12 myths and facts about acne

PHOTO: 12 myths and facts about acne

How many times have you heard aunties tell you: "If you don't wash your face properly, you'll get acne!"

It's one of the most common myths perpetuated by the misinformed. In fact, it has been medically proven that acne is not a hygiene issue, and frequent washing will not prevent acne, said Dr Raymond Kwah, dermatology specialist and consultant at Raffles Aesthetics and Raffles Skin Centre.

Acne is already a stressful enough and depressing event without having to deal with the false information put out there. With that in mind, we shed a light on some of the common "facts" out there:

Most people have good skin: FALSE

If you suffer from acne, you are not alone - acne is a lot more common than you think.

It was the second most common condition patients sought consultation for at the National Skin Centre in 2011. In a 2007 study, it was revealed that 88 per cent of Singaporean adolescents aged between 13 to 19 identify themselves as having acne, said Dr Kwah.

Of these, more than 50 per cent were classified as having mild acne, 40 per cent moderate acne and 8.6 per cent severe acne.

Mild acne: Mostly comedones (blackheads and whiteheads). Few inflammatory lesions.

Moderate acne: More inflamed lesions, such as papules (small red or pink lumps) and pustules (small elevations of the skin containing pus).

Severe acne: Many large inflamed nodules (relatively hard lumps) and pustules (small elevations of the skin containing pus). May extend beyond the face.

Acne breakouts are worse during pregnancy

Acne is only a "teenage condition": FALSE

It is true that most cases of acne start during puberty when the body is undergoing hormonal changes.

However, what many people don't know is that it can occur in different age groups as well, said Dr Kwah.

There's infantile acne, where newborns get acne due to exposure to maternal hormones. Then there's adult acne.

Dr Hazel Oon, consultant dermatologist at the National Skin Centre said the prevalence of adult acne - which affects both men and women above the age of 25 - is increasing.

Adult acne tends to be more common in women and can be both mild and severe. Flare-ups also often occur around menstruation time for women, said Dr Oon.

Acne breakouts are worse when you are pregnant: POSSIBLE

Acne can improve or worsen during pregnancy due to the fluctuation in hormone levels, said Dr Oon. In fact, acne may improve towards the end of the pregnancy cycle due to the rise in oestrogen.

Many women report that their skin looks better when they are pregnant. But the hormonal fluctuations during pregnancy can result in an increase in oil production and increase the shedding rate of cells lining the hair follicle unit, said Dr Kwah. This can result in the plugging of the pore and consequentially, pimples or acne pustules.

The downside is that acne during pregnancy is difficult to treat as many of the conventional therapies are not suitable for pregnant women.

Does having sex improve acne?

Acne is brought on by stress: FALSE

While excess stress such as from taking examinations has been shown to be associated with acne flares, stress alone is not the major causative factor for acne, said Dr Oon.

The acne flare-ups that result from stress is due to hormonal changes. Stress alone does not cause acne.

In low doses, stress can actually be a good thing for your productivity, while not harming your skin much.

Acne is brought on by not washing your face regularly: FALSE

As mentioned, this is probably one of the most common housewives' tale.

"Removing the oil or dirt alone on the face cannot cure acne. Acne is caused by a combination of increased oil production which fuels the growth of a specific bacteria - propionibacterium acnes," said Dr Oon.

This results in obstructed follicles and inflammation. Excessive washing will not help the situation and can even result in skin irritation and eczema, she said.

Sex clears up acne: FALSE

The answer is simple: There's simply no evidence that sex cures acne.

In fact, there are also myths perpetuated that having too much sex causes/aggravates acne. There is no evidence to substantiate the claim either way, Dr Kwah said.

Eating chocolate can make acne worse 

Acne is brought on by chocolate: POSSIBLE

While some previous studies have debunked the theory that chocolate aggravates acne, these studies had numerous problems, such as small sample sizes, short follow-up periods and lack of proper control groups, Dr Oon said.

There are certain studies that have suggested that a diet that is high in sugar, carbohydrate and dairy products may increase the risk of acne and its severity, she added.

Therefore, there is a possiblity that chocolate can promote acne in susceptible individuals.

But Dr Oon highlighted that acne is due to a multitude of factors, and diet alone is not the sole cause of acne.

People with acne should eat a well-balanced, healthy diet and avoid an overly-restrictive diet, she advised.

The sun causes acne: POSSIBLE

Sun can improve or aggravate acne, depending on the individual.

Mild sun exposure may to lead to an improvement in acne, as certain light sources such as blue light, red light and other light therapies are sometimes used to treat acne.

However, a sunburn can actually trigger an acne flare and necessitate a temporary stop to acne treatment.

But if you are taking medications for acne, such as tretinoin, adapalene, benzoyl peroxide, doxycycline and isotretinoi, you may want to wear a hat as these medications make your skin more sensitive to the sun.

Can I use toothpaste on acne

Steam your face to get rid of acne: FALSE

The belief is that steaming the face opens up the pores, makes them easier to clean and promotes sweating, flushing out the toxins from the pores and preventing the formation of black or white heads.

"The truth is that steam doesn't actually cleanse out or clear the plug from the pores. It also will not stop new pore blockages from forming," said Dr Kwah.

He added that that's not to say facial steaming doesn't have a place in skin care. Facial steaming does not open pores, but can help soften blackheads and blockages, facilitating removal with a comedone extractor.

However, be warned that in cases of moderate to severe acne, you should never try to extract an inflamed lesion as it may cause a severe scar.

Most experts will recommend the use of creams, like those containing retinoids, or chemical peels to help in the improvement of these blocked pores, Dr Kwah said.

Toothpaste will clear up acne: FALSE

"The concept is that toothpaste is drying and will absorb the oil. As seborrhea is a factor for acne development, it can help clear up acne," said Dr Kwah.

Some toothpaste may contain triclosan which has antibacterial properties and this may address the bacterium that contributes to acne formation. However, there are no studies to substantiate this.

Going to rush out to try it? Don't.

Toothpastes are not formulated as leave-on preparations for acne treatment and may contain ingredients that can irritate the skin and cause inflammation.

Such chemicals include sodium lauryl sulphate, alcohol and hydrogen peroxide, said Dr Oon.

You'd be better off buying topical acne preparations that have better efficacy with fewer side effects.

What superfoods help in acne? 

Acne clears up when you take birth control pills: POSSIBLE

Not necessarily. There have been women who've reported that the pills did nothing for their acne, and even some who've reported that their acne actually got worse.

What birth control does is that it regulates the hormone levels in the body. The female hormones in the pill work by lowering the male hormone levels, resulting in reduced oil production, said Dr Oon.

But yes, birth control pills may be prescribed in women to control acne that is of moderate to severe grade, or not responding to application of topical creams.

However, do note that they can have side effects such as headaches, blood clots in the legs and even cause a stroke. Your medical history, risk factors and treatment options should be discussed with your doctor before starting birth control pills.

There are superfoods that can help in acne: FALSE

There are numerous claims that certain "superfoods" like green tea or seafood can improve acne.

According to Dr Oon, you should take such claims with a pinch of salt. There is no conclusive evidence that super foods, zinc, vitamins A, C or E prevent acne. 

As mentioned, there are some studies suggesting certain foods can make acne worse. So it's probably a wise move to stay away from junk food, pizzas and chocolate, and eat more veggies. A healthy, balanced diet creates a healthier you, and healthier skin in general.

yamadak@sph.com.sg