Acne triggers: what flares up acne?

A trigger (things which can irritate and make acne worse) for one person’s acne may not be a trigger for another person’s. In general, anything that can make the skin produce more oils can be a trigger for an acne flare-up. Ollie and Tom heard that stress was an acne trigger but didn’t think it had been the case for them personally. Shu En finds that doing sports makes her acne worse, but Becky thinks it helps her skin to ’empty out’ blocked pores.

Working out your own triggers for acne can be ‘trial-and-error’. Ish says it took eight years for him to work out his acne triggers, like stress, and the importance of developing a skin care routine. Deborah will ‘work backwards to see what could have caused’ a particular break-out. Trying lots of different beauty and cosmetic products, including face washes, could be time-consuming and expensive. Sarah cut out gluten and milk from her diet but didn’t find any difference to her acne. Some people said there were triggers they knew of, but break-outs could still happen unexpectedly. Hester and Becky talked about times when their acne got worse for no obvious reason.

Tom finds it unclear and confusing with working out acne triggers.

Age at interview 15

Gender Male

Age at diagnosis 15

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The main examples of triggers were:

Molly and Deborah noticed a cycle between acne and stress: stress triggered acne, which created stress and led to more acne. Becky worries others will think she studies ‘too hard’ because of her acne. Shu En thinks that living independently can be a source of stress on a daily basis.

Marga thinks the interaction of stress, eczema and diet might impact her acne.

Age at interview 24

Gender Female

Age at diagnosis 18

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  • foods and drinks – some foods were seen as ‘bad’ for acne, especially those which are ‘sugary’, ‘fatty’, ‘oily’, ‘greasy’ or fried;

Spicy food was also a trigger for Yi. Harriet, Molly and Marga had all tried cutting dairy out. Chocolate (or particular brands of chocolate) was a trigger for Becky, Ish, Eli and Deborah. Alcohol can be a trigger, as for Harriet with wine and cider. Some people thought being dehydrated (not drinking enough water) added to their acne. Others, like Shu En, were unsure if diet made any real difference to their acne. A few people said they would rather enjoy foods like pizza than miss out on them, even if it meant having more spots.

Becky shares her experiences with food triggers and drinking water.

Age at interview 19

Gender Female

Age at diagnosis 16

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Molly finds it challenging adjusting her diet to work out food triggers for her acne.

Age at interview 20

Gender Female

Age at diagnosis 11

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  • weather/environment – some people found cold weather made their acne worse, but others said the opposite;

Lots of people thought sunshine helped and Alexandra said she also feels better with a slight tan. However, others found that hot and/or humid climates made their skin sweaty and more prone to spots, so they preferred cold and dry weather. Many said finding a sunscreen which didn’t irritate their acne was difficult but important. Other aspects of the environment include: air quality (Becky and Deborah both found ‘polluted’ air worse for their skins), air conditioning (which Deborah noticed was a problem with air flights), water quality (based on mineral content) and water type (sea water helped Naomi’s acne but made Kosta’s worse). Moving to a new city or country triggered flare-ups for Marga and Deborah.

Yi talks about the impact of the weather on her acne.

Age at interview 23

Gender Female

Age at diagnosis 14

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Molly thinks her acne is affected by water quality.

Age at interview 20

Gender Female

Age at diagnosis 11

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Some people believed makeup did make acne worse, but others rejected this idea. Yi thinks makeup means that her ‘skin cannot breathe’ and Molly worried it might ‘clog’ her pores. Others disagreed that makeup affected their acne and found it upsetting when people implied it was the case. Some people looked for special products which were ‘anti-blemish’, contained ingredients like tea-tree or were labelled as ‘non-comedogenic’. Rebecca’s GP prescribed her an oil-free moisturiser as she had found previous ones triggered her acne.

Emma prefers to remove her make-up before going to sleep, which can impact on her social life and hobbies.

Age at interview 20

Gender Female

Age at diagnosis 10

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Ish is careful about cosmetic and body care products he uses.

Age at interview 22

Gender Male

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Eli thinks wearing make-up worsens her acne.

Age at interview 13

Gender Female

Age at diagnosis 11

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Marga disagrees that make-up triggers her acne and instead highlights how it helps her feel more confident.

Age at interview 24

Gender Female

Age at diagnosis 18

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Other things mentioned as triggers were:

  • being tired/not getting enough sleep
  • scratching acne – when asleep (Eli), anxious or sweaty (Kosta), or bored (Hester)
  • having hair touching your face – Ollie and Abbie changed their hairstyles to stop this
  • shaving facial hair
  • fabrics – polyester bed sheets once caused Deborah’s acne to flare-up

Many people thought their acne was probably triggered by a combination of things so it wasn’t always obvious what prompted a flare-up. Triggers can be unavoidable, as for Sarah who found that ‘simply going outside seems to make [my acne] quite a bit redder’. Marga, Tom and Becky tried to strike a balance with food triggers – sometimes having a particular ingredient, but not very often or in small quantities. Becky explained, ‘I don’t think that chocolate is a main reason for causing me acnes. So if I completely quit eating chocolate, which is my favourite, it just reduces a lot of fun in my life’.

Becky found that moving to the UK impacted her acne in terms of climate and diet.

Age at interview 19

Gender Female

Age at diagnosis 16

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Naomi thinks there are several factors which might explain why her acne clears up whilst on holiday.

Age at interview 22

Gender Female

Age at diagnosis 9

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