By Teresa Alasio MD
Did you know that June is Acne Awareness Month? Acne affects nearly 50 million Americans each year, and despite how common it is, there are still a lot of misconceptions floating around about what causes it and how to actually treat it.
It is not a hygiene problem
This is the one I most want people to hear. Acne is a medical condition, not a reflection of how well someone washes their face. It develops when hair follicles become clogged with oil and dead skin cells, creating conditions where bacteria can multiply and drive inflammation. Hormones, genetics, excess oil production, stress, certain medications, and pore-clogging skincare products all play a role. Washing more aggressively will not fix it, and it can sometimes make things worse.
Not all acne is the same
Understanding what type of acne you have actually matters for treatment. Comedonal acne, which includes blackheads and whiteheads, involves clogged pores without significant inflammation. Inflammatory acne produces the red, tender bumps most people picture when they think of a breakout. Nodular acne goes deeper, forming large painful bumps that can persist for weeks. Cystic acne is the most severe form, with deep inflamed cysts that carry a real risk of permanent scarring if left untreated. Different presentations respond to different treatments, which is why what works for your friend may do nothing for you.
Hormones are usually the biggest driver
Hormonal fluctuations are among the most common triggers I see in practice, which explains why acne shows up during puberty, around menstrual cycles, during pregnancy, and again during perimenopause and menopause. Genetics play a significant role as well. If both of your parents struggled with acne, there is a reasonable chance you will too. Stress worsens existing acne by driving up inflammatory signals in the body and influencing hormone levels, which is part of why breakouts tend to cluster around high-pressure stretches of life.
What about food?
Diet is rarely the sole cause of acne, but it does matter for some people. High-glycemic foods, the ones that spike blood sugar quickly, like sugary drinks, white bread, pastries, and heavily processed snacks, may worsen breakouts in certain individuals. Some research has also found a link between acne and dairy, particularly skim milk, though that relationship varies quite a bit from person to person. A diet built around vegetables, lean protein, healthy fats, and whole grains supports skin health in a general way, but no single food change is going to clear up acne on its own.
How to actually treat it
The right approach depends on severity and type. For mild acne, over-the-counter ingredients like salicylic acid and benzoyl peroxide are a reasonable starting point. For persistent acne, prescription options include topical retinoids, antibiotics, hormonal therapies, and in severe cases, isotretinoin. Professional treatments like chemical peels, medical-grade facials, laser therapy, and light-based devices can also improve acne and reduce scarring risk. The honest reality is that most treatments need weeks to months before you see meaningful results, so consistency matters more than intensity.
What about a quick fix before an event?
This is probably the question I hear most often. There is no overnight cure, and I say that not to be discouraging but because chasing quick fixes usually backfires. Picking or squeezing blemishes increases inflammation and raises scarring risk considerably. Spot treatments with benzoyl peroxide or salicylic acid can reduce redness and swelling to some degree. If you have a large cystic lesion before something important, a cortisone injection can bring it down quickly, and that is something a physician can do in the office. Beyond that, a personalized treatment plan will always outperform anything you find on a shelf.
The bottom line
Acne is one of the most treatable skin conditions we have, and yet people struggle with it far longer than they need to. Whether you are a teenager experiencing your first breakout or an adult who has been dealing with recurring acne for years, effective options exist. Treating it earlier reduces the risk of permanent scarring and helps patients feel comfortable in their skin again sooner. Acne is not about hygiene, willpower, or anything else you should feel embarrassed about. It is a medical condition, and like any medical condition, it deserves real evaluation and proper care.
The information presented above is for educational purposes only and not meant as a substitute for medical advice. If you have a specific medical condition that requires attention, please seek the care of your medical provider.
Dr. Teresa Alasio is a Board-Certified Medical Doctor and the Medical Director and Owner of Intentional Self Aesthetics located in downtown New Canaan. She is also a New Canaan resident and lives in town with her family.
