Reality Facial blemishes are not caused by dirt.1 Contrary to what you may have seen in commercials, pores do not get blocked from the top down due to "impurities." Rather, the walls of a pore stick together deep within the skin, starting acne formation. Far from preventing acne, frequent washing actually irritates pores, which can cause them to become clogged. A washcloth or any other cleansing device can add even more irritation. The best bet is to wash very gently with bare hands and only wash twice a day.2
Reality Stress can affect hormones and can theoretically promote acne. However, an effective acne treatment regimen is more powerful than a bout of stress any day. Some psychiatric medications, notably lithium, which is often prescribed for bipolar disorder, may have acne as a side effect but stress itself is no big deal.3 Your time is better spent determining the right course of acne treatment rather than feeling guilt about stress.1,4
Reality This antiquated notion, originating as early as the 17th century to discourage young people from having premarital sex, is not based on scientific evidence.
Reality 10-20 minutes per day of sun exposure for people with lighter skin and 20-30 minutes per day for people with darker skin may prove beneficial for acne symptoms, especially body acne. However, overly exposing your skin to the sun creates skin damage, which leaves the skin irritated. This irritation can result in more acne in the weeks following over exposure as the skin heals itself. If you notice a break out "out of the blue," ask yourself if you got sunburnt about two weeks ago. That may be the cause.1-2,5 Don’t be afraid of the sun but try not to get burnt.
Reality Available scientific evidence does not yet support a compelling case for a diet and acne connection. The bottom line is we need more research. We do know that people in some hunter/gatherer societies do not experience acne whatsoever across the entire population. This is in stark contrast to the widespread presence of acne throughout all modern society. It leaves us to ponder whether the indigenous people's unprocessed diet contributes to their acne-free skin or whether their clear skin is a result of genetics or some other factor. Discovering a dietary way of preventing acne may be a future reality. However, we may live so differently from our ancestors that it has become close to impossible to replicate our ancestral diet.1-2,6-8. Note: If you feel that you have cleared your acne using a particular diet or if you are planning on attempting a diet of some kind, please post your method on the Nutrition & holistic health forum. Keep in mind that almost any diet will appear to work in the short term because as your body loses weight, insulin and other hormones react and acne tends to recede. Then, as body weight levels out or increases, acne symptoms tend to return. Any legitimately effective anti-acne diet should continue working after the initial weight loss period.
Reality So many adults now experience acne that some dermatologists refer to it as an “adult acne epidemic.” Exactly why this occurs is unknown but 50% of adult men and 25% of adult women now experience adult acne at some point.9-11 The good news is that it is treated the same way in an adult as in a teen.
Reality Accutane (isotretinoin) provides long-term remission of acne symptoms in approximately 2/3 of people who take an adequate dosage (1mg/kg).12-15 Since “cure” is defined as “a complete or permanent solution or remedy,” a strong case can be made that isotretinoin provides a cure for many people. However, since isotretinoin comes with such severe side effects, it is essential that anyone considering the drug enter into a careful decision-making process alongside a trusted physician.
Reality If you search online, the vast majority of medical sources specifically warn against popping a pimple. However, this advice is never based on scientific evidence. While it is commonly agreed that attempting to pop pimples which are not yet ready and do not have a white or yellow center can cause the pimple to become more severe and potentially scar more severely, popping a zit which is ready and does in fact have a white or yellow center can actually eliminate the infection and initiate healing. Popping must be performed correctly to achieve the best result. Also, it is vital that popping never be combined with picking of the skin. Countless plastic surgeons who specialize in acne scar correction will tell you that picking the skin causes as much or more scarring than the initial acne lesion itself.
Reality It is best to leave acne-prone skin relatively untouched. However, this is not because touching the skin moves bacteria around. Bacteria on the surface of your skin has nothing to do with acne. It is the bacteria deep within your pores (Propionibacterium acnes) that are part of the acne formation process. The reason it is important to leave your skin relatively untouched is because physically irritating the skin can cause breakouts and not because you are moving bacteria around.
Reality Even though acne is the #1 reason people see dermatologists, this does not mean that a dermatologist is a specialist in acne unless he/she specifically decided to focus his/her practice on this area. Becoming a dermatologist requires a person to study and understand a huge list of skin diseases, and acne is simply one of many. It is important that an acne sufferer be his own advocate when it comes to acne and learn everything he can about available treatments before speaking with a dermatologist to prevent a revolving door of prescriptions which very often do not provide adequate clearing of the skin.