Globally acne is the commonest reason for consulting a dermatologist. Nearly everyone sees a dermatologist at one time or the other with acne. This is also steeped in many beliefs and myths, some true and some totally false. Here we look at some common myths surrounding acne with a view to finding out if there is a basis for the myth.
1. Eating oily food causes acne
The basis for this myth is possibly that acne is a problem associated with increased size of oil producing glands of the skin (sebaceous glands). The gland however is enlarged and produces more oil due to the effect of internal hormones (which could be well within the normal limits). There have been several scientific studies to show that acne is not directly associated with consumption of greasy food. However, acne is more common in the overweight as fat in the body converts good hormones to bad hormones. Eating greasy food high quantities causes fat accumulation in the body, this can be associated with hormonal imbalance and pimples.
2. It is normal to get acne in the teens and it should be allowed to heal naturally
Yes and No. It is normal to get acne in teens and every teen gets acne although with very variable severity. In people with mild acne which heals spontaneously with no scarring, it is OK to let acne heal on its own. However, some people are prone to develop scars with acne. In this group of teens, if left to heal on its own, it will eventually heal but will leave a scarred face. These acne scars can be quite disfiguring, they lower the individuals self esteem and are very difficult and expensive to treat. In this group of individuals, I therefore recommend treatment (medical and/or cosmetic) for the acne.
3. Acne occurs in people with poor skin hygiene and therefore one should go for a regular cleanup
Acne is not associated with poor hygiene. The factors which can aggravate acne when used on the skin surface are occlusive creams or occlusive make-up left overnight on the face. If one cleanses the face twice a day, uses non-comedogenic creams and takes off the make-up at night before retiring to bed, usually there in no aggravation of acne.
Very often we find that clean-ups at salons use a comedone extractor which can be very harsh on the skin. This often leaves marks on the skin and is better avoided. Also sometimes in the process of pushing the infection out, the infection is actually pushed to the deeper planes which increases the risk of future scars. It is preferable to use medicated creams and ointments to treat acne.
4. Excessive consumption of chocolate is associated with acne
Several scientific studies conducted to date show that there is no direct association between chocolate consumption and acne. However, excessive chocolate consumption is associated with weight gain and all its attendant risks. For general health and well being, it is advisable to moderate chocolate consumption.
5. Washing the face several times a day helps treat acne
Since the underlying problem in acne is an oily face, there is a general belief that if the skin is kept dry by washing it several times a day, the acne is treated. Studies however show that washing the face several times a day and using harsh cleansers on the face may actually aggravate acne. This is because our body is designed to give feedback from each and every organ. If the face is cleansed and kept dry, the feed back to the brain is that the skin is dry and needs to be moisturised and the brain then sends chemical messengers to increase oil production aggravating the problem. The consensus is that people with acne need to use a mild cleanser twice a day for optimum benefit.
6. People with acne should not use a moisturiser
The problem in acne is not moisturiser applied on the skin but the glands which produce the natural moisturiser (sebum). Even people with acne need to use a mild moisturiser on the skin to soothe and hydrate the skin. Greasy occlusive moisturisers however need to be avoided.
7. I have acne, I can’t use a sunscreen as that triggers off the problem
This is totally not true. People with acne need a sunscreen perhaps even more than people with clear skin. When people have acne and go out in the sun without a sunscreen, it tends to cause pigmentation of the acne spots. The challenge is to find a suitable sunscreen, one could use a gel based sunscreen which is not occlusive and can give UV protection without aggravating the acne.
8. A colonic wash will help clear my acne
Yes and No. While constipation may be associated with acne, there is no clear scientific evidence pointing to the benefit of a colonic washout in acne. I generally recommend consuming a diet which is rich in brightly coloured fruits and vegetables and drinking plenty of oral fluids (2 litres in an adult woman and 2.5 litres in an adult male). This will provide you with a healthy dose of natural antioxidants and will also help clear up the gut.