While they’re cute, they can trap acne-causing dirt, oil, and bacteria too so be sure to wash your hair accessories often.
9. You’re Dehydrated
While it may seem counterintuitive, having dry skin can actually make you more acne prone. How? When your body senses that you’re dehydrated, it’ll start to produce more oil like an automatic trigger. This overproduction of oil is what can cause breakout to appear.
10. It’s Your Pillowcases
While laying in bed is a great stress reliever, your pillowcase could be an acne-causing culprit thanks to the buildup of dead skin, oils, sweat, and bacteria that can build up on your pillowcase over time. If you’re breaking out more than usual on your cheeks, be sure to change your pillowcase often (at least every other day) and opt for a silk pillowcase or a satin one (this ZOE AYLA Satin Pillowcase is suuuper comfy and soft) which can be gentler on skin.
11. You Need Retinoids
“Topical retinoids have a comedolytic effect, meaning that they help to prevent and treat clogged pores. This is because they increase the turnover of skin cells and reduce the tendency of cells and keratin debris to clump together and clog up pores. They also decrease the discoloration that can be left after a pimple, and because they increase the turnover of skin cells, this reduces the healing time for acne. Topical retinoids are helpful for both inflammatory and non-inflammatory acne, and they're helpful for post-inflammatory hyperpigmentation too,” says Dr. King.
12. You Need Other Medication
If these measures are not sufficient to treat acne, see a board-certified dermatologist, who can evaluate your acne and consider prescription options such as stronger topical retinoids, Aczone Gel, systemic medications like oral antibiotics, oral contraceptives, spironolactone, or isotretinoin. Oral antibiotics are short-term solutions for inflammatory acne flares. Oral contraceptives (certain birth control pills) and spironolactone are helpful for hormonal acne in women. Isotretinoin is helpful for moderate to severe acne that hasn't responded to other treatments and may be scarring,” Dr. King tells us.
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