Unless you’ve won the genetic and lifestyle lottery, acne happens to the best of us. Whether you’re faced with the occasional zit or prolonged cystic breakout, knowing your acne triggers is as important as knowing the appropriate solutions.
Despite your best efforts, a three or even elaborate eight-step beauty regime is sometimes no match for acne triggers, common ones being hygiene and the cleanliness of your pillowcase or say, phone. Even failing to effectively double cleanse your sunscreen and make-up off warrants pore-plugged, oil-clogged skin. But that’s all child’s play if you’re already religious about your skincare and still facing flare-ups beyond your teen years.
Acne can be a symptom of underlying health issues, with triggers such as hormonal imbalances requiring more time to address. As this isn’t merely a superficial challenge (in more ways than one), quick fixes such as pimple cream or concealer just won’t cut it. Expect your doctor (whether dermatologist, functional medicine professional or endocrinologist) to potentially recommend tests and/or anti-inflammatory supplements to promote healing from deep within.
In fact, more things affect our hormones than we may realise. Other acne triggers such as cutting down on dairy or sugars may require a level of godlike discipline and changes in lifestyle. Why? Well, Dr Sylvia Ramirez is about to break down how sugar affects your hormones which in turn, may trigger a galaxy of new zits. Ageing and our reproductive health even plays a hand at breakouts, according to Dr Toby Hui of Freia.
Be it on your face or body, there’s never a good time for a pimple. But arming yourself with the four lesser known triggers is the first step to reducing and potentially preventing their appearance in the long haul.

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Sugar and acne breakouts
“Anyone who has experienced chronic recurrent acne knows that this is a debilitating disease that can cause scarring both literally and psychologically. Research suggests that in some cases, what you put in your mouth may be as critical as what you put on
your skin. This leads me to dietary contributors to acne.
“One important factor that is supported by clinical evidence is the impact of a food’s glycemic index, or the rate and extent of rise of blood sugar levels. Foods that increase blood glucose quickly (those with a high glycemic index such as refined carbohydrates
and sugars) have been strongly linked to acne.
“This is because the high sugar levels make us release insulin and other hormones that have been shown to stimulate oil production with resulting inflammation of the skin. High glycemic diets also raise the
levels of Insulin-like growth factor-1(IGF-1), which contributes to oxidative stress and further inflammation. The increase in IGF-1 also stimulates production of androgens, which we know leads to even more sebum production.
“Interestingly, studies found that reducing these types of food can reduce acne lesions. What’s the bottom line? Eating a well-balanced diet with whole foods, and plenty of vegetables benefit us in so many ways including the prevention of acne.
“If you do already have breakouts regardless of cause, several simple treatments may be of benefit. This includes topical products such as topical vitamin A and salicylic acid which can help unclog pores. Topical antibiotics and other anti-inflammatory products including benzoyl peroxide also kill acne-causing bacteria.
“Finally, if resistant, medical treatments such as oral antibiotics, chemical peels or even laser treatments may be of help.”
– as shared by Dr Sylvia Ramirez, medical and scientific director of Cutis Medical Laser Clinics

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Hormones
“Although our hormones surge during adolescence, adult females from the ages of 20-40 may experience acne due to changes in hormone levels through their menstrual cycles.
“Typically, these breakouts worsen right before, or at the start of menses. In most cases of hormonal induced adult acne, the body produces too much androgen (male sex hormones), or there’s increased sensitivity to normal levels of androgen at the level of the skin. In addition, anything that compromises the immune system, whether it is emotional stress or nutritional deficiency, is likely to upset your cortisol and insulin balance, which can affect your skin, as well.
“Warranting special mention will be 2 other unique groups of women, those that fall within the peri-menopausal age group and pregnant mothers to be.
“Perimenopausal acne develops in women for similar reasons that haunted our adolescent years in puberty. The changes and imbalances in their natural hormone levels during this stage of life impact negatively on their skin’s natural defense system and trigger blemish formation.
“Many women are also unpleasantly surprised with a zit attack during pregnancy although it might not be a skin woe that bothers them before there’s a bun in the oven. This is most common during the first and second trimesters, as an increase in circulating androgens can lead to hyperactivity of oil glands in the skin with increased sebum production; leading to bacterial colonisation, inflammation, clogged pores and breakouts.
“While we may not be able to eradicate acne completely, good solutions to manage symptoms would be sebum balancing or anti-inflammatory serums like Beauty Drops 3, Rescue Recovery Repair; deep cleansing facials like Hydrafacial or treatments which use ultrasound waves to soothe and reduce inflammation.
“In severe or persistent acne conditions, it will be best to seek professional medical help whereby a course of oral medication such as isotretinoin or even intralesional steroid injections may be necessary.”
– as shared by Dr Toby Hui, Freia Medical

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Dairy
“A number of clinical studies have suggested that all types of cow’s milk (whole, low-fat, skim) have been found to trigger acne breakouts.
“However not all dairy products are associated with acne. No studies have found that yogurt and cheese for example, to trigger breakouts.
“While the precise link between the two has not been clearly established, hypotheses include the presence of
natural and artificial hormones, and whey protein in milk. Hence limiting your dairy intake may help reduce
these hormone and testosterone spikes that may cause breakouts.
“Dairy consumption is one of the first things I enquire with patients who have recent onset adult acne to
either reduce or eliminate. In young patients with active lifestyles, it is certainly worth asking about use of
supplements and whey protein shakes and bars.”
– as shared by Dr Melvin Tan, founder of Epion Clinic

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Stress
“Though stress does not directly cause acne, it can exacerbate it by increasing levels of certain stress-induced hormones. Stress causes the body to release hormones such as cortisol and androgens, which increase the oil production in the skin and can potentially worsen acne.
“Furthermore, stress can also exacerbate acne by triggering the production of cytokines—proteins that create inflammation in the area around the sebaceous glands.
“It is always important to handle stress positively by adopting healthy practices that relieve stress, whether it’s through exercise or relaxation techniques that can lower cortisol levels and reduce stress-related acne breakouts.”
– as shared by Dr Kenneth Thean, founder of Ensoul Medical Clinic