If you are willing to believe what people tell you, acne is caused by everything from an “acid condition” to “bad blood,” whatever they may be! There seems to be no limit to the bizarre reasons given as the cause of this con­dition. Statements attributing acne to “poisoning in the system,” “too much rich food,” and even “it’s the mean­ness in you coming out,” are heard all too often.

These false and meaningless claims arose in ignorance and superstition. It is to be expected that a condition as commonplace as acne would have its share of folklore and old wives’ tales. It is also high time that these myths be dispelled and replaced with modern scientific knowl­edge.

 

There is another group of misconceptions about the cause of acne which do contain an element of truth. Some of these may have originated from medical books or articles that young people have read hoping to find a solution to their acne. Others probably got started from the instructions acne patients received from their doc­tors. Unfortunately, by the time such information is passed from mouth to mouth, much of the original meaning has been distorted. Therefore, these ideas are criticized here because they are half-truths, and not whole-truths as you are led to believe. The quotation “A little learning is a dangerous thing” is particularly true where acne is concerned.

 

One of the most common examples of these half-truths is the notion that eating certain foods is the only cause of acne. Such expressions as “too many sweets” or “too many starches” are heard all the time. Fatty foods and greasy cooking are reputedly a cause. It may be true that excessive helpings of pastries or too many fried potatoes may aggravate your particular eruption, but this does not mean that all acne is affected in the same way, nor does it mean that these foods are the only cause of your eruption. At one time, very likely, your acne has been blamed on everything edible from milk to straw­berries. If you were to heed all the advice that is offered, it would soon become very difficult to know what to eat. It might almost seem safer to eat nothing at all.

 

Undoubtedly many of you have heard of the all-important role that chocolate is supposed to play in acne. This is probably the most commonly reputed cause. One mother who had brought her young daughter to see me could hardly restrain herself long enough for me to ex­amine the patient before she said, “Every time Joan eats chocolate her face breaks out. She is always eating candy and can’t seem to get enough of it. I’ve told her that her pimples are caused by sweets and yet she continues to eat them. I don’t know how a doctor can help her if she keeps on this way.” The young girl agreed with what her mother said.

 

She had become convinced that her mother was right, but there was something about candy which she could not resist. The more she tried to control herself, the stronger became this uncontrollable urge for candy. The whole situation made her miserable. Actually, it is more likely that the struggle she was having with herself did more harm to her acne than the sweets. As much as I would like to say so, this does not mean that chocolate or sweets are good for acne! But in moderation and in most instances they do not cause as much trouble as one would suppose. We are certain of one fact and that is that sweets are not by any means the sole or main cause of acne.

 

The presence of acne is so disturbing to some young people that they will follow so-called advice even when it is obviously unreasonable. Despite the pleading of par­ents, or the reasoning of friends, they will persist in hot pursuit of the latest “cure.” After a time, when the re­sults have not been as expected, they will try a new ap­proach with equal determination until, alas, that too has failed.

 

I remember a young girl rather on the plump side and very self-conscious about it who somehow got the idea that all she had to do to cure her acne was to lose ten pounds. She started out to do this by simply not eating, except for a snack now and then when she could no longer stand her hunger. Naturally her parents were very disturbed, but she continued with a vengeance until even she could see that, if anything, her acne was worse.

There is so much talk about allergy these days, it is no wonder that people ask if acne is an allergy. The answer is no. When the science of allergy was new, many acne patients were tested to see if it could be shown that they were allergic to some food or pollen. It was found that acne patients were no more nor less allergic than people who did not have acne.

Another misconception of the cause of acne is that it is due solely to some kind of infection in the body. Bad tonsils and decayed teeth have been removed with the mistaken hope that this alone would cure acne. It is true that any such source of infection should be corrected for the benefit of the body as a whole. It may even help some types of acne. However, this does not mean that most cases of acne can be cured by any such procedure by itself.
You may have heard that acne comes from an infec­tion of the skin or even believe that it is catching! At one time, skin specialists felt that infection played an impor­tant role in acne. Some even thought that a special organ­ism was the cause. Today, most dermatologists have abandoned this idea. They do admit that bacteria are present in the lesions of acne, sometimes in large num­bers, as in pustules and infected cysts. But they feel that these organisms are only of secondary importance, just as bacteria will infect any cut or bruise. This concept is borne out by the fact that acne cannot be treated like a true infection, as, for example, one might treat a boil. At least it does not respond to such treatment alone. 

 

Patients sometimes ask, “How about a shot of penicil­lin, Doctor, won’t that help?” The answer is, “Not very much.” When penicillin was discovered, the theory that acne was caused by bacterial infection was further ex­ploded. The opportunity arose to study this problem during World War II through a research project estab­lished by the Army Medical Department. Penicillin was being found to have such valuable healing powers on so many types of infections, it was important to prove as quickly as possible just which infections it would cure and which ones it would not. The sooner this was known, the more lives would be saved.

 

While this work was under way, it was decided to see if penicillin was effective against acne. To find out what it would do, many patients with severe acne were treated with large amounts of penicillin, but it was soon shown that acne is one of the conditions which is not helped by penicillin. To be sure, the badly infected cysts con­taining pus showed some improvement, but the under­lying acne eruption was unaffected. So we can conclude from this that the evidence is against acne being caused by a simple infection. There is another reason for not using penicillin on everyone with acne. Some people be­come allergic to penicillin and if they should ever need it for a serious infection, they might not be able to toler­ate it. This risk is not worth taking, as a rule.

 

Since penicillin was discovered newer drugs have been found which kill bacteria. They have at least two advan­tages over penicillin. One is that they can be taken in pill form, which is very comforting for those who are “allergic” to needles. Secondly, they are effective in kill­ing a wider variety of bacteria. But while these new antibiotics may be lifesavers under certain conditions, they too are no cure for acne, though sometimes helpful.