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Take Control of Your Acne!

By Megan Griffith

Reviewed for medical accuracy by Dr. Jaggi Rao,
MD, FRCPC Double board-certified dermatologist

How can you control acne? Is regular visits to the dermatologist and medications the answer? Are home remedies and natural solutions effective? Are there any methods that absolutely, positively always work? The simple fact is, there are as many effective treatments for acne as there are people who have acne, but certain general skin care practices are a good idea for everyone and should be at the top of every acne sufferers to-do list.

Clean Skin to Fight Acne
The most important step in fighting acne, is keeping your skin clean.


  • No acne care product works every time for every user.
  • Some skin care practices are always a good idea, especially keeping skin clean without trying to scrub acne away.
  • The foods that cause acne are usually foods that are otherwise healthy. These foods don’t have to be absolutely avoided, but it is important not to over-indulge. Dietary causes and effects are not all myths!
  • One common food can change the balance of stress and inflammation and heal acne while lifting mood.

The Most Important Step in Keeping Acne Under Control

Cleanliness is the foundation for acne freedom. All your efforts to kill acne bacteria on your face will come to no good if you constantly reinfect your skin with dirty washcloths and towels.

In fact, it is probably a good idea not to use washcloths at all, at least not on acne-affected skin. It is never possible to rub acne away. Vigorous rubbing of the skin only damages1 the delicate linings of pores, creating a red ring around a whitehead or blackhead, or puncturing a pimple to let even worse bacteria inside.

Let your cleanser do the work for you, applying a lather of cleanser with your fingertips. But when it comes to lather, more is not necessarily better.

A Lust for Lather Can Keep Acne Alive

Soaps, shampoos, and detergents that make big bubbles are especially detrimental to dry, normal, and even slightly oily skin. The problem with bubbles is that they break down lipids2, ceramides, and cholesterol in the outermost layer of skin. This irritates the skin3, opening tiny pathways for infection (usually not the organisms that cause acne, however). Inflammation swells the skin, strangling pores and trapping oil and acne bcteria inside.

When you apply a cleanser to your face, it should only form small bubbles. The bubbles don’t get rid of oil and dirt. They just irritate the skin. Even if your cleanser makes no bubbles at all, it may be doing a very good job of cleansing your face.

Tingling is a Warning Signal

Tingling skin is almost never a sign of anything good4. A tingling on the lip can be the sign of a cold sore. A tingling at the back of your neck can be a sign you are coming down with a cold or the flu. And tingling after you use a skin care product and rinse it away is a strong indication that the product has worn away an invisible layer of skin.

Certain tingly sensations are easy to recognize. Mint, menthol, “menthyl” chemicals, peppermint, lavender, cinnamon, citrus, and wintergreen usually leave a tingly sensation on the skin. They can irritate the skin5, causing the creation of new whiteheads and blackheads on fair skin, and even causing permanent skin discoloration on dark skin.

The rule for acne products is: If it tingles, take it back. Don’t put any tingling sensation on acne-affected skin.

The Foods That Make a Difference Probably Are Not What You Expect

The old advice for acne sufferers used to be to avoid chocolate. It turns out that dark chocolate really does increase production of pimples6, sometimes by a factor of up to 2000%. (Milk chocolate is not as likely to cause breakouts.) But most other traditional advice about food and acne turns out to have been wrong. Here is nutritional information about acne updated.

  • Iodine is important for thyroid health7, but iodine-rich foods can cause irritation of the skin. If you notice more pimples after you eat8 kelp, dulse, fish, shellfish, or after you use a lot of iodized salt, reduce consumption of these foods next time. People who have acne should get enough iodine, but not too much.
  • Foods that contain plant chemicals lycopene (tomatoes, watermelon, and shrimp) and zeaxanthin (sweet corn, kale, and mustard greens) increase sebum production. This won’t necessarily increase acne activity if you are keeping pores open by an effective daily cleansing routine, but it helps not to eat too much of these otherwise healthy vegetables.
  • Drinking water keeps the skin hydrated9 and helps keep pores open, but you don’t have to drink so much water that you slosh when you walk. As little as 5 cups (1200 ml) of water a day is usually enough. If you are going to the bathroom all the time and you aren’t taking a diuretic and you don’t have another health condition, you are drinking more water than your skin needs.
  • Every kind of “soda water” is not necessarily bad for your skin. Everyone with acne should avoid carbonated beverages sweetened with sugar (as should people who don’t have acne), but seltzer waters that are rich in magnesium and selenium are good for the skin and good on the skin. To use a facial water, however, be sure to lock it into the skin with an application of moisturizer after you apply to the face.

It Always Helps to Control Stress

Every pleasant activity is just a little stressful. There is no need to try to eliminate all stress from your life if you have acne.

However, if you are an adult who has acne, and you have to deal with unremitting stress in your life, it is highly likely that stress is a major contributing factor in your condition10 and that reducing stress will help clear up your skin. Changing your life to change your skin is not usually practical. But there is a connection between diet and stress that can make skin care easier.

About 80 years ago, acne experts used to think that stress caused constipation, and that avoiding constipation was important for “flushing out toxins” that cause acne. It turns out that the digestive problem that contributes to some forms of acne is not the presence of toxins but the absence of regulatory chemicals made by Lactobacillus bacteria in the colon.

These bacteria, which are found in yogurt and many other fermented foods, interact with the immune system in ways that reduce inflammation throughout the body11, especially in the brain and the skin. Not only does reducing inflammation in the gut reduce inflammation in your skin, it also reduces the inflammation in your brain that keeps stress alive.

A single serving of yogurt a day, preferably eaten as a snack on an empty stomach, can help reduce stress and clear up your skin. If you can’t eat yogurt, take a probiotic supplement. Of course, all other kinds of stress reduction—most of which require a great deal more effort—are likely to help keep acne under control.


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  2. Okuda M, Yoshiike T, Ogawa H. Detergent-induced epidermal barrier dysfunction and its preventionJ Dermatol Sci2002 Dec;30(3):173-9.
  3. BETTLEY FR. Some effects of soap on the skin. Br Med J. 1960;1(5187):1675–1679.
  4. Flores S, Davis MD, Pittelkow MR, Sandroni P, Weaver AL, Fealey RD. Abnormal sweating patterns associated with itching, burning and tingling of the skin indicate possible underlying small-fibre neuropathyBr J Dermatol2015 Feb;172(2):412-8.
  5. Orchard A, van Vuuren S. Commercial Essential Oils as Potential Antimicrobials to Treat Skin Diseases. Evid Based Complement Alternat Med. 2017;2017:4517971.
  6. Chalyk N, Klochkov V, Sommereux L, Bandaletova T, Kyle N, Petyaev I. Continuous Dark Chocolate Consumption Affects Human Facial Skin Surface by Stimulating Corneocyte Desquamation and Promoting Bacterial Colonization. J Clin Aesthet Dermatol. 2018;11(9):37–41.
  7. Chung HR. Iodine and thyroid function. Ann Pediatr Endocrinol Metab. 2014;19(1):8–12.
  8. Kucharska A, Szmurło A, Sińska B. Significance of diet in treated and untreated acne vulgaris. Postepy Dermatol Alergol. 2016;33(2):81–86.
  9. Palma L, Marques LT, Bujan J, Rodrigues LM. Dietary water affects human skin hydration and biomechanics. Clin Cosmet Investig Dermatol. 2015;8:413–421. Published 2015 Aug 3. 
  10. Zari S, Alrahmani D. The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clin Cosmet Investig Dermatol. 2017;10:503–506. Published 2017 Dec 5.
  11. Plaza-Díaz J, Ruiz-Ojeda FJ, Vilchez-Padial LM, Gil A. Evidence of the Anti-Inflammatory Effects of Probiotics and Synbiotics in Intestinal Chronic Diseases. Nutrients. 2017;9(6):555. Published 2017 May 28.
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