The cause of acne in unknown

All of a sudden, you have a zit to zap. A pimple to pop. How, you wonder, did it get there? What went so wrong that your once flawless skin is covered with a red spot or two or three? Blame your yoga mat. Or your cell phone. Or even that pretty new shade of eyeliner you've been wearing. "Acne is a complex medical condition caused by four factors: hormones, inflammation, bacteria, and dead skin cells that clog pores," says dermatologist Jessica Krant, founder of the Art of Dermatology practice in New York. Triggers include "stress, poor sleep, and dietary choices. For some people, chocolate really does cause breakouts; for others, it's greasy foods, or a diet heavy in dairy."

And that's just the beginning of the list. Be alert to these often-sneaky causes of acne:


Makeup

Zit-causing ingredients could be lurking on your beauty shelf. Unlike most prescriptions, however, you do have control over what you put on your face and hair.

Acne caused by topical creams, lotions, and makeup is known as Acne Cosmetica, and is most common on the face, neck, hairline, and scalp.

If you regularly apply a product to an acne-prone area, it’s possible that it's doing more harm than good. Products that contain mineral oil clog pores, so switch to brands labeled non-comedogenic, which are oil-free, don't strip skin of necessary moisture and nutrients, and don't block pores.

Some people may also go to bed with ointments or oils in their hair that can get on the pillow case and then rub on your face, Fusco says, in which case it’s best to put a clean towel over your pillowcase every night to prevent buildup. Washing that foundation and powder off every night is important too.

Makeup brushes are constantly collecting leftover makeup and gathering bacteria and yeast, which can lead to a type of acne known as Folliculitis. Fusco recommends cleaning makeup brushes once a week to keep them gunk-free and face-friendly.


Cell phones

Cell phones like your iPhone or Android is a cesspool of dirt and bacteria. It's gather all kinds of dirt and bacteria throughout the day, and there's a good chance it'll trigger breakouts on your chin and around your mouth. Wiping down your Smartphone daily with alcohol or Clorox wipes will keep your phone—and your face—clean.


Medication

Check your medicine cabinet and tread particularly carefully with prescriptions that emphasize steroids, such as prednisone, cortisone, and hydrocortisone. These can both aggravate and cause acne. Also watch out for lithium, lithium chloride, and certain forms of iodine. "Unfortunately, many of these medications are given for serious conditions, and there are few available substitutes," Krant says. "So people can get stuck in troubling situations, having to take important medication that causes distressing side effects." Keep an open line of communication with your doctor, and make sure he's aware of your concerns.


Yoga mats

Your workout could be making you break out, but it's not the act of exercising that is causing those unsightly spots. Go to class, grab a mat ... and consider all those who have come before you. "You're using a mat other people have been on, and who knows whether they had their feet where your head is," Fusco says. Soon, you'll be dripping with sweat and oil, and rubbing your face against the bacteria on the mat. "That provides a fertile environment for breaking out." The solution? Place a clean towel on the end of the mat where your head and face will be, even if you're using your own personal yoga mat.


Touching your face

Beware of contact acne: "It can appear anywhere you apply repeated or extended pressure on your skin," says dermatologist Ava Shamban, author of Heal Your Skin. "Resting your chin on your hand while you work, pressing your cell phone on your chin, or wearing tight clothing can all contribute to acne." She recommends trying not to touch your face, switching to a headset, and opting for a ponytail holder instead of a headband. And during the summertime, don't sit down in a wet bathing suit: Doing so puts you at risk of developing butt acne.

Avoid touching your face at all costs—even after you wash your hands. "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 increased production in oil," Fusco says. And don't even think about trying to pop that pimple!


Dandruff

Dead skin blizzard? Not fun, for plenty of reasons. And it doesn't help that dandruff often causes acne, typically in the form of tiny pimples lining the scalp. Using shampoo designed to treat dandruff is helpful, Fusco says. "A lot of people don't like to because of its medicinal nature and smell," she says. "But there are new lines that smell nice and can be used every day." Fusco recommends, for example, Clear Scalp and Hair Beauty Therapy products.


Sunscreen

Yes, you need it when you venture into the sun. But make sure it's oil-free and non-comedogenic. Avoid sunscreen with perfume or dyes, and steer clear of spray-on formulas; many of these contain alcohol, which may irritate sensitive skin, Shamban says. Products made with zinc oxide are often more tolerable than those with titanium dioxide.


Traveling

Changes in environment—humidity, weather, and even minerals or fluoride in water—can trigger breakouts. There's nothing you can do about the heat index, of course. But wash your face with bottled water when you can, and avoid using hotel soaps.


Stress

It triggers heightened levels of androgens, hormones that contribute to adulthood breakouts. Stress also releases cortisol and other adrenal steroids that can stimulate the sebaceous glands and lead to acne flare-ups, Shamban says. Though it doesn't always cause new cases of acne, stress tends to worsen matters in those already struggling with the condition. Make sure to get enough sleep, and allot 15 minutes each day to relaxing or doing something you enjoy. Squeeze in some exercise, too, since research suggests it helps deflate stress.


Hair-styling products

It's called pomade acne: Breakouts caused by hair gel or any other styling staple. These cause oil to seep onto your forehead, trapping acne-causing bacteria in your pores. Apply products with your hands, keeping them away from the hairline, and wipe your skin with facial cleanser to remove any remaining traces. Be wary of bangs, too, since they bring hair products directly against your forehead.


Chin straps

Bikers and athletes who wear helmets are prone to this type of acne, caused when straps rub against the skin. "Wash your face before and after putting it on, and keep the strap clean," Fusco says. She also recommends using an antibacterial pad to wipe straps down before and after use.


Anti-aging creams

Think you're doing your skin a favor? Think again. Many of these contain retinol, which stimulates cell turnover, increasing the number of acne-like lesions. "Too much turnover can cause a traffic jam in the skin layers," Krant says. Though Retin-A, which contains retinol, is sometimes prescribed to treat acne, experts warn that many people find it to be a skin irritant; plus, anti-aging creams tend to be oily. "Always use these sparingly, and ideally, under a dermatologist's instruction."


Dairy

A study published the Journal of the American Academy of Dermatology found that boys who had two or more servings of milk a day were the most likely to have acne. Researchers believe this applies to older men, too.

“Milk contains many biological products apart from protein and nutrients, like insulin growth factor-1, which is similar to insulin, and alpha reduced sex hormones,” explains study author Clement Adebamowo, M.D., professor at the University of Maryland. “These molecules are designed to enhance the growth and development of the calves, which can cause a biological response in the person who drinks it,” he says. One response: Increased sebum production, an oily substance that can clog pores. Researchers aren’t sure why some people have this reaction while others are fine.

Just one cup of milk can cause breakouts, says Adnan Nasir, M.D. and Men’s Health dermatology advisor. If you break out frequently, opt for almond milk, instead. Try this for 2 months and see if it makes a difference, Dr. Nasir recommends.


Carbohydrates

Researchers gave young men a face cleanser and assigned them to one of two 12-week diets: Either an eating plan high in carbohydrates, or one high in protein, vegetables, and whole grains. Though both groups saw a decrease in the number pimples, the high-protein subjects had double the drop.

The researchers believe increased insulin can cause inflammation in the skin, leading to breakouts, but more research still needs to be done. “Processed foods could be another factor,” says Alan Aragon, M.S. and Men’s Health nutrition advisor. Lay low on the sugar and switch to whole grains to be safe (solid advice for even smooth-skinned men).


Not Enough Omega-3s

A 250 mg supplement of EPA—the kind of omega-3 found in sardines and anchovies—reduced the number of pimples in a study published in Lipids in Health and Disease. The total lesion count among five people dropped from 63 to 40 after 2 months, presumably because of reduced inflammation.

“Inflammatory chemicals increase the production of sebum,” says study coauthor Alan Logan, N.D., an independent researcher. Omega-3s prevent these chemicals from making sebum, which is known to cause acne, he says.


Using Toothpaste to "Treat" a Zit

Contrary to the popular belief that toothpaste will stop a breakout in its tracks, certain toothpastes can actually cause you to develop acne or an acne-like eruption called perioral dermatitis on the lower third of your face. Fluoride and other whitening and anti-cavity ingredients, especially sodium pyrophosphate, are quite abrasive, Fusco says, and could potentially burn the skin, cause irritation, and initiate breakouts.