There is almost nothing worse than acne. It doesn’t matter if you suffer from regular acne or just the occasional breakout, it’s the worst. There are hundreds of products promising to give you beautiful clear skin, but it seems impossible to know what to trust. To take the guesswork out of preventing acne, we turned to Neutrogena and their expert, Toronto dermatologist, Dr. Paul Cohen.

Q: There are a lot of rumours and tales on what causes acne, but what are the actual most common causes of acne?

A: There are many different factors that can cause acne – hormones, genetics, bacteria, poor skin barrier function. Recent research also says diet can even have an impact. It’s a multi-factorial skin condition. Acne is primarily a hormonal condition driven by male hormones. Sensitivity to such hormones, combined with bacteria on the skin, and fatty acids within oil glands, cause acne. Simply explained – skin cells, sebum and hair can clump together into a plug in your pores; this plug gets infected with bacteria, resulting in a swelling. A pimple starts to develop when the plug begins to break down. Sometimes, p. acnes, the bacteria that live on our skin, also gets inside the clogged pore. Inside the pore, the bacteria have a perfect environment for multiplying very quickly and the pore becomes red and swollen. If the inflammation goes deep into the skin, an acne cyst or nodule can appear. Common sites for acne are the face, chest, shoulders, and back — the sites of oil glands. Up to 90% of people will suffer from acne at some point within their lifetime.

Q: Outside of skincare, are there lifestyle changes that people with acne should take?

A: I would say diet is important. The thoughts on this connection have really changed over the years. In the past, we were told that we should stay away from chocolate to avoid acne. Then that connection was disproved and the school of thought changed, saying food was not a factor. Now, we know that diet does affect breakouts from recent research. Specifically milk and dairy products, especially in women, have been recently proven to have a direct correlation. High sugar levels have also been noted as a factor, as they cause insulin levels to spike and cause a shift in hormones to regulate, and also foods with high-glycemic content.

Q: Are there different ways to treat different types of acne?

A: There are different types of pimples but they all start with plugged-up pores. Different medications or treatments may be used to treat the different types of acne, but all in all, it all starts the same. I tell all of my patients that using proper hygiene and the right treatment for your skin should help your skin.

Proper hygiene for acne-prone skin includes washing your face about twice each day. Use a mild soap made especially for people with acne, and warm water. Do not scrub the skin. Don’t try to burst the pimples. You may push the infection further down, causing more blocking and worse swelling and redness. Popping pimples makes scarring more likely. I also ask them to try to refrain from touching their face with their hands – it spreads dirt and bacteria that can aggravate acne.

Q: Moving into winter, are there any changes that people with acne should make to their skincare routine?

A: Alter your skincare routine for the cold weather – your skin changes with the seasons, so your skincare routine should as well! Use a milder cleanser, I usually recommend a liquid cleanser. Cleansers containing salicylic acid and benzoyl peroxide can be particularly drying, especially if you are using them in conjunction with other acne treatment products. You can go back to an acne-fighting cleanser once your skin doesn’t feel as dry. Instead, try using a gentle foaming cleanser.

If your skin is feeling very dry, you may want to scale back use of your acne creams and treatments. Try using your treatment products every other day until the dryness and flaking lessens.

Regular use of a moisturizer is important, even for those with acne. Remember, nearly all acne treatment products dry the skin to some extent. Choose a moisturizing gel or lotion because they are lighter than products labeled cream. Whatever moisturizer you choose, be sure it is marked non-comedogenic and oil-free.

Stay tuned for next week when we talk to Dr. Cohen about what you should look for in your cleanser to fight acne!