Western and Eastern Medicines’ Views on Acne Causes (Part I)

How to prevent acne - west vs eastPhoto from Intent Blog

Last time I mentioned that: in order to prevent acne, we need to first know what acne is and how it forms physiologically. Today we’ll be taking a further step and looking into what the causes and root causes of acne breakouts are. Well, the most exciting part of the post? I have combined both Western and Eastern Medicines’ perspectives to present to you here a more holistic and in-depth picture on acne causes. Considering I would like to share with you information as complete as possible, I have divided the very long post into two parts. Here is the first part: Dermatologists Explaining Acne Causes.

While no one can exactly figure out what causes pores and follicles to overproduce skin cells and become clogged, from the Western Medicines’ stand point, below are 10 factors that dermatologists believe have demonstrated links to increased acne breakouts.

Dermatologists Explaining Acne Causes

1. Hormones

Hormones are a major reason for acne breakouts. They can cause overproduction of sebum (oil) in the oil glands and accumulation of follicle lining cells, which, in return, creates a favorable environment for acne-causing bacteria to start growing. In particular, androgen, a male hormone found in both men and women, can commonly lead to breakouts when overproduced.

2. Diets

At this point, if you are still unconvinced by the negative influence of a poor diet on your skin health, here is a response for you to re-consider: “the reality of the matter is that diet absolutely matters when it comes to having clear skin”, a statement strongly held by Dr. Howard Murad, a leading visionary in health, wellness and dermatology and founder of the Inclusive Health movement (I found that the vision behind this movement is very fascinating, as it incorporates a holistic view that touches every aspect of life to restore and maintain great skin, and to improve health from the cellular level). Also, I have written a post earlier showing my very own strong belief that diets do affect skin health, which I highly recommend you go visit.

“Clear skin is healthy skin and the health of your skin is dependent on the health of your body overall.” – Dr. Howard Murad Team

3. Chemicals in the nervous system

According to The Clear Skin Diet, new research has found out that chemicals derived from the nervous system can also innervate the sebaceous glands and promote oil production. Substance P, most well-known a chemical that promotes pain in the body, is a nervous system chemical recently noted to promote sebum production. This chemical could also potentially cause depression and anxiety, which are key toxicities that promote acne breakouts.

4. Cultural stress

As mentioned above, nerves release a chemical called substance P, which stimulates sebum production. Interestingly, psychological stress and anxiety are associated with enhanced substance P release; on other hand, relaxation therapies can decrease substance P levels, according to Logan and Treloar, co-authors of The Clear Skin Diet. Worse still, stress can cause the follicle walls to weaken and burst, which ultimately leads to inflammation acne. It can also trigger the overproduction of androgen – the root cause of hormonal acne – in the adrenal gland.

5. Toxins and pollutants from external environment and personal care products

Environmental factors also have a direct impact on our skin’s overall health, which can potentially lead to acne and blemishes. For example, the absorption of unnatural substances like cigarette smoke and chemicals increases the chances of acne breakouts. Speaking of chemicals, I immediately relate to Environmental Working Group (EGW)’s New Year Resolution on asking manufacturers to remove chemicals from cosmetics which could disrupt our hormonal system (if interested, check out News No. 3 at my latest “Tracy’s Pick of the Week” for you!).

6. Makeup

Makeup can oftentimes contribute to acne breakouts as well, otherwise there wouldn’t be a medical name specifically created for this type of cause – Acne Cometica. There are two ways that using the wrong makeup can hurt our skin. The first is by causing reaction that irritates the skin, breaking down the follicles and triggering inflammatory acne. The second occurs when makeup isn’t removed properly, which leads to clogged pores and creates a breeding ground for acne-causing bacteria.

7. Skincare products and routines

Then, let’s turn to skincare products and routines. Using the wrong skincare products or following an improper skincare routine can also be another cause of breakouts. For example, harsh ingredients may irritate or even dry-out the skin. When the skin gets too dry, it naturally produces more oil to compensate. For people who already have oily and acne-prone skin, overproduction of oil can only worsen the skin problems. In the meantime, harsh skin care routines like overly scrubbing the face can aggregate skin irritation and worse breakouts.

8. Medication

Next, have you ever considered there can be triggers in your medicine cabinet that cause acne breakouts? No? Then maybe you should start to be more aware of that from now on.

Steroids found in the prescription drugs are a key offender, either taken internally or topically. Here comes Dr. Fusco teaching us how to recognize different types of steroids and educating us on the danger of overusing both types. Steroids will be listed as prednisone (a tablet form) when taken internally. This is used to treat a variety of inflammatory disorders such allergies and arthritis. If used topically, steroids are known as cortisone (prescription) and hydrocortisone (over-the-counter). “If either form is overused – and I stress overused because just a few application won’t do it – it could aggregate or cause a ‘’steroid acne,” Dr. Fusco says.

Other ingredients to watch out for include: lithium, lithium chloride, and certain forms of iodine. Dr. Fusco advises us to check out if acne is listed as a side effect, if we are taking any form of medication.

Based on her medical practice, Dr. Fusco mentions taking oral contraceptives is the most common cause of acne. Even though taking birth control pills are known to improve skin conditions, the change in hormone levels takes time for the body to adjust to the sudden interruption and balance itself (that’s right – natural healing takes time). Here comes an astonishing message (at least for me): when starting or stopping the pills, it could take up to six months for related acne to appear!

“Whenever there is a change in hormone levels in the your body – even if it’s for the better – it’s a change that can result in breakouts.” – Women’s Health Magazine advised by Dr. Francesca Fusco, M.D., dermatologist and member of the Women’s Health advisory board

9. Daily life habits

Additionally, tidbits of daily life habits can also be hidden triggers to acne breakouts. In general, anything that is directly exposed to our skin can be a trigger.

For example, have you encountered a situation where you couldn’t help but touch your face relentlessly specially on areas where breakouts occur (okay, I have to confess: I used to do that very often)? If yes, we should all make a very firm decision of not doing so ever again. Dr. Fusco advises that we avoid touching our face at all costs – even after we wash our hands. She says, “touching can inflame the skin, and if you’re touching the same area, you might get an increase in oil production, so it’s three-pronged: it’s the bacteria, the inflammation, and the increase production in oil”.

10. Environmental change/traveling

Changes in environment – humidity, weather, and even minerals or fluoride in the water – can also trigger breakouts. In my blog on acne cleanse diet recommendations for the winter, I mentioned that one reason that I suddenly had severe acne breakouts after I landed in Boston can be me moving from my hometown, an evergreen subtropical city in China, to New England.

This seems to be sad since it is probably what we have little control over. But at the very least, we still can try our best to follow foods and nutrition tips, skincare tips and lifestyles tips for acne-prone skin (we should always focus our time and energy on things we have control over)! Also, when we do short-term travels, we can try washing our face with bottled water when we can and avoid using hotel soaps if we think they are too drying (some hotels actually offer pretty high-quality soaps).

I hope this gives you enough information to start assessing the reasons that cause your acne. As you see, there are multi-facted reasons behind acne breakouts. It can be what foods you eat, what products you use, what personal habits you’ve developed, what new environments you’ve encountered (if any), and even what emotions you are experiencing.  What is more interesting; it can also be a sign of dysfunction in one of the organs inside you. Why so? Well, stay tuned for my next post to see how Traditional Chinese Medicine explains it for us.

Based on the knowledge of this post, what do you think is the primary reason for your acne breakouts? Please share your comments below!


What the Heck is Acne? Here is How It Forms.

Western and Eastern Medicines’ Views on Acne Causes (Part II)


  1. “Causes of Acne” by Murad Acne Resource Center
  2. Women’s Health Magazine
  3. Acne.org
  4. US News Health
  5. Book: The Clear Skin Diet



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