Why do movies and rock stars or famous people never seem to have acne? What are their acne free secrets?

If we ever think they will never have acne, we are absolutely wrong. They are just like you and I, may get affected by acne as acne is a disfiguring condition that can affect anyone of any age, gender or ethnicity at any time.

The reasons why they don’t seem to have acne are:

1. They wear a lot of makeup; or
2. They see their dermatologists often.

But most importantly, they know how important it is to keep their skin looking good and to follow a rigorous skin care routine to better take care of their skin.

Why does my acne get better or worse when I go in the sun or tanning salon?

Basically, sun exposure has a drying effect on our skin and cause damages to the sebaceous gland (i.e. oil-producing glands located in the deeper layers of our skin, and are attached to the hair follicle) to make them temporarily less active. For this reason, people with overactive sebaceous glands may find their skin gets initially better after sun exposure. For some people, especially those with inflammatory acne (such as papules, pustules and cysts), there usually a dramatic improvement in their skin over the summer, when the days are longer or when they spend more time outdoors, or after sun exposure. This is actually due to ingredients called porphyrins that are part of the P. acnes (i.e. short for Propionibacterium acnes, a bacterium that grows and flourishes under certain condition and is the main culprit for inflammatory acne) bacteria which are very sensitive to sunlight, especially in the 410-420 nm wavelength of light.

However, the heat and sweating that often accompany sun exposure can actually make acne worse for some people. In fact, the types of ultraviolet radiation of concern to our skin are the invisible ultraviolet A and ultraviolet B (i.e. UVA and UVB for short, in natural sunlight there is 90% UVA of 320-400 nm wavelength and 10% UVB of 290-320 nm wavelength of light). These invisible ultraviolet is damaging to our skin in many ways, i.e. cause various types of skin cancer, and noted to make acne worse and known to be comedogenic (i.e. induce open or closed comedones to form).

If you are like some people thinking that tanning salons is a safe way to get the effect of "sun" and to better treat your acne, you got to think twice. In fact, tanning beds contain the same ultraviolet radiation found in natural sunlight (as mentioned above) but with a higher amount of ultraviolet A and less ultraviolet B than in natural sunlight.

Studies have shown that prolonged exposure to ultraviolet light may actually increase comedonal acne (i.e. mostly blackheads and whiteheads) and that tanning beds are not safe. In fact, chronic sun exposure from any source can increase our risk of skin cancer, premature aging and immunosuppressive to the skin and slows our wound healing process. The result is that, our collagen (i.e. the main protein in the deeper layers of our skin and is responsible for the elasticity of the skin and plays a prominent role in development of scars) formation gets affected, i.e. the marks left behind from any healing lesions will take longer to disappear and will even have a higher chance of leaving a permanent scar (including acne scars).

Therefore, it is advisable to avoid excessive sun exposure in general and tanning beds in particular, especially if we have acne. Studies have shown that this is the best way to keep our skin to look younger, more healthy, and radiant. Still like the look of a suntan? Then, try those sunless tanning products that usually offer a quick, easy way to get the color of a suntan we want without the sun damage, i.e. safe to help us have a very natural-looking "tan" without the damage of sun exposure.

In general, the active ingredient in sunless tanners is DHA (i.e. short for dihydroxyacetone, a simple nontoxic ingredient that stains the upper layers of our skin to create brown or golden brown compounds) and most of the self-tanners have concentrations of between 2% and 5% of DHA. Other ingredients that may be added in shall include sunscreen and fragrance to make the products more enticing.

Does stress cause and affect acne?

Research has shown that stress does not directly cause acne but it does affect acne and is one of the factors that make acne worse. To have a complete view of what causes acne, please visit this page.

Believe you have notice that when we are under stress, we tend to do things or reacted to stress differently, i.e. getting angry more easily, picking at our skin more, sleep less, lose hair, get migraines, eat different foods such as foods higher in fat and sugar and so on.

Basically, in times of stress, our body will release hormones of what we called cortisols. These hormones indeed are very helpful in helping us survive life-threatening situations and are known as the "fight or flight" reactions. The released of these hormones puts our body on high alert, i.e. our palms sweat, our heart rate increases, and all of our energy becomes available in one blast to get us through the immediate, threatening stressor. Believe you will agree that this is fine and even necessary, especially in situations where what happened was a matter of life or death. However, when it comes to stressors, chances are that we received more than what we should to see us through, i.e. our body release cortisols whether in respond to a meeting, a date or any other perceived bad or good factors.

Hence the longer-term effects of increased cortisols are suppression of our immune system (i.e. a collection of cells and structures in our body that fight disease or infection, for example, white blood cells, lymph nodes, and lymph vessels are the primary components of the immune system) and of course, acne, as the P. acnes (i.e. short for Propionibacterium acnes, a bacterium that grows and flourishes under certain condition, such as that of very low or no oxygen concentration and is the main culprit for inflammatory acne) bacteria tend to flourish in depressed immune state.

What is the solution then? Since stress can make our acne condition worse, the best solution will be to learn something that helps us to manage our stress well. From the acne clear and acne care perspective, proper stress management not only help to keep our skin clear through its profound effects in the treatment of acne, it also helps in every part of our life, i.e. clear our body and our mind.

A simple technique that we may want to try is to slowly take in a deep breath, hold it for 5 seconds, and then slowly breathe out. As we slowly exhale, let and feel our entire body relax with the positive energy return to our body. This technique is very useful before a big meeting or in the middle of an exam or even on a long night of studying. Try it and see whether it does wonder for you.

Can my sunscreen make me break out?

This is another myth that most people think sunscreens can cause acne. Studies showed that those who have break out after using sunscreens are because of having irritant reaction to the sunscreen or to the sun. These types of rashes can have the red bumps that look just like acne but don't typically improve with acne medications. It is recommended to avoid the irritant, whether it is due to the sun or the products with which we have reacted.

Sometimes, the break out could be due to how the sunscreen was prepared, i.e. either too greasy or occlusive and not the active ingredient of the sunscreen itself. If that is the case, a different choice of sunscreen preparation should be used, hence, if we are using a cream, switch to a lotion and if we are using a lotion, try a gel. The good news is that sunscreens are also available in oil-free preparation for those with especially oily or acne-prone skin.

For younger with oilier skin, it is recommended to use a sunscreen in a gel formulation as the gel will dry more quickly and will not run into the eyes, this is especially useful for those who are more physically active and sweating more.

In fact, there are many wonderful SPF-tinted moisturizers that can help us to conceal the acne while protecting us from the sun. It is noted that many new combination of preparations of sunscreen and acne treatment products are available in the market, in short, there are always something for everyone.

Does makeup cause acne?

If the makeup is kind of greasy and thick cosmetics that alter the cells of the follicles and make them stick together more easily, this will help produce a plug that is the beginning step in the onset of a pimple, i.e. first step in all types of acne.

Also cosmetics that contain certain oils, such as mineral oil will leave our skin shiny and can be aggravating to acne. Usually oils that are problematic are those that are produced by our sebaceous glands (i.e. oil-producing glands located in the deeper layers of our skin and are attached to the hair follicles. The oil produced will travel up the follicle and end up on the surface of our skin. You may want to view here for the structure of human skin). In contrast, certain oils, fats or lipids that are naturally found in our skin will help our skin function as an effective barrier to block bacteria from penetrating our skin, prevent water loss from our skin as well as improving water retention within the skin to keep it looking healthy and supple.

Usually those products that do not aggravate acne are labeled as non-comedogenic or non-acnegenic (i.e. will not induce inflammatory lesions such as papules and pustules to form, usually within 2 to 3 days of using the product). Unfortunately, the exact comedogenic (i.e. that can induce open or closed comedones to form) potential of any product is not known as it is simply too difficult to take into account all of the interactions with all the individual comedogenic and noncomedogenic ingredients included in the final mixture of those products. In short, results are not guaranteed to be consistent; hence, knowing the ingredients and the physical characteristics (such as the density and oiliness) is not enough to help us make an accurate predication about whether a product will be acnegenic. Also, the unscrupulous practices that cosmetics do not contain comedogenic agents are not guaranteed to be noncomedogenic.

Points for reference:

• We have to look at our own skin and see how our skin toleration with certain products.
  
  
• A big and continuing trend toward oil-free everything exists as a way to prevent acne; however, different kinds of "oils" can be found in products that may or may not have an effect to acne.
  
  
• Many of the acne-control products available are in many ways sebaceous oil-control products.
  
  
• Since acne treatments are usually drying or otherwise irritating to the skin, a more emollient or creamier moisturizer may be needed especially in the evening before bed because water loss from the skin is increased at night while we are sleeping.
  
  
• For acne-prone people, try to keep thing simple by choosing products that have 10 or fewer ingredients. In choosing foundations, look for loose powders since they help absorb excess oil from the skin. If we use a liquid foundation, try to look for ones that are silicone (dimethicone, cyclomethicone) based since this ingredient sits very smoothly on the skin and is nongreasy, nonacnegenic and noncomedogenic. It is good to avoid cosmetics that contain D&C red dyes as they are highly comedogenic, though it can be difficult to find the right blush without D&C red dyes.
  
  
• A product which is labeled as "natural" does not mean it will do well for our skin. Remember that the word natural is largely undefined and unregulated, and even products that are labeled "all-natural" may include ingredients that are comedogenic and acnegenic.

Does exercise affect acne?

It is unclear the exact effect exercise has on bringing out acne, however, it was reported that some people notice their acne got worse after exercise, especially on their back.

The reason it happened is believed to be a combination of factors, i.e. increased sweat combined with sticky surface skin cells that lead to blockage of our pores, or the heat combined with friction that activates the P. acnes bacteria. Another possibility is that exercise, heat and sweat lead to the increased in activity of our sebaceous glands (i.e. oil-producing glands located in the deeper layers of our skin, you may want to view the structure of human skin here) that are attached to our hair follicles and are especially prominent on our face and upper back. It is noted that the sebum (i.e. oil) produced by the sebaceous glands is food for the P. acnes bacteria that live at the base of the follicles. Further, the increased food supply will eventually lead to more active P. acnes with the end result of more acne.

The suggested solution is to apply acne treatment medications before our workout and to shower immediately after the workout. The acne that occur is mostly inflammatory type of acne (i.e. a class of acne where the main lesions are papules and pustules but not comedones), hence, topical acne antibiotics are helpful, especially when used along with a topical BP (i.e. short for benzoyl peroxide, a commonly used topical acne antiseptic, which does not induce bacterial resistance). However, we must careful with the leave-on topical BPs because they are known to cause bleaching of fabrics and can ruin our workout clothing. Alternatively, we could try using BP and/or salicylic acid cleansers after the workout.

Can greasy food or any food cause or make acne worse?

As with chocolate, studies have not been able to show any association between acne flares and greasy foods. However, it does seem that all of the foods implicated in causing acne are tasty, e.g. chocolate, nuts, soda, candy, fried foods and orange juice.

The reality is that there is no scientific evidence available to show that high-carbohydrate and/or fat intake has any effect on human sebum production or acne. True to be believed, there are so many factors that can actually cause acne to get worse. In short, it is very difficult to isolate a single factor and prove that it does or does not affect this condition.

Nevertheless, many do believe that certain situations or stressors that make those foods more tempting or harder to resist at any given time may be the ultimate culprit for acne flares. As such, if we feel that a certain food makes our acne worse, the best we could do is to avoid that food.

Anyhow, we certainly will not become malnourished from giving up those high-fat, high-carbohydrate junk food or most of the foods that people most commonly complain of as being a cause of acne flares, right?

However, one ingredient that will definitely make our acne worse, if eaten in large enough quantities, is iodine. Therefore watch out for eating large volume of foods like seaweed and other seafood which are high in iodine.

Do medications cause acne?

Sadly to say that there is a long list of medications that list acne as a possible side effect.

Does this mean that we should never take these medications if our physician prescribes them? The correct way should be to discuss our concerns regarding this side effect and to get the physician to consider alternate treatments if the medications seriously affect our acne condition.

Basically, acne caused from medications is similar to acne from other causes, hence should be treated with the same. However, it may take longer to gain control of the acne that arises from medications.

What follows are medications that may aggravate our acne condition:

• Antipsychotic medications
• Corticosteroids (i.e. a group of anti-inflammatory drugs often used to inhibit allergic reactions or to treat severe inflammation)
• Dilantin
• Estrogens (i.e. female sex hormone)
• Isoniazid
• Lithium (i.e. a chemical element often used as mood stabilizer)
• Potassium iodide
• Quinine
• Testosterone (i.e. a male sex hormone)

Does dirty skin make acne worse?

The answer to this common myth is a big No. Dirt does not cause blackheads and other acne lesions but poor skin hygiene does. On the other hand, over-washing can actually do more harm to our skin.

In fact, using drying, harsh soaps on our skin on a regular basis can strip away our skin's natural, healthy barrier and leave it more vulnerable to infection and irritation. Worst still, it leave our skin red and may cause a rash that mimics acne.

The important of proper skin hygiene is that it not only helps control our acne from the acne clear and acne care perspective by working from the outside to help reduce buildup of skin cells around the pores, it actually helps to keep our skin healthy and looking its best even at the deeper layers.

It is advisable to choose a soap-free cleanser for our acne face. Unlike soap, soap-free cleanser does not contain “sur­factants,” (i.e. chemicals that are often used in soaps and detergents to lower the surface tension of a liquid to allow for easy spreading) which give the soap its marvelous lather. But the problem is that they often remove more oils than we need to have removed.

Instead, we should use a gentle exfoliating cleanser at night to remove the dirt (which shall include makeup too). When comes to the morning, it is better for us to use a gentle soap-free cleanser, one that may not even create any lather and then followed by our usual morning routine of sun­screen as well as other regimen that we may follow.

How can I have acne at my age?

One of the greatest myths about acne is that it happens only in teenagers and that if we can get through those years we are home free. The reality is that acne in adults is a very common occurrence and needs to be addressed too. Why is it so? It is because the hormonal influences sometimes don’t take effect until later in teenage years or even later into our 20s or 30s or even later in our life.

Also, for those in whom the hormones have an early effect during their adolescence, there is no guarantee that the hormones responsible will slow down or have less of an influence over time. This is because there simply have many other factors that may affect us over time, such as work, family, relationships and other issues for acne to persist for many many years.

As for acne distribution, there is quite a different between teens, preteens and adults. In teens and preteens, acne starts as mostly comedones in the central area of the face, i.e. the forehead, nose, and cheeks. For adult, the acne tends to center more on the lower part of the face, around the chin, and along the jaw line and is more common in women than in men. Also, women will often find more difficult to control because their skin in this area is often more sensitive, hence more easily irritated from the often drying medications used in acne clear and acne care products.

For women, they also need to consider whether they are currently pregnant or planning pregnancy in the near future when considering different acne treatment options, this is because some medications should be avoided due to their potential side effects and the risks involved. Often, women may find that starting an oral contraceptive pill is the best therapy, sometimes to the point where they don't need any or at worst very minimum topical acne treatments.

Does chocolate cause acne?

Despite there are myths exist about foods such as chocolate that cause acne, so far no studies have been able to show to that effect. In fact, what effect foods seem to have on either the development or the course of acne in most people remains unclear.

In a study looking at the possible effects of chocolate on acne, the result showed that chocolate had no major effect on most patients, i.e. a mixed result with some patients reported to say it made their acne worse, while some reported it made their acne better. However, for those who feel eating chocolate made their acne flares, it could be due to an overlap of condition that look like acne which we called rosacea.

If we are not convinced that chocolate has no effect on acne break out, the best acne care and acne clear solution would be not to eat the chocolate.

Should I use only oil-free products on my acne prone skin?

We may not aware that those oil-free products will try to avoid ingredients that contain the word "oil" in their name, for instance "mineral oil." On the same note, there are also plenty of ingredients that do not have the word "oil" in their name, e.g. glyceryl tribehenate or lanolin. However, ingredients such as carnauba and oily hydrocarbons such as petrolatum and squalene although they are not oils but should not be included in an oil-free product.

Generally, oil-free products can be divided into two groups. The first group contains strictly oil-free products, which are usually drying though there are some excellent exceptions, i.e. glycerin, propylene glycol and silicone bases which are not oils and are not drying. Usually strictly oil free products are used to complement topical acne therapy for people with acne condition that is resistant to treatment. These shall include solutions, gels as well as emulsions of oil-free ingredients. In fact, ingredients such as fatty acids, fatty alcohols, sterols, and silicones are acceptable in a strictly oil-free preparation.

The second is made up of borderline oil-free products called esters (i.e. oil-like emollients that may found in skin care products). It is good to know that, many of the ingredients that have been classified as comedogenic (i.e. products that induce open or closed comedones to form) are emollient esters. Also oil-free emulsions of emollient esters and water are kind of weak moisturizer which is best to be used by people with slightly oily to slightly dry skin.

Another thing to note is that powders are used to absorb water and oil, and many of them have been modified to be less drying and more cosmetically acceptable for people with a wider range of skin issues.