What Causes Acne Flare-ups? 5 Common Triggers

Acne is the most common skin condition, affecting up to 50 million Americans a year. The condition occurs in various forms, predominantly in adolescents during puberty. Most of those affected develop pustules, pimples, and blackheads on the face, mainly on the forehead and chin. Acne on the back and cleavage also occurs but is less common.

You can treat mild acne yourself, but you should see a dermatologist for more severe acne. At Jordan Valley Dermatology Center, Douglass Forsha, MD, and our team of skin care specialists treat active acne and acne scarring so you can feel confident again. 

Almost everyone experiences acne at some point. Here are five common triggers that can cause or exacerbate your acne problems.

Acne basics

Three factors contribute to acne formation:

• Overproduction of sebum
• Blockage of the exits from the sebum glands and hair follicles
• Skin bacteria

Acne occurs when the skin's sebum glands become clogged with oil (sebum) and dead skin cells. Sebum protects skin and hair and keeps it supple, and it’s transported out through the skin along the hair follicle. When your body produces too much sebum, it accumulates in the ducts of the sebum glands and clogs them up by forming a soft plug.

Such a plug can cause the gland wall to bulge outwards and form a whitehead. The plug can also be darker and form a blackhead. When the clogged hair follicles become inflamed, pimples appear on the affected area as red spots with a white center (pus). The blockage and inflammation that develop deep in the hair follicle create a tender bump (cyst) on the skin’s surface. 

5 common acne triggers

The reasons for increased sebum production are unknown. However, many factors such as hormones, diet, certain medications, genetic makeup, and stress can play a role.

1. Hormones

Hormonal changes cause the most common form of acne, especially during puberty. Androgens are hormones that regulate the growth of sex characteristics in boys and girls during puberty. The androgens stimulate the skin's sebum glands to produce more sebum. The sebum builds up under the surface of the skin, causing acne.

Hormone fluctuations occur not only during puberty but also during pregnancy and menopause. Skin becomes increasingly oily at these times, triggering new acne outbreaks.  

2. Diet

Several studies suggest that eating certain foods can trigger or worsen acne. Foods like pasta and sugar increase insulin production with fast-absorbing carbohydrates, leading to high blood sugar levels. 

High blood sugar stimulates the release of insulin and an insulin-like growth factor. This immediately affects the sebum glands and encourages your outer skin layer to increase cell growth. Ultimately, this increases the risk of acne formation. 

3. Stress

Stress doesn't cause acne, but it can worsen acne, often setting a vicious cycle in motion. Acne breakouts can be embarrassing and may lead to social withdrawal to avoid rejection. This can turn into more stress or anxiety, prompting more acne problems.

This embarrassment may tempt you to pick, squeeze, or compulsively scratch at pimples and blackheads, which intensifies the inflammation. What was originally a mild form of acne can worsen significantly. 

4. Medications

Certain medications can cause acne, though most cases aren’t drug-related. These include corticosteroids, antibiotics, testosterone, and lithium. Anabolic steroids contain androgens and can lead to severe forms of acne. However, most drug reactions aren’t true acne but acneiform drug eruptions.

5. Genetics and lifestyle

You may have a genetic predisposition for acne development. If your parents or several family members are affected or have had acne symptoms, there is a greater risk that you will develop acne.

Smoking, UV radiation, and certain cosmetics can also trigger acne.

Professional acne care

There are many reasons your skin may produce too much sebum and trigger acne flare-ups, but whatever the cause, you may need professional help to clear it up.

Jordan Valley Dermatology Center in South Jordan, Utah, is the number one prescriber of Accutane in America. We also treat acne using laser therapy, microneedling, and oral or topical antibiotics. Our acne treatments are highly personalized, and we consider medical, cosmetic, and research factors while designing your treatment. For professional acne care, call the office or book an appointment online today.