Acne Myths: Dermatologist Edition

Acne is one of the most common skin conditions in the world — and also one of the most misunderstood. As a board-certified dermatologist who’s treated thousands of patients, I see firsthand how misinformation can lead people down the wrong path: over-cleansing, over-treating, and overlooking the real causes behind breakouts.

Let’s unpack the science behind acne and separate the facts from fiction once and for all.

1. Understanding the Science Behind Acne

Acne isn’t about “dirty skin.” It’s a complex biological process involving the hair follicle, oil (sebaceous) glands, hormones, and inflammation. When pores become clogged with excess oil and dead skin cells, they create an environment where Cutibacterium acnes (formerly P. acnes) bacteria can thrive — leading to inflammation and visible breakouts.

Here’s what actually drives acne:

• Excess oil production: often genetically determined or hormonally influenced.
  

• Abnormal skin shedding: dead skin cells can stick together instead of shedding properly.
  

• Bacterial growth: natural skin bacteria become trapped in clogged pores.
  

• Inflammation: the body’s immune response causes redness and swelling.
  

It’s not about hygiene — it’s about biology. In fact, people who scrub too aggressively or use harsh antibacterial cleansers often worsen their acne by stripping the skin barrier, triggering even more oil production.

One of the oldest and most damaging acne myths is that acne happens because your skin is dirty. That belief blames the patient instead of explaining the process. The truth is, over-cleansing can actually make things worse.

2. Separating Fact from Fiction: Common Misconceptions

Let’s tackle some of the most common myths I hear in my practice.

Myth #1: Acne Means You’re Not Washing Enough.

False. You can’t scrub away acne. Over-washing disrupts your skin barrier and increases irritation. Cleansing twice daily with a gentle, sulfate-free formula is plenty — more than that risks damaging the skin’s microbiome.

Myth #2: Popping Pimples Helps Them Heal Faster

Also false. The truth about popping pimples is that it pushes bacteria deeper into the skin, causes inflammation, and often leads to scarring. Instead, use a spot treatment — or you can even see your dermatologist for an extraction or cortisone injection.

Myth #3: Makeup Causes Acne

Not necessarily. Can makeup cause acne? Only if it contains pore-clogging ingredients (commonly called “comedogenic” ingredients). Look for products labeled non-comedogenic and avoid heavy silicones, isopropyl myristate, and certain oils.

Remember to remove makeup gently every night — double cleansing with a gentle cleanser like GENTLCLEAN that also hydrates skin while it cleanses. 

Myth #4: All Acne is Hormonal.

This one’s tricky — because hormones do play a role, but they’re not always the root cause. Correlation is not causation. Hormones can trigger oil production, but product ingredients, diet, and stress are often just as influential. It’s important to remember how nuanced and multifaceted the root causes of acne are and stay persistent to find out what works for you. 

3. The Role of Hormones, Diet, and Skincare

Hormones and Acne: What a Dermatologist Wants You to Know

Hormones can absolutely influence acne — especially in adult women. When testosterone and other androgens rise, oil glands produce more sebum, which can clog pores and trigger inflammation. That’s why hormonal acne often shows up along the lower cheeks, jawline, and chin.

Medications like spironolactone can help regulate hormonal acne by blocking androgen receptors. It’s one of the most commonly prescribed treatments in my dermatology practice — but it’s not right for everyone.

Spironolactone is safe and effective when used appropriately, but it can sometimes cause mild side effects like dizziness, fatigue, or breast tenderness — particularly in people who already have low blood pressure or live very active lifestyles.

Patients who lift weights or train intensively may notice reduced energy or difficulty building muscle while on the medication. And since spironolactone can cause mild dehydration, it’s not ideal for athletes or people who already have low blood pressure.

If you fall into this category, talk to your dermatologist about other options — including topical treatments, gentle retinoids, or acne supplements like MINDBODYSKIN® that support hormonal balance naturally.

The Caffeine Connection

Interestingly, what we reach for to combat spironolactone’s side effects (like fatigue) can create a vicious cycle. High doses of caffeine — from coffee, pre-workout, or energy drinks — can temporarily spike testosterone levels and increase oil production.

“Anything that speeds you up can break you out,” says CLEARSTEM Co-Founder Danielle Gronich. “Caffeine and stimulants raise heat and inflammation in the body, which can make acne worse.”

That doesn’t mean you need to cut out coffee completely, but moderation matters. If you rely on multiple espresso shots or energy drinks to power through the day, it might be time to reassess your caffeine habits.

The Role of Diet and the Gut

While diet isn’t the sole cause of acne, it can contribute — particularly through inflammation and insulin spikes. Diets high in dairy or refined sugar can increase hormonal fluctuations and oil production. Supporting gut health and digestion with fiber, probiotics, and whole foods helps reduce systemic inflammation that can show up on your skin.

At the same time, it’s important not to over-restrict. Acne isn’t a punishment for eating a cupcake. It’s a reflection of multiple interconnected systems — your hormones, your microbiome, and your barrier health — all speaking to each other.

4. Evidence-Based Treatments That Actually Work

There’s no one-size-fits-all acne cure, but a few key treatments have decades of solid evidence behind them:

• Topical retinoids (like adapalene): normalize skin cell turnover and prevent clogged pores. But watch out for hidden pore-clogging ingredients, especially in the white form of tretinoin. A gel format may ultimately end up being more acne-friendly.
  

• Azelaic acid: reduces redness, bacteria, and pigmentation.
  

• Niacinamide: strengthens the skin barrier and balances oil production.
  

• Chemical exfoliants (AHAs/BHAs): remove excess buildup, revealing clearer skin. CLEARITY® is an amazing option here! 

For some patients, oral medications such as antibiotics, spironolactone, or isotretinoin (Accutane) may be appropriate — but always under medical supervision and ideally as part of a holistic plan that includes nutrition and barrier support.

The best acne treatment addresses both the internal and external factors. You can’t just treat the surface — you need to understand what’s driving the inflammation from within.

5. Expert Tips for Long-Term Acne Management

Clear skin isn’t about perfection — it’s about balance and consistency. Here’s what I recommend for long-term management:

1. Build a consistent, gentle skincare routine. Use an acne-friendly, gentle cleanser, treatment serums like CLEARITY® and CELLRENEW®, and a lightweight, non-comedogenic moisturizer like HYDRAGLOW.
   

2. Avoid harsh scrubs or over-exfoliating. More irritation equals more breakouts. Strategic use of exfoliants is important, but make sure you choose ones that are supportive of your barrier like VITAMINSCRUB, CLEARITY®, and BRIGHTMEUP.
   

3. Check your ingredient lists. Even “clean” or “natural” products can contain pore-clogging ingredients.
   

4. Support your hormones naturally. Prioritize sleep, hydration, stress management, and balanced blood sugar.
   

5. Be patient. Acne takes time to resolve — think in months, not days.
   

6. Work with professionals. Combining dermatology with acne-specialist guidance (like CLEARSTEM’s inside-out approach) ensures every root cause is addressed.

The Bottom Line

Acne is not your fault. It’s not a reflection of poor hygiene, bad habits, or personal failure. It’s a multifactorial condition that requires understanding, patience, and the right science-backed approach.

By separating fact from fiction — and treating acne from both the inside and outside — you can finally break free from the myths and find clarity in your skin and your confidence.

As a dermatologist, I’m proud to recommend CLEARSTEM to my patients as a way to help support their clearest, healthiest skin possible. Remember that everyone’s acne journey is different, and ultimately, it’s about what works best for you and your skin. 

Sometimes prescriptions are part of the solution; sometimes they aren’t. Either way, I love CLEARSTEM’s skincare and supplements to support the path to clear skin!