Forgetting to wash your face isn't the only reason for acne flare ups—everything from what you eat to where you live could be behind those pesky breakouts.
Why You Have More Acne Now
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More than 50 percent of women in their twenties, 26 percent of thirty-somethings, and 25 percent of 40- to 49-year-olds are breaking out, according to the American Academy of Dermatology. "Adult acne is skyrocketing," says Dendy Engelman, M.D., a dermatologist in New York City, who says she's seeing record numbers of adults who are plagued with breakouts. "It's not just an episode here and there; it's chronic."
On the bright side, because of the growing problem, there's more research being done to figure out what's behind these skin issues and the most effective ways to treat acne flare-ups.
Read on for the latest science—and solutions.
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You're Dealing with Inflammation
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Medical experts are finding that we're living with too much inflammation and that it's responsible for a whole host of issues, including acne flare ups. "We now understand that acne is driven by inflammation," says Carl Thornfeldt, M.D., a dermatologist in Fruitland, Idaho, and the founder of Epionce Skincare. "It causes the sebaceous glands to be more active, and it allows increases in skin bacteria and yeast."
Why are we so inflamed these days? One major culprit: stress. (Check out 10 weird ways your body reacts to stress.) Daily stressors raise your cortisol level, which increases inflammation. Your glands release more oil and your immune system is suppressed—the perfect storm for a breakout. Managing your stress levels (try these simple techniques for relief) may help you with runaway inflammation and acne. As can these 15 anti-inflammatory foods.
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Your Tech Is Filthy
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Cell phones are pretty much as dirty as a toilet seat—gross, but unfortunately true. There are abundant bacteria that you facetime with daily, and it doesn't stop there. Listening to music while you work out is very therapeutic, and who doesn't like to listen to music on the subway? But be cautious, because sweat accumulates under earphones and can lead to acne flare ups. Clean them off with makeup remover wipes after you leave the gym, or at night when you finish your commute. (See how to clean your phone without ruining it.)
You're Eating the Wrong Carbs
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Despite all the protein-heavy diets out there, the average American diet is full of carbohydrates, and research says that it affects our skin. "We've always observed a link between diet and acne, but now we know the science behind it," says Robyn Gmyrek, M.D., a dermatologist in New York City. Studies have shown that refined carbs with a high glycemic index—processed foods like white pasta and white bread—increase insulin levels and insulin-like growth factor 1; that in turn causes the production of androgens, male hormones (women make them as well) that increase oil production and inflammation, which leads to acne flare ups.
Dr. Gmyrek advises pimple-prone patients to adopt a low-glycemic-index diet full of lean protein and lots of vegetables, and to boost their intake of antioxidant-rich fruits and veggies and omega-3 fatty acids (get them from wild salmon, walnuts, and flaxseeds) to quell the inflammation that spurs acne flare-ups.
Related: 10 Foods That Are Good for Your Skin
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You're Consuming Hidden Hormones
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There has long been a link between dairy products and acne, and while there's still no definitive answer as to why, many experts suspect that hormones are to blame. "All milk, even organic, contains hormones, because cows are often kept in a pregnant state to produce more milk," Dr. Gmyrek says. Also, chemicals that mimic or disrupt hormones, such as BPA found in plastic containers and the linings of canned foods, can unleash an inflammatory cascade in the body, which may also lead to pimples, Dr. Thornfeldt says. If you're dealing with persistent acne flare ups, switching to a nondairy alternative (such as coconut, hemp, or these nut milks that taste better than the real thing) and avoiding BPA may help.
Photo: Getty Images/Alina Kulbasnaia
You're Overusing Meds
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You may have heard that the overuse of antibiotics is giving way to powerful superbugs, like MRSA, that don't respond to drugs. (And have you seen that you may not need to take that full course of antibiotics?) Acne isn't on the same scale as MRSA, but experts say that the long-term use of skin-clearing oral antibiotics such as tetracycline and erythromycin may be a contributing factor to antibiotic resistance. P.acnes, the bacterium that causes acne, can grow resistant to certain drugs in as little as two weeks, Dr. Engelman says. Yet a study in the Journal of the American Academy of Dermatology found that people with severe acne flare-ups are on a medication for an average of 11 months before their doctors switch their treatment. "I've had first-time patients say they've been on antibiotics for as long as two years," says Dr. Engelman. "That's not effective."
Pollution Is At an All-Time High
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It's bad not just for the planet but for your complexion. "There are so many pollution particles in the air, especially if you live in an urban area, and they're tiny enough to clog pores and cause inflammation of the skin," says David Bank, M.D., a dermatologist in Mount Kisco, New York.
To rebuff them and prevent acne flare ups, apply a moisturizer with SPF every morning, Dr. Bank says. "It will act as a sealant, blocking whatever may be bombarding the skin." If you're afraid that it will make your oily skin too slick, Dr. Bank suggests using an oil-free mattifying formula. (See more of the best skin products that protect against pollution.)
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Your Acne-Fighting Skin-Care Routine
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The first step in curbing acne flare-ups? A stellar cleansing routine. Deep clean pores with a salicylic-acid cleanser—try Yes to Tomatoes Clear Skin Detoxifying Charcoal Cleanser (Buy It, $10, ulta.com)—or up the ante with an oscillating skin brush that flexes pores, dislodging gunk., like the Clarisonic (Buy It, $200, sephora.com). It's safe to use daily on broken-out skin, as long as you don't press hard; let the bristles do all the work, says Dr. Bank.
It may also be helpful to look for common blemish fighters, like salicylic acid and benzoyl peroxide, that are combined with calming ingredients to stop inflammation. "Research shows that adding anti-inflammatory botanical agents to OTC acne treatments leads to better results," Dr. Gmyrek says. "These agents also help to prevent post-inflammatory hyperpigmentation, which are dark spots that linger for months after your pimples clear." Look for acne treatments that contain soothers such as algae, aloe, ginseng root extract, ginkgo biloba leaf, chamomile, turmeric, licorice, and grapeseed oil. Try Kiehl's Dermatologist Solutions Breakout Control Acne Treatment Facial Lotion (Buy It, $48, kiehls.com), which contains aloe, and MD Complete Breakout Spot Treatment (Buy It, $20, mdcomplete.com), which has chamomile.
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In addition to your skin-care routine, probiotics can also help with acne flare-ups. Research suggests that restoring balance to an unhealthy gut may help reduce acne-triggering inflammation. That's where probiotics, which encourage healthy bacteria, come in, says Dr. Engelman. Get your fill from probiotic-rich foods and drinks, such as yogurt, saur kraut, pickles, kimchi, kombucha, kefir, or miso paste, suggests Dr. Gmyrek. If you want to pop a supplement, experts say to opt for one with a high organism count—30 to 50 billion colony-forming units (CFUs)—and to stick with well-studied strains like lactobacillus. Using probiotics topically may also keep bumps at bay. The theory is that probiotics shield cells from bad bacteria, calm inflammation, and have an antimicrobial effect. Two to try: Biossance Squalane + Probiotic Gel Moisturizer ($52, sephora.com) and Tula Volume Defense Deep Wrinkle Serum (Buy It, $78, dermstore.com). (More this way: Should You Be Using Probiotic Skin-Care Products?)
Lastly, if, like clockwork, your acne flares up right around the time you have your period, try taking 100 milligrams of vitamin B6 in the days leading up to and during it. This vitamin reduces the flare-up of breakouts because it prevents an excessive imbalance of the hormones, says Dr. Thornfeldt. Spearmint tea might help too. The minty beverage is not only anti-inflammatory and antibacterial but has also been shown to block acne-stimulating androgens. In a study done on women with polycystic ovarian syndrome, a condition marked by high androgen levels, women who drank the tea twice a day had significantly lower levels of the male hormones after one month.
Photo: Getty Images/vitapix