Have you ever dealt with acne that only ever seems to get worse? While some acne breakouts are easy to deal with, others can seem immune to treatment, bouncing back in days after even the most aggressive and extensive cleansing and skin care efforts.
If you’re prone to bad acne breakouts, it’s easy to become frustrated and overwhelmed by the seemingly endless number of products available claiming to clear your skin.
The reality of acne is that it’s largely caused by a few factors, namely your skin’s production of oils, the accumulation of dead skin cells and the growth of bacteria on your skin.
Behind these factors are a few root causes, which may include your hormone levels, skin care habits, use of cosmetics and general hygiene.
If you have bad acne, don’t panic. Once you’re able to identify the cause of your acne, treating your breakouts becomes far easier.
Below, we’ve explained how acne develops, as well as the root causes of acne breakouts that can affect your skin. We’ve also explained exactly how you can treat severe or persistent acne to get rid of breakouts and keep them away for good.
To understand why your acne is so bad (as well as how to treat it), it’s important to be aware of how acne develops in the first place.
Acne develops when your hair follicles, or pores — the tiny, microscopic holes in the surface of your skin — become clogged.
Several factors can cause your pores to become clogged. The two most common are a natural, oil-like substance called sebum and dead skin cells that can accumulate on your skin’s surface as a result of your skin’s natural rejuvenation and repair process.
Sebum is an oil that’s produced by your sebaceous glands. It plays a major role in keeping your skin lubricated and healthy. Sebum allows your skin to retain moisture and forms a part of your skin’s protective barrier, keeping bacteria, fungi and other germs out of your body.
In addition to producing sebum, your skin constantly repairs itself through a process referred to as epidermal turnover.
As part of the epidermal turnover process, new skin cells are created in the basal layers of your skin. Over 40 to 56 days, these cells travel upwards to your skin’s surface to replace older skin cells that have been exposed to the environment.
The outermost layer of your skin, which is known as the stratum corneum, is mostly made up of old, dead skin cells left behind by this process.
These old, dead cells shed naturally over the course of each day, such as when you rinse your skin or touch your face.
Over time, debris from dead skin cells can build up on the surface layer of your skin. When this debris mixes with sebum on your skin, it can form into plugs that clog your pores, causing acne lesions to develop.
There are several different types of acne. The smallest, mildest acne lesions, which form when sebum and dead skin cells clog pores, are known as comedones. Whiteheads and blackheads are both forms of comedonal acne.
While sebum and dead skin cells cause acne, the presence of bacteria can make acne lesions become far worse.
When bacteria such as P. acnes become trapped inside a clogged pore, they can multiply at a rapid pace, causing the acne to become red, inflamed and painful.
Acne lesions that contain bacteria are usually known as papules or pustules. When inflamed, infected acne becomes severe or develops deeper within your skin, it’s referred to as nodular acne, or cystic acne.
Technically, all acne is caused by sebum, dead skin cells and/or bacteria. However, a variety of different factors all have an effect on things like your body’s sebum production or the amount of bacteria that grows on your skin.
These include your genetics, your production of certain hormones, your use of certain products that may irritate your skin and even simple things like how often you touch your face.
If you have bad or persistent acne, identifying these root causes and taking action to treat them can reduce the severity of your acne and have a real positive impact on your skin.
One of the biggest factors related to acne is your production of certain hormones. Your body is constantly producing hormones such as estrogen, progesterone and even male sex hormones such as testosterone.
These hormones are extremely important for your health. For example, estrogen plays a major role in maintaining your reproductive health. It also helps to maintain your brain, cardiovascular system, bones and other tissue.
Similarly, despite being a “male” hormone, testosterone is vital for your health and wellbeing as a woman. In fact, your body relies on testosterone as a building block for many other hormones, including estrogen.
Some hormones can affect your skin. For example, testosterone plays a part in regulating your production of sebum — the oil-like substance that can cause acne.
As we’ve explained our guide to hormonal acne, your production of hormones fluctuates during your menstrual cycle. Before and during your period, your production of hormones like estrogen and testosterone increases.
This sudden increase in testosterone production stimulates the production of sebum, which can clog your pores and cause those annoying breakouts that occur before or during your period, or when you first start using a new form of hormonal birth control.
Research shows that your family’s history of acne is closely associated with your risk of dealing with acne breakouts, suggesting that acne has a genetic component.
If your parents were prone to acne during their youth or as adults, you may have a higher risk of experiencing acne breakouts. A study of twins found that as much as 81 percent of the variance of acne may be attributable to genetic effects.
Unfortunately, experts aren’t yet aware of what you can do to treat the genetic factors that may contribute to acne.
Your skin care and personal hygiene habits can have a huge impact on the appearance of your skin, including your risk of dealing with acne breakouts.
While acne isn’t always caused by poor hygiene, some habits can increase bacterial growth on your skin and worsen your acne. Others can increase your risk of developing the clogged pores that turn into comedonal or inflamed acne lesions.
Skin care and hygiene factors that may cause or worsen acne breakouts include:
As we briefly mentioned above, some types of makeup and certain hair care products may have the potential to make your acne worse.
Although makeup as a whole doesn’t cause acne, the oils in some cosmetics can build up on the outer layer of your skin and clog your pores just like sebum. This type of acne is usually referred to as acne cosmetica.
If you’re prone to acne, you can lower your risk of developing acne cosmetica by using makeup that’s labeled “oil-free” or “non-comedogenic.” These products are formulated to be less likely to cause comedones (small acne lesions) to develop on your skin.
It’s also important to practice good makeup habits. Make sure that you completely remove your makeup before you go to bed. Every week, carefully clean your makeup brushes to stop dead skin cells, bacteria and other substances from making their way back onto your skin.
Clothing and other items that frequently come into direct contact with your face, such as hats, sports helmets, visors, masks and even pillowcases and other forms of bedding, can all contribute to acne breakouts.
This is because oils, dead skin cells and bacteria can grow on these items and aggravate your acne when you wear them. Skin and hair care products containing oils can also make their way onto these items, then eventually back onto your skin.
You can reduce your risk of developing acne from these items by washing them regularly. It’s particularly important to wash items that come into contact with your head for long periods of time, such as pillowcases and sheets.
Some medications can cause acne, including severe or persistent acne. If you use medication, there’s a possibility that it could trigger or worsen your breakouts. Medications that may cause acne include:
Other medications may also cause or worsen acne. If you’re prescribed medication and notice that your acne has gotten worse since you started to take it, you should talk to your healthcare provider to learn more about your options.
Dealing with acne can be a frustrating experience, especially when your breakouts are severe, painful and seemingly impossible to get rid of.
The reality of acne is that while it can be immensely stressful to deal with, it’s almost always a treatable issue. Once you’ve identified the cause of your acne, simple things such as changes to your habits and use of medication can almost always clear up your skin.
Below, we’ve explained how you can treat your acne using a combination of over-the-counter products, prescription medications and effective skin care habits.
If you have acne, one of the best things you can do to stop your breakouts and improve your skin is to talk to a licensed healthcare provider.
Based on the type and severity of your acne, they may recommend using one or more of the following medications:
If you’re prescribed medication to treat acne, make sure that you closely follow your healthcare provider’s instructions. You may need to continue taking your medication to prevent acne, even after your breakouts clear up.
Certain habits, such as those listed above, can aggravate your acne and make your breakouts worse. If you have habits that are linked to acne breakouts, it’s important to change them while you treat your acne using medication.
You can change your habits and improve your skin care routine using the tips and tactics we’ve listed above under each cause of acne.
Acne becomes significantly easier to treat once you identify the factors that are causing you to experience breakouts.
If you’re prone to acne breakouts and can’t seem to stop them, the best thing you can do is talk to a healthcare provider to find out what’s causing your acne breakouts and what you can do to stop them for good.
Depending on the severity of your acne, you may need to use one or more medications to stop pimples from developing and keep your skin acne-free in the future.