For many adults, it is a familiar problem: troubled skin or acne that does not disappear after puberty. You still see them in the mirror in the morning, even though you may be eating very healthily. Blemished skin can affect your self-confidence, but it can also cause pain. Where do those spots come from? Is chocolate really the culprit, as is often claimed? Or are there other factors at play?

In this article, you will read about:

  • The main causes of blemished skin
  • The influence of diet, stress and lifestyle on acne
  • Practical tips to calm your skin.

How does troubled skin develop?

Acne develops when sebum production and skin cell renewal become unbalanced. Clogged pores are the starting point, after which inflammation can occur: red or white bumps on the face or elsewhere on the body.

Dermatologists cite the following main causes:

  • Heredity: Acne often runs in families.
  • Hormones: Fluctuations in androgens can stimulate sebum production. In women, acne flare-ups are more common just before menstruation or during pregnancy.
  • Cosmetics: Liquid foundations and oils in particular can clog pores.
  • Medications: Some medications, such as corticosteroids or certain antibiotics, can cause or worsen acne.

What is the role of diet and stress?

There are many myths about diet and acne. Chocolate is often cited as a cause, but there is no scientific evidence that dark chocolate directly causes acne. What research does show is that:

  • Chocolate with a high sugar and milk content (such as milk chocolate) can contribute to a higher glycaemic load, which stimulates sebum production and can exacerbate inflammation.
  • Dark chocolate with a high cocoa content contains antioxidants and appears to be less strongly linked to acne.

In short: it is not the chocolate itself, but mainly the combination of sugar, fat and dairy that can play a role.

Foods with a high glycaemic index, such as sugary products and white bread, can stimulate sebum production and inflammatory reactions, while a diet rich in vegetables, fruit, fibre and healthy fats has a protective effect. Healthy eating is therefore important, but it is not the direct cause of acne. It also explains why someone with a very healthy diet can still suffer from troubled skin.

Stress also indirectly affects the skin: elevated cortisol levels can stimulate sebum production and aggravate existing spots.

Does the location of the spots matter?

There are many stories online that spots in specific locations say something about your health: chin = hormones, forehead = digestion, and so on. In fact, this is not scientifically proven.

Acne can occur on:

  • Forehead
  • Between the eyebrows
  • Nose
  • Cheeks
  • Chin
  • Sometimes also on the chest, back or shoulders

Sebaceous glands are located everywhere under the skin except on the palms of the hands and soles of the feet. They are most active on the face, which is why spots most often appear there.

What can you do about acne?

You cannot completely prevent acne, especially if heredity plays a role, but you can reduce its severity:

1. Support hormone balance:

  • Getting enough sleep, managing stress and eating a balanced diet help keep your hormones in balance.
  • Limiting sugar and processed foods can reduce insulin and androgen responses, resulting in minor improvements in the skin.
  • Regular exercise also helps to keep hormone levels and blood sugar stable, which can indirectly contribute to calmer skin.

2. Adjust your cosmetics:

  • Avoid pore-clogging liquid make-up. Powder foundation or light, non-comedogenic products are better.
  • Be sure to remove your make-up thoroughly before going to bed to prevent clogged pores.

3. Supplements can be a valuable addition:

  • Foods or supplements that support hormone balance, such as evening primrose oil, vitex (monk's pepper) or maca, can help with hormonal acne.
  • Unsaturated fatty acids such as linoleic acid and gamma-linolenic acid (GLA), found in borage oil or hemp seed oil, for example, can reduce inflammatory reactions in the skin.
  • Zinc plays a role in wound healing and can help with inflammation-prone skin.
  • Vitamin A (retinoids) can support skin cell renewal.

4. Medical options:

  • In some cases, a dermatologist may recommend local treatments (such as retinoids) or hormone therapy.

Additional tips for calmer skin:

  • Maintain a regular cleansing routine, but avoid excessive scrubbing, which can irritate the skin.
  • Hydrate the skin with a light, non-comedogenic moisturiser to prevent dehydration and sebum production imbalance.
  • If necessary, note down your acne triggers (diet, stress, menstrual cycle) to discover what affects your skin.

Conclusion

Adult acne is often a combination of hormones, genetics and skincare. Diet and stress play a role in exacerbating the condition, but are rarely the main cause. Supplements and a healthy lifestyle can support the skin and help reduce symptoms, in addition to proper skincare and medical advice if necessary.

Source

  1. Lichterfeld, A., Hauss, A., Surber, C., Peters, T., Blume-Peytavi, U., & Kottner, J. (2015). Evidence-Based Skin Care: A Systematic Literature Review and the Development of a Basic Skin Care Algorithm. Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society, 42(5), 501–524. https://doi.org/10.1097/WON.0000000000000162
  2. Reynolds, R. V., Yeung, H., Cheng, C. E., Cook-Bolden, F., Desai, S. R., Druby, K. M., Freeman, E. E., Keri, J. E., Stein Gold, L. F., Tan, J. K. L., Tollefson, M. M., Weiss, J. S., Wu, P. A., Zaenglein, A. L., Han, J. M., & Barbieri, J. S. (2024). Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology, 90(5), 1006.e1–1006.e30. https://doi.org/10.1016/j.jaad.2023.12.017

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