But nothing worked permanently so it wasn’t a surprise for Gill, 27, to commonly wake up with pimples on her face.
The psychology graduate student at the University of Toronto dreaded going to school because she was scared of what people would think of her acne.
“I remember thinking, ‘I am the most unattractive person ever right now,’” Gill said. “I took pictures and I sent them to my old coworkers and friends from back home because I just felt so alone and just so awful about myself.”
Gill, who has struggled with acne over the last nine years, is one of 5.6 million Canadians who struggle with persistent acne problems — which is nearly 20 per cent of the population — according to the Canadian Dermatology Association.
There are a number of myths people believe about acne. Experts break down four of the most common ones.
Myth 1: Acne is always an external problem, not internal
Many believe skin-care products and makeup can cause acne. Although this may be true for some, acne is mostly an internal problem.
Dr. Julia Carroll, a dermatologist at Compass Dermatology in Toronto, said acne forms when dead skin cells clog the pores, leading to a buildup of sebum. Sebum is the oil that is found in the glands on the face.
Bacteria within pores, called Cutibacterium acnes (C. acnes), can cause pore blockage and inflammation, seen as redness, swelling and pus. People may have a stickier kind of skin cell that will clog the pores as well.
More often than not, Carroll said, hormonal imbalances lead to acne.
“It’s just normal hormonal fluctuations that you might see in puberty or around a woman’s period,” said Carroll, who is also on staff at the University of Toronto medical school. “Some people’s skin environment is more sensitive to those hormonal changes than other people are, and that can lead to acne.”
Myth 2: Going on birth control will permanently clear skin
Taking the pill is sometimes just a temporary solution, Caroll said. When you use birth control, the hormones causing the acne are levelling out. But it is possible for the acne to come back for some people once they get off the pill because the underlying problem was not solved.
READ MORE: Which acne home remedies actually work?
Myth 3: Bad hygiene can cause acne
While good hygiene can help support other acne treatments, Carroll said, severe and persistent acne does not reflect poor hygiene habits. She added that blackheads are not dirt-filled pores. They are black because the oil in them is oxidized when exposed to the air.
“It’s important to let patients know that it’s not their fault and it’s not because they’re not doing something properly.”
Carroll, who specializes in cosmetic dermatology, acne and rosacea, said that telling teenagers they need to wash their face more is not going to get to the bottom of the problem. It may just be something they are genetically prone to. Over-washing can also irritate the skin and increase inflammation, she said.
Myth 4: Acne will go away quickly
Although acne may clear up, it can get worse before it improves. Carroll said there is a skin cycle and when you see an acne spot, it has been developing for a number of weeks.
“You can’t expect by dabbing a little potion or lotion on a spot that it will then conversely go away overnight,” she said. “It takes time for the body to respond to the medication, or even if you’re not medicating, it takes time for your body to deal with the breakout.”
The best way to clear your skin is to talk to your doctor about what treatment is right for you, Carroll said.
How to maintain clear skin
If taking medications or trying yet another topical cream is not the route you want to take, naturopathic doctor Makoto Trotter said taking supplements is a holistic approach to clearing acne.
Trotter, who specializes in skin conditions, hormones and digestion, said indole-3-carbinol (I3C) and dimer diindolylmethane (DIM) are popular supplements known to improve acne problems.
When a person is about to have their monthly cycle, for example, they may notice hormonal acne forming along their chin, jawline, the side of their face or down their neck. Trotter said this happens as a result of a buildup of estrogen — the primary female sex hormone — leading up to menstruation.
“Those are compounds that help to remove excess estrogen to the liver because that’s where estrogens are metabolized,” said Trotter, who is the co-owner of Zentai Wellness Centre in Toronto.
Zinc picolinate is another supplement that can help clear skin. It is known to have antibacterial effects, support the immune system, and produce and balance hormones, including testosterone, he said.
Whether it is dealing with a problem at work or in a relationship, Trotter said regulating cortisol (the stress hormone) and managing stress levels can also help with clearing your skin.
“Deep breathing, meditation, exercise and making time for yourself,” he said. “Those are all important things to balance out your stress hormone.”
Although there are many natural paths to take, eating healthy, whole foods is a very effective way to help heal and prevent acne.
Trotter said it is important for people to remember that inflammation causes acne, so eating anti-inflammatory foods and getting enough protein can help.
Illustration by Laura Whelan
“Your skin is made up of collagen,” Trotter said.
“Twenty per cent of your body’s protein requirements goes to collagen. So you don’t need to be buying these collagen supplements as long as you have adequate protein. Your body’s a collagen factory and it will make collagen as long as you give it adequate protein.”
Trotter noted that reducing refined carbohydrates and avoiding sugar spikes are also important habits to not only help maintain clear skin, but for your overall health as well.
Illustration by Laura Whelan
Although taking supplements, managing stress and eating whole foods can help the skin, Carroll said everyone has different skin types. What works for someone else may not work for you, and that’s why a dermatologist can help.
Another piece of advice that helped Gill is to remember that people see you beyond your acne.
“When you’re feeling really down on yourself,” she said, “if you see a breakout, you’re going to imagine it to be a lot worse than it probably is.”