Risk Factors for Acne
While excess sebum, dead skin, and bacteria cause acne physically, there are many factors that cause breakouts. We call these acne risk factors, which we’ll outline below.
Age
Acne is commonly considered an adolescent rite of passage. But while it’s true that 85 percent of people between the ages of 12 and 24 experience at least some degree of acne, that has less to do with age itself than the fact that adolescence corresponds with puberty and hormonal changes.
In truth, acne can occur in people of all ages, and its prevalence in adults is increasing — the American Academy of Dermatology says acne affects up to 15 percent of women, though some studies put that number even higher.
Research also shows that adult acne is more common in women. In a 2018 survey of 1,013 people, the following percentages of women reported having acne:
Almost 5 percent of women ages 20 through 29
35 percent of women ages 30 through 39
26 percent of women age 40 through 49
15 percent of women over 50
The study also identified two subtypes of adult acne: persistent acne, which continues from adolescence into adulthood, and late-onset acne, which appears in those aged 25 and older who were not previously affected by acne vulgaris.
Hormonal Change
It’s no secret that pregnancy, periods, and puberty can wreak havoc on the skin. These are all tied to hormonal fluctuations.
For example, puberty and the first two trimesters of pregnancy increase the amount of androgens in the body, which increases sebum production and can lead to breakouts. Estrogen and progesterone drop right before your period starts, which can also cause breakouts.
Some Endocrine Disorders
Endocrine disorders disrupt hormones, which can impact skin. These conditions include:
Polycystic ovarian syndrome (PCOS): This condition creates excess androgens in the body and causes irregular menstrual cycles, unwanted hair growth, and acne.
Cushing syndrome: This condition occurs when the body produces too much of the hormone cortisol. Cortisol can increase oil production and contribute to acne development.
Androgen-secreting tumors: These are rare tumors that produce androgens and can cause acne in both men and women (though the tumors are more common in women).
Genetics
There’s no gene for acne, per se, but your genetics influence how prone you are to breakouts.
For example, some research shows that genetics play a role in how effectively your immune system fends off a bacteria known as Propionibacterium acnes (P. acnes) that causes acne.
A large study on the DNA of 26,722 people found genetic variations in 15 genome regions (parts of genetic material) that were more common in people with severe acne. Basically, if you have a family history of acne, you’re more prone to it yourself.
Certain Medications
Some medications and supplements can cause what’s called “drug-induced acne.” These include:
Vitamin B12
Thyroid hormones
Halogen compounds (iodine, bromine, fluorine, and chlorine)
Antibiotics (tetracycline and streptomycin)
Antituberculosis drugs (INH)
Lithium carbonate
High doses of oral corticosteroids
Antiepileptic drugs (phenobarbital and hydantoin derivatives)
Cyclosporin A
Antimycotics
Gold salts
Isotretinoin (an anti-acne drug that can cause an initial purge)
Clofazimine
Epidermal growth factor receptor inhibitors
Interferon-beta
Supplementing with testosterone may also cause acne because of the hormone’s effect on sebum levels.
Contact With Bacteria
Being exposed to germs and bacteria is a part of life, but there are things you can do to reduce the amount of bacteria that gets on your face, where it can cause acne.
Clean your makeup brushes regularly (regular soap and water are fine), wash your bedding frequently, and wipe your phone down to avoid introducing unnecessary bacteria onto your face.
Tight-Fitting Clothing and Headwear
Friction from clothes, headwear, or accessories can cause acne. This includes things we may not think twice about, like leggings, helmets, tight collars, and backpacks. Heat and sweat may also exacerbate this.
Using Greasy Personal Care Products
Sometimes, heavy oil-based skincare and makeup products (like thick foundations or rich moisturizers) can clog pores, leading to breakouts.
But oily products aren’t the only culprits here. Products that contain alcohol can be drying to the skin, leading to an overproduction of oil as the skin attempts to balance. Certain occlusive products with ingredients like petrolatum and mineral oil create a barrier on the skin that can trap bacteria and sebum in the pores, causing acne.
Look for makeup and skincare products marketed as “noncomedogenic,” which means they are formulated without pore-clogging ingredients. And this may be obvious, but you should avoid using expired products that may introduce bacteria onto the skin’s surface.
Particular Foods
The link between diet and acne isn’t entirely understood, but it’s thought that some foods can contribute to acne, including:
High-glycemic-index foods: These are foods that raise blood sugar quickly. Research suggests that blood sugar and insulin spikes can cause inflammation throughout the body, potentially leading to acne. You’ve almost definitely heard that chocolate causes acne, but it’s not the chocolate itself, but rather the blood sugar spike (and, potentially, the milk, which we’ll cover next).
Dairy products: Cow’s milk specifically has been linked to acne. One study found that high school-aged females who drank two or more glasses of skim milk daily were 44 percent more likely to have acne than those who didn’t.
Foods high in saturated fat: This includes foods like red meat, cheese, butter, and hydrogenated oils. Some research has indicated that more acne lesions are present when the ratio of saturated to monosaturated fats (like those found in avocado or olive oil) is higher. Acne can also sometimes be caused by coming into contact with grease (like cooking with frying oil).
Acne
Wrinkles
Dry Skin
Eczema