Acne is one of the most common conditions I treat — and also one of the most heavily laden with misinformation. Patients arrive at the clinic having tried toothpaste, applied lemon juice, stopped eating chocolate, or spent hours in the sun based on advice from friends, family, or social media. Some of these things are harmless. Some are actively damaging.
Here is a plain-language guide to common acne myths and what the evidence actually says.
Myth 1: Acne is caused by poor hygiene
Fact: Acne is not caused by dirt. Washing your face more does not clear acne — over-washing can actually worsen it.
Acne develops from a combination of four factors: excess sebum (oil) production, abnormal shedding of skin cells inside hair follicles, colonisation by Cutibacterium acnes bacteria, and inflammation. None of these are caused by inadequate washing.
Over-washing (more than twice daily) strips the skin barrier, triggers compensatory oil production, and can irritate inflamed lesions. Twice-daily gentle cleansing with a mild, non-comedogenic cleanser is appropriate. Scrubbing vigorously or using harsh soaps makes acne worse, not better.
Myth 2: Eating chocolate and oily food causes acne
Fact: The relationship between diet and acne is more nuanced and less dramatic than popular belief suggests.
Current evidence shows a modest association between high-glycaemic index foods (refined sugars, white bread, sugary drinks) and acne in some individuals. There is also some evidence linking dairy, particularly skim milk, to acne in susceptible people. However, these are population-level associations — not every person responds the same way.
Chocolate itself has not been convincingly shown to cause acne in controlled studies. The common belief likely arose because chocolate is often consumed with sugar and milk, and because confirmation bias is powerful.
If you notice a consistent personal connection between a specific food and acne flares, it is worth reducing that food and observing. But there is no need to follow a severely restrictive diet based on current evidence.
Myth 3: Sun exposure helps acne
Fact: Sun exposure does not treat acne and causes long-term harm.
Some patients report that their acne looks better after sun exposure. There may be a short-term drying effect, and tanning temporarily masks redness. But UV radiation damages the skin barrier, promotes post-inflammatory pigmentation (the dark marks left after acne), and increases the risk of skin cancer over time.
Many acne medications — including retinoids and certain antibiotics — also increase photosensitivity, meaning sun exposure while using them can cause serious burns or irritation.
Daily broad-spectrum SPF 30+ sunscreen is recommended for acne patients — it does not worsen acne if you choose non-comedogenic formulations.
Myth 4: Toothpaste dries up pimples
Fact: Toothpaste can cause contact dermatitis and should not be applied to the skin.
This is one of the most persistent skin myths. Toothpaste contains ingredients like fluoride, baking soda, and sodium lauryl sulphate that are formulated for tooth enamel, not skin. Applying it to a pimple commonly causes contact irritation — redness, burning, peeling — which can look worse than the original pimple and leave a dark mark.
If you want a targeted spot treatment, use a product containing benzoyl peroxide, salicylic acid, or adapalene — all of which have evidence behind them and are formulated for skin use.
Myth 5: Popping pimples gets rid of them faster
Fact: Squeezing pimples forces bacteria deeper into the skin, increases inflammation, prolongs healing, and is the main cause of acne scarring.
I understand the temptation — a pimple that has come to a head looks like it needs to be emptied. But the pressure applied when squeezing pushes bacteria and sebum into the surrounding dermis, creating a wider zone of inflammation. This increases the risk of a nodule or cyst forming, and almost always increases post-inflammatory pigmentation.
Leave pimples alone, or seek professional extraction if lesions are repeatedly bothersome. A dermatologist can perform properly sterile extractions that minimise damage.
Myth 6: Acne is only a teenage problem
Fact: Acne affects adults of all ages, including many people in their 30s, 40s, and beyond.
Adult acne — particularly in women — is increasingly common and often has a hormonal component. It typically presents on the lower face, jawline, and neck, and may fluctuate with the menstrual cycle.
Adult acne often requires different treatment from teenage acne. In women, hormonal therapy (oral contraceptives, spironolactone) may be part of the management plan. A dermatologist can distinguish adult hormonal acne from other conditions that can look similar.
Myth 7: More moisturiser will clog your pores
Fact: The right moisturiser is important even for oily or acne-prone skin.
Many acne patients avoid moisturiser because they associate it with greasiness. But acne medications (particularly retinoids and benzoyl peroxide) are drying, and an intact skin barrier actually reduces acne-promoting inflammation. Skipping moisturiser can lead to over-drying, which triggers more oil production.
The key is choosing a lightweight, oil-free, non-comedogenic moisturiser. These support the skin barrier without clogging pores.
What Actually Works
Evidence-based first-line treatments for acne include:
- Benzoyl peroxide — kills C. acnes bacteria, reduces inflammation
- Topical retinoids (adapalene, tretinoin) — normalise cell turnover in follicles, prevent new lesions
- Salicylic acid — exfoliates inside follicles, reduces blackheads and whiteheads
- Topical antibiotics (clindamycin, erythromycin) — used in combination with benzoyl peroxide for inflammatory acne
- Oral antibiotics — for moderate-to-severe inflammatory acne, used for a limited duration
- Hormonal therapy — for women with hormonal acne
- Isotretinoin (Roaccutane) — highly effective for severe or scarring acne; requires close medical supervision
- Chemical peels — can help with comedones and post-acne pigmentation
- Light-based treatments — as adjuncts in appropriate cases
Most cases of acne can be significantly improved. The key is an accurate assessment of the type and severity of acne, and a treatment plan matched to that assessment.
When to See a Dermatologist
- Acne that has not responded to over-the-counter products after 2–3 months
- Acne that is leaving scars or dark marks
- Cystic or nodular acne (deep, painful lumps)
- Acne that appears suddenly or is associated with other symptoms
- Significant psychological impact on confidence or daily life
Acne is treatable. You do not have to wait it out.
Content is for educational purposes only and is not a substitute for medical advice. Consult a qualified dermatologist for assessment and treatment.