Nicola Elliott
There’s more gossip about acne than there is about reality TV – and most of it is about as reliable as your ex’s text messages. From “just drink more water” to “it’s definitely the chocolate”, everyone seems to have a theory on acne, but very few people have the science to back it up.
To separate fact from fairy tale, we sat down with Dr Toni Philips, Group Clinical Director at DestinationSkin, who spends her days up close and personal with breakouts. She answered the big questions people ask about their skin, dismantled a few stubborn myths, and shared exactly what does – and doesn’t – help when it comes to acne.
So… what actually is acne?
Before you start blaming your hormones, your diet or last night’s takeaway, it helps to understand what acne actually is doing to your skin.
“Acne is a condition which mainly involves the pilosebaceous gland. This is the oil gland in the skin that is attached to a hair follicle – which then appears at an opening in the skin.” explains Dr Toni.
Put simply, that little oil factory under the skin goes into overdrive.
“Acne is a condition where there is excessive sebum production from the oil gland, accompanied by inflammation and bacteria which leads to clogging up of the pores, producing a pimple.”
Too much oil, a bit of inflammation, some bacteria having a party in your pores – and boom: pimple, papule, full-on breakout.
Does acne run in families – or is it just bad luck?
If you’ve ever looked at your parents’ teenage photos and thought “ah, there it is, my fate”, you’re not completely wrong – but you’re not doomed either.
“There is no one cause of acne. There can be a familial tendency in certain severe cases, but it’s not actually a genetic disease. Typically, hormonal influences can trigger the sebaceous glands to be more active than usual, causing acne.”
In other words, you might inherit a tendency to be oilier or more hormonally sensitive, but you don’t inherit acne like you inherit your dad’s ears. It’s more complicated – hormones, lifestyle, skin type and environment all pile in together.
Can stress cause acne – or is that just another thing to worry about?
We all know stress makes everything worse, and yes, that includes your skin. But does it actually cause acne?
“Stress doesn’t cause acne directly; however heightened levels of stress can cause the adrenal glands to go into overdrive. Adrenal glands are in charge of regulating stress and can stimulate sebaceous glands to secrete more sebum (oil). This excess oil can cause acne.”
So stress isn’t technically the culprit – it’s more like the dodgy midfield general who keeps over-motivating the oil glands till they sprint off in the wrong direction. Manage stress, and you may well notice your acne calming down too.
The big one: does chocolate cause acne?
If you’ve ever eaten a brownie and then stared accusingly at your chin 24 hours later, this one’s for you.
“There is little evidence that chocolate specifically causes acne. However certain diets can predispose an individual to acne, such as high milk and dairy intake or high calorie intake because these diets can encourage certain growth hormones that can stimulate the oil gland and when the oil gland is more active, acne tends to form.”
So it’s not that a single square of chocolate will summon a spot by morning, but a consistently high-calorie, high-dairy diet can nudge those oil glands into overdrive. Blame the pattern, not the one rogue dessert.
Why does acne show up in random patches on my face (and chest)?
One of acne’s more annoying habits is its sense of geography. Some people get forehead constellations, others get cheek flare-ups or chest breakouts that appear just when you’ve planned a low-cut top.
“An interesting fact is that the sebaceous glands associated with acne, are a genetic remnant from the prehistoric days when humans had complete facial hair! Therefore, different areas can be affected by acne, and where it appears on the face comes down to the number of sebaceous units a person has in that area.”
“Some people might have a very high number of sebaceous units on the cheek, so they may see more acne on the cheeks.”
“The concentration, distribution, and activity of these sebaceous units vary from person to person. That’s why some people might suffer with acne more on their forehead compared to others who might have it more on the chest.”
So no, your right cheek isn’t cursed. You just have more oil factories in certain zones than others.
Can topical products fix acne scarring?
Once the spots have gone, the marks they leave behind can feel like an unfair extra level of the game. Sadly, not all scars are created equal.
“Unfortunately, topical treatments are not particularly useful for most types of acne scarring. However, they do work for a subtype of acne scars, called macular scarring. This is essentially small patches of intense redness or pigmentation that is a very early form of scarring.”
“Using Vitamin A preparation in all various concentrations and forms can help prevent acne scarring and in some mild cases reverse this macular type of scarring. However, for the atrophic scars, such as box scars, ice pick scars and rolling scars, the best treatments are slightly more invasive such as micro-needling, derma-stamping and injectable gels such as Profhilo.”
Translation: early red or brown marks can respond nicely to Vitamin A (retinoids), but deeper indents need in-clinic, slightly more invasive treatments.
Toothpaste on pimples: genius hack or terrible idea?
We’ve all heard this one – dab on some toothpaste, wake up with angelic, clear skin. Right?
“The myth of using toothpaste is really a cosmetic one. Applying toothpaste to a spot can quickly but temporarily reduce redness and swelling by drying it out, but it will not help to clear the spot. In fact, toothpaste can really irritate the skin.”
“Typically, toothpaste contains ingredients such as alcohol menthol and hydrogen peroxide. These things all have the potential to dry out acne, but they also risk causing real irritation which in turn can lead to an overproduction of oils in the skin.”
So yes, toothpaste might shrink a spot for a few hours – and then your skin may retaliate with more irritation and, cruelly, more oil. Reach for targeted acne treatment instead of raiding the bathroom shelf.
Is my period to blame for monthly acne flare-ups?
If your breakouts run like clockwork with your cycle, you’re not imagining it.
“When a woman is on her period, the hormonal changes can trigger your sebaceous glands to secrete more oil or what we call sebum, this can cause pores to block and result in a breakout of acne – this often occurs a few days before your period starts.”
“When you’re having hormonal skin changes, usually making your skin oilier, you should wash your face regularly in the morning and evening, and even consider using a different cleanser containing Salicylic Acid (BHA) during those days. Make sure you reduce the chances of getting blocked pores, so remove makeup before going to bed.”
Think of it as a mini “oil surge” each month. The key is not to panic, but to tighten up your routine in that pre-period window: salicylic acid, gentle cleansing and absolutely no sleeping in your make-up.
Does sweat cause acne – should I skip the gym?
Good news for your gym membership: exercise is not the villain. But sweat, friction and tight clothing can gang up on your pores.
“Excessive levels of sweating from exercise for example, can lead to clogging up of the pores which can in turn affect people that are prone to acne. It can also trigger acne in milder forms for those who don’t have a pre-existing condition.”
“That said, although sweat can negatively impact the skin, exercise is good because it increases the blood flow, which washes away the toxins, leading to healthier skin. It also reduces the oxidative stress and counteracts the reactive oxygen species between the oxidative sweat, which is good for the skin.”
So keep moving – just shower promptly, change out of sweaty kit, and avoid tight, non-breathable fabrics if your acne is flaring on the body.
What ingredients actually help acne?
Scroll any skincare aisle and you’ll see half a dozen buzzwords screaming at you. Dr Toni strips it back:
“For milder forms of acne that may appear on healthy skin, ingredients such as glycolic acid or salicylic acid in cleansers can certainly help. There are also some over-the-counter products that contain mild anti-inflammatory ingredients to help with the treatment and prevention of acne.”
“The main ingredient in these is niacinamide, an antioxidant and anti-inflammatory which is becoming more popular in acne treatment.”
“To quickly clear up a new breakout, benzoyl peroxide is useful and will dry out spots and kill bacteria.”
So for everyday acne-prone skin, look for:
- Glycolic acid – helps exfoliate dead skin cells
- Salicylic acid (BHA) – unclogs pores and dissolves oil
- Niacinamide – calms redness and supports the skin barrier
- Benzoyl peroxide – for short-term, targeted use on active breakouts
Does the sun help clear acne – or just damage your skin faster?
This one is sneaky because, at first, it can look like it’s working.
“Yes UVA/UVB rays can improve the appearance of acne by killing off the associated bacteria. However, UV is well known to have more damaging effects on the skin so it is not recommended to rely on this method.”
“A much safer photo-dynamic therapy involves using red and blue light to kill bacteria and encourage skin repair, and Intense Pulsed Light (IPL) is also useful to improve the redness and other discolouration caused by acne.”
So while your acne might look better after a holiday, the long-term trade-off – pigmentation, wrinkles, and skin cancer risk – simply isn’t worth it. Controlled light therapies in-clinic are the safer, smarter way to use light in acne treatment.
Dr Toni’s top products to treat acne
If your bathroom shelf currently looks like a chemistry lab, here’s a more curated, expert-approved shortlist. As Dr Toni puts it:
Dr Toni’s Top products to treat acne:
Cleansers – OBAGI Clenziderm or Dermaquest DermaClear BHA Cleanser
Correction – Dermaquest DermaClear Serum (day or night) or Dermaquest Retinol Brightening Serum (night only)
Protection – Heliocare 360 Dry Touch Gel SPF50 or Heliocare Mineral Tolerance SPF50
A simple three-step structure – cleanse, correct, protect – is far kinder to acne-prone skin than a dozen half-used bottles you bought on TikTok’s recommendation at 1 am.
The bottom line
There’s no single cause and no single cure for acne – but there is solid science on what helps and what definitely doesn’t. Toothpaste, sunbathing and blaming every spot on chocolate can all retire gracefully now.
Understanding how your oil glands work, listening to your hormones, choosing evidence-based ingredients and, where needed, seeking professional treatments can make all the difference between endlessly fighting your skin and finally working with it.
For more expert-led advice and treatment options, you can visit www.destinationskin.com
