Fungal acne does not exist but here is how to treat Malassezia Folliculitis

Fungal acne is the new buzz term in the beauty world and everyone and their Moms think they have fungal acne right now.  But fungal acne doesn’t even exist! Literally, it’s not a thing y’all. So if you jumped on the fungal acne bandwagon and are now convinced that your acne is caused by fungus, read on.

ACNE CANNOT BE CAUSED BY FUNGUS

Just the very term ‘fungal acne’ is a contradiction in terms because acne is defined as a chronic condition caused by a genetic dysfunction called Retention Hyperkeratosis (RH).  RH is a disease that causes an overproduction of skin cells to get backed up in the follicle which then creates little acne “seeds” called microcomedones. These seeds then grow like a flower due to a number of internal and external factors like diet, products, and bacteria called triggers.  If the seed becomes big enough to rupture the follicle wall, inflammation sets in but inflammation is just a symptom of acne, not the cause of it. So acne is a formation of lesions formed primarily by dead skin cells, not fungus.  

WHAT EXACTLY IS ‘FUNGAL ACNE’ THEN?

What is inaccurately referred to as ‘fungal acne’ is actually a condition called pityrosporum folliculitis or malassezia folliculitis (MF).  MF and acne both occur in the hair follicles but unlike acne which is caused primarily by an overgrowth of dead skin cells, malassezia folliculitis is caused by an overgrowth of yeast called malassezia.  We actually all have yeast and bacteria all over our skin and inside of our bodies and they serve important functions but MF develops when this particular fungus (yes, it is a fungus) proliferates for a number of potential reasons.  Antibiotic usage can kill all of the “good bacteria” in our bodies and cause a yeast imbalance. And similar to acne mechanica, prolonged heat and moisture caused by occlusive clothing like tight, sweaty exercise clothes can also cause yeast overgrowth. 

WHY DO THEY CALL IT FUNGAL ACNE IF IT’S NOT ACTUALLY ACNE?

Two words: ignorance and confusion.  Even the most highly paid beauty bloggers and influencers are so freakin’ ignorant about acne that they just refer to any type of bumps on the skin as acne. It’s also easy to confuse the two because there are 7 different types of acne and one type of acne, non-inflamed acne, looks similar to MF because they both look like small bumps under the skin.  This is a tricky type of acne that most people don’t identify as acne because it’s not big or red. A lot of people don’t even refer to it as acne, they refer to it as “texture” and I have even had some clients who have been mistakenly told by their Dermatologist that it’s an allergic reaction! If the skin doctors have trouble discerning the different types of bumps on our skin then it’s no wonder there is so much garbage information out there.

HOW DO I KNOW IF IT’S FUNGUS OR ACNE?

A fungal infection like MF can look so similar to non-inflamed acne that it can be hard to tell the difference.  The only way to know for sure if you have MF is to have it checked and examined under a microscope by a Doctor but here are some hints:

1. Does it itch? 

   Acne does not typically itch and MF does.  The only time you will have itchy acne is if you have an inflamed acne lesion but that kind of itching is typically mild and doesn’t last a long time.  And if it is inflamed acne, it will be swollen, red, and maybe full of pus so it will look very different from the small uniform bumps that characterize MF. 

2. Pattern

   MF bumps tend to appear in clusters and are uniform in size whereas acne tends to be randomly distributed and appears in varying sizes.

3. Is there a head or a core?

   All types of acne start with a little “seed” called a microcomedone that is made up of mostly dead skin cells so all of the 7 types of acne have a grain-like seed inside of or on the surface of the skin.

FOREHEAD BUMPS ARE USUALLY CAUSED BY THIS

Lots of bloggers and influencers who talk about fungal acne claim that it usually appears on the forehead.  But MF is actually more common on the body than it is on the face. It’s more likely that your forehead bumps are caused by Retention Hyperkeratosis and triggered by comedogenic hair products.  I say triggered because acne, regardless of what type or where it is located, is always caused by RH. If you are genetically prone to acne and are using a shampoo, conditioner, or hair styling product that contains one of these pore-clogging ingredients or you have recently gone to the hair stylist or gotten your hair blown out and they used a comedogenic product in your hair, you are likely breaking out from that. We have a whole Pinterest board with acne-friendly hair product recommendations that you can check out but make sure to double check the ingredients of every product (even if I suggested it!) before purchasing since products get reformulated all the time.

HOW IS FUNGAL ACNE TREATED?

Only your Doctor can diagnose and propose a treatment for your MF but it’s usually treated with one or a combination of these:

1. Lifestyle adjustments

   Avoiding saunas, sun exposure, and steaming
   Wearing loose fitting clothes
   Changing sweaty workout clothes right away
   Showering immediately after exercising

2. Anti-fungal shampoo or body wash

   You might be prescribed a shampoo that contains selenium sulfide, pyrithione zinc, or ketoconazole like Selsun Blue or Nizoral.

3. Oral anti-fungal medication

4. Prescription topical creams

HOW TO GET RID OF ACNE ONCE AND FOR ALL

Hopefully you have a better idea after reading this whether or not you actually have “fungal acne”. If you are one of the few who actually has MF, you should get in touch with your Physician so they can advise you on next steps. If you are just of the many people who have been mistakenly thinking that you have fungal acne but you actually just have stubborn acne, our acne programs offer a prescription free method for getting clear in a way that offers sustainable, long term results.

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Heat and steam are actually terrible for acne so skip the sauna and the steam

Your Esthetician steams your face before extractions because she says it opens up your pores. You go into the sauna thinking that it’s expelling toxins and letting your pores breathe.  Sorry to burst your bubble but none of that is actually happening and you are likely causing more harm than good to your acne-prone skin. We never steam our clients before an acne facial or body treatment and we’ve had some clients get upset that they are because they think we are cheating them out of some essential part of the process.  But we don’t use steam because heat and steam are more likely to swell your pores shut than open them up! Also, we never perform extractions during the initial appointment precisely because we want clients to begin using the product kits which help break up congestion in the follicles so they are loose and easy to extract so even if steam did open up the pores, it wouldn’t be necessary anyways.

This is explained by basic physics people
Heat expands, cold contracts. Just think about wearing a ring on your finger-have you noticed that it might feel tight and swollen in the summer when the weather is warmer and a little looser in the winter when it’s colder?  This is exactly what happens to your pores. When you are exposed to heat or steam, your pores swell up and the congestion that is already struggling to be contained inside of our follicles can get squeezed so tight that the follicle wall might rupture and become more inflamed.  So if you are already struggling with an inflamed acne type, especially cystic acne, you should be avoiding saunas and steam because they can worsen inflammation. If you have a primarily non-inflamed acne type, you might be able to get away with heat and steam as long as you don’t notice an increase in inflammation symptoms such as redness, swelling, pus, and soreness.

Only oil can stretch the pores open or closed
Pore size is mostly genetic and there isn’t anything you can do to significantly change it.  Pores don’t actually get smaller or bigger on their own: How big or small your pores are depends on the amount of oil your sebaceous glands produce because oil is what flows through the follicle and stretches the pores open, making it appear larger or smaller.  And oil production is determined by testosterone levels because testosterone is the chemical messenger that triggers the oil gland to get pumping among many other things. Testosterone levels are primarily biological. For example, we are born with biological clocks that signal our testosterone levels to surge during puberty, pregnancy, and the menstrual cycle.  There are certain dietary and lifestyle factors that are within our control like dairy, soy, and stress that can impact testosterone levels so if we can reduce the levels of testosterone in the body, we can reduce oil production, and maybe cause the pores to appear smaller because there is less oil stretching the pore open. This is a big maybe though and it’s unrealistic to expect poreless skin because all of humans have oil glands that are constantly producing oil throughout our lives.  I know this is not good news if you are a pore-hater but remember that oil and pores serve really amazing life saving functions so if you really had the choice, you wouldn’t want to close them up!

Topical products might help 
Some active ingredients in acne products like benzoyl peroxide can help absorb oil on the skin which might make pores appear smaller.  Other ingredients like alpha hydroxy acids can exfoliate and break up congestion in the follicles so pores might appear smaller as congestion gets purged out of the follicles.  Our Clearing Treatment contains benzoyl peroxide and our serums and peels contain alpha hydroxy acids and other exfoliating ingredients that help cut oil and clear the follicles from the inside out.  The holistic aspects of our program include dietary and lifestyle recommendations that aim to target and reduce oil production. We don’t promise that our program or products will deliver smaller looking pores because, as I mentioned, it’s largely biological and the changes we might be able to achieve will be minimal.  There really is no program or product out there that will give you flawless poreless skin but if you have a chance at minimizing your pore size at all, our program is probably your best shot.

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Biotin Breakouts: How your hair, skin, nail supplements might actually be making your acne worse

Biotin has been all the rage in recent years for those seeking glossier nails, glowier skin and fuller, more luxurious hair.  And why the heck would someone with acne think twice about taking something as natural as biotin that is specifically clouted as being good for skin?  Unfortunately, if you have acne, you SHOULD think twice or maybe even three or four times before taking a biotin supplement because it can potentially make acne much worse.

What is biotin?
Biotin (also known as vitamin B7)  is a B vitamin that plays an important role in many essential functions such as gene regulation, cell signaling, and metabolization.  It also plays a role in the functioning or your nervous system and, yes, your hair, skin, and nails. Although it’s an essential nutrient, most of us in developed countries ingest the recommended amount of around 30mcg a day from our regular diets since biotin can be found in a number of different foods including spinach, broccoli, whole grains, eggs, yeast, seeds, nuts, beef, dairy, pork, hamburgers, and sweet potatoes.  Most supplements contain an excessive amount of biotin that far exceeds the amount our bodies actually need to maintain healthy functioning.

How does biotin affect acne?
Acne is caused by a genetic condition called Retention Hyperkeratosis that causes an overproduction of dead skin cells.  When the skin overproduces skin cells, they clog up the follicles, mix with oil and other debris and set off a chain reaction that results in acne.  So if acne is caused by too many skin cells and biotin promotes the growth of skin cells then of course it can exacerbate acne!

Biotin may or may not make your acne worse
Nothing is ever black and white when it comes to acne because everyone’s acne is different.  Each person’s acne may different in terms of severity, type, location, and triggers so biotin may or may not be a piece of your unique acne puzzle.  In order to determine whether or not biotin is actually a trigger for you, you would need to test it much like you would test an allergy. Ingestible acne triggers like certain foods, supplements, and medications take quite a while to get processed through your body and show up as visible acne on the surface of your skin so it will likely take approximately 1-3 months for you to actually be able to determine whether or not biotin is actually triggering for you.

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You don't have to avoid sugar, caffeine, fried food, alcohol, or gluten if you have acne

I cannot stand when skincare professionals tell people with acne that in order to get clear skin, they need to eat clean and avoid sugar, caffeine, fried food, alcohol, and gluten. I have even heard that some “specialists” recommend avoiding certain vegetables like tomato and eggplant!  During my acne struggle, I got so much advice about what I shouldn’t eat from the internet, Doctors, Estheticians, and even “Acne Specialists” that at one point, my diet was reduced to nearly nothing. I had a client once who was basically living off of boiled chicken and greens because she read so much bullshit online that she was convinced that everything else made acne worse.  I actually made her eat a cookie before she left my office because advice like this is unnecessary, irresponsible, and just cruel! Acne is such a difficult condition to live with to begin with so telling someone with acne that they also need to severely restrict their diets and abstain from things that they might find great pleasure in like their morning cup of coffee or a bar of chocolate can compromise their mental health. People with acne are also desperate and will pretty much do anything they are told will improve their condition so I consider it my responsibility to only recommend the guidelines that are absolutely necessary to get clear and no more so that their lives aren’t taken over even more by acne.

Acne research is flawed and unreliable
I am not saying that “unhealthy” foods are good for acne or your body and that there is no connection to breakouts.  I am saying that there is no reliable research that proves there is and over the many years I have been closely monitoring acne sufferers as they get clear and stay clear using our method, I have never once had to make someone eliminate or even reduce their “unhealthy” food or beverage intake.  

Inflammation is a very manageable symptom
Most of the professionals that recommend avoiding unhealthy food and beverages cite an increase in inflammation that can occur.  But even if certain foods increase inflammation, inflammation isn’t the cause of acne and it’s not even a trigger: it’s a symptom.  And it’s a symptom that can easily and very effectively be managed through icing and the proper use of an acne-friendly product with the right amount of benzoyl peroxide like our Clearing Treatment.  

IF eating unhealthy makes your acne worse, you have bigger fish to fry
I have had a few clients swear that sugar or greasy foods or caffeine makes their acne worse before they start our program and I still don’t bother making them avoid those things because IF that is actually the case, I know it’s merely a symptom of a whole lot of other underlying issues that need to be managed.  I even had one client get upset with me because she truly thought the reason she had acne was because she ate too many sweets and I wouldn’t agree with her. But I gave her this analogy: imagine you had a broken back that you weren’t getting professional help for or properly taking care of. So every time you bent down to grab your purse, your injury flared up and you got a shooting pain that went down your leg.  You wouldn’t then blame your purse or bending down or your leg for giving you pain, would you? No. You would blame your back because your back is the underlying issue, bending down is a trigger, and shooting pain down your leg is a symptom. So if someone told you they wanted to avoid their purse because it was causing them pain down their leg, you would think they are silly because you know logically that once they fixed the underlying issue (your back), bending down to get their purse wouldn’t trigger pain.  Well think of the connection between unhealthy food and acne the same way: acne is caused by a genetic condition that is triggered by a number of different factors including oil and hormonal fluctuations and inflammation is merely a symptom that appears as a result of those triggers flaring up an underlying condition. So if unhealthy food is causing an increase in inflammation, it’s just a sign that there are a myriad of underlying issues that need to be dealt with.

A sustainable acne program balances enjoyment and mental health with stress
You know what increases inflammation levels?  Stress. And you know what’s stressful? Living with acne. And you know what’s also stressful?  Living without chocolate. Or chips. Or cake. So even if eating something unhealthy raises inflammation levels, so does significantly restricting your diet and a sustainable acne-friendly lifestyle balances our quality of life with what we need to do to get and stay clear.

There are foods and drinks that you should avoid if you have acne
There are certain foods and drinks that should be avoided if you have acne-at least until you are clear and can test which things actually are a trigger for you.  Dairy, soy, excess iodine, and high androgen foods can all trigger acne but not just because they are “unhealthy” or inflammatory but because they have a direct link to some part of the hair follicle where acne takes place. 

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The root cause of acne is a genetic disease called Retention Hyperkeratosis-not hormones or diet or a poor lifestyle

When clients first come to see me, it takes a while to clear their heads of all of the lies and misconceptions they have been brainwashed into believing about acne.  Whether a client is starting our program with an in-person Consultation or our E-Course, we always start with a lesson on the cause of acne because I have never met a single person who actually knows what the cause of acne is.  Most people blame their acne on puberty, hormones, stress, diet, lack of exercise, weather, pollution, gut imbalances, and the list goes on and on. Although all of those things can be contributing factors, the true root cause of acne is a genetic disease called Retention Hyperkeratosis (we just call it RH because it’s so much easier).  The entire first lesson of our e-course breaks down the details of RH but here are a few tidbits: 

We are born with RH in our DNA
We are either born or not born with a predisposition towards retention hyperkeratosis. Just like any gene, it doesn’t have to be passed down directly from our parents and we might have inherited it from a grandparent or great great grandparent. The gene also has dormant and active periods and usually requires a trigger to become activated. This is similar to how you might have a genetic predisposition towards an allergy that might not get triggered until you are in your 20s and you might have periods where your symptoms are not as active as other periods. The gene also tends to manifest in different ways in different family members so your Mom might have had mild non-inflamed acne that was primarily diet triggered only for a few years as a teenager but you can have severely inflamed acne that is hormonally triggered from the ages of 13 to 45. 

RH is similar to diabetes
Our method is largely based on the research of Dr James Fulton and in his book, Acne RX, he compares acne to diabetes. Diabetics are born with a genetic predisposition that makes them unable to effectively process insulin and those of us with acne are born with a gene that makes it difficult for us to process skin cells effectively.  Acne and diabetes are also both conditions we are born with that don’t usually show symptoms until later and they are both multifactorial diseases in that they are triggered and exacerbated by a multitude of internal and external factors including diet and lifestyle.

RH manifests in many different ways throughout our lives
Even though RH is the root cause of acne, there are many other internal factors (e.g. hormones, stress) and external factors (e.g. skincare products, household products) that play a role in determining how the condition manifests itself.  So what type of acne we have at any given moment, what triggers our acne and in what amount, the location of the acne on our face or body, and the severity of our acne shifts throughout most of our lives. This is one of the many reasons why acne treatments still have such a low rate of success.

RH is a chronic disease but most of us reach a burnout stage at some point
For most of us, acne is a chronic condition that we will have to deal with for many years.  Most of us reach a burnout stage at some point in our lives where the condition just goes dormant but nobody knows when or why that happens.  For the lucky few, their acne gets triggered when they start puberty and it burns out when puberty ends which is why there is a misconception that acne is a teenage phase but many of us suffer with it well into our twenties, thirties, and forties although it might go through phases of being active and dormant throughout.  I have had many clients who were initially triggered by puberty in their teens whose acne slowed down in their twenties, completely cleared in their forties, and then got retriggered in their fifties because of menopause.

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Your acne is not caused by hormones. "Hormonal acne" is bullsh*t.

Out of all of the bullsh*t information floating around about acne, “hormonal acne” drives me the most crazy.  If hormones were the cause of acne then every human on earth would have acne because, guess what?  Every human on earth has hormones. Lots of them!  And those hormones are fluctuating, like, all the time.   Just think about it-if hormones were the cause of acne then every human who is pregnant, stressed out, not getting enough sleep, or on their period would be breaking out but that is not the case.  I think there are two reasons why “hormonal acne” has become such a prevalent term in the acne world.  The first is those stupid face map illustrations that are floating around all over the internet.  And the second is ignorant professionals who blame acne on hormones because, although they mean well, they really don’t know squat about acne.

Chin and jawline breakouts are not caused by hormones

Those face map illustrations that have become popular all over Pinterest and social media supposedly map the connections between where your acne is located on your face and which internal system is causing your acne.  According to those illustrations, acne on the cheeks is supposedly caused by dairy, breakouts on the nose are caused by indigestion, and, yup, breakouts on the chin and jawline are caused by hormonal imbalances. All of this is bulllllllsh*t.  I’ve had lots of clients who have RH but they never get triggered on their nose when they have indigestion and I have had lots of clients who never have cheek breakouts even though they consume a ton of dairy.  That is because where we break out is not a reflection of some internal system gone awry.  The location of our breakouts is determined by two things: our genes and product usage. 

The location of our breakouts is determined by these factors

Acne tends to flare up in areas where our oil glands are most active.  Genes determine where and when our oil glands get activated and they tend to get activated on different areas of our face at different points in our lives which is why acne tends to move in a wave around our face as we get older.  The “acne wave” usually starts around our t-zone around puberty and migrates to the lower half of our face in our 20s and 30s.  Comedogenic products also affect where we break out so if you are using a pore-clogging shampoo, you might break out along your hairline and if you are using a lip balm that contains coconut oil, you will likely break out around your mouth and chin.  There are dozens of skincare, personal care, and household products that can cause us to break out in various locations not just on your face but our bodies.  We go over each product in our e-course The 8 Steps To Clear Skin.

Dermatologists and skin care professionals use “hormonal acne” as a cop out

So many professionals including Dermatologists, estheticians, coaches, and acupuncturists fail to successfully treat acne so they use hormones as a reason to excuse themselves for failing.  After all, if it’s hormones then there is nothing anyone can do so it’s not their fault, right?  Wrong.  We actually don’t have to control 100% of the acne puzzle to get clear and the AES method is all about teaching you how to manage the factors that are within your control.  If you live in the San Francisco Bay Area, you can make an appointment at our clinic or check out our e-course if you are not local to learn more about our method.

Hormones can trigger or exacerbate acne but they do not cause it

Like I said, if hormones caused acne then everyone going through puberty and their menstrual cycle would be breaking out.  But if your acne journey started anything like mine then you remember dealing with middle school breakouts while everyone else seemed to maintain perfectly clear skin. The reason why some teenagers break out while others don’t isn’t because the teenagers who experience breakouts are the only ones going through puberty.  Every teenager goes through puberty but only some develop acne because hormones are a potential trigger but the root cause of acne is a genetic condition called Retention Hyperkeratosis (RH).   RH is the condition underlying acne regardless of what combination of hormones, diet, products, lifestyle, and other factors you are triggered by. 

What is the connection between Retention Hyperkeratosis and hormones?

Those of us that are born with RH have a genetic dysfunction that causes little acne seeds to be planted in our skin.  These seeds then grow due to a combination of natural, dietary, product, and lifestyle triggers.  One of those natural triggers is hormones. Without the underlying condition though, there is nothing for a trigger to set off.  In this sense, acne is similar to diabetes.  Someone who is born with Type I diabetes wouldn’t blame their condition on donuts would they?  Of course not!  They know that donuts in and of themselves don’t cause diabetes because there are plenty of people who can eat dozens of donuts without problems. Donuts are a potential trigger but the root cause of their condition is a biological dysfunction that affects insulin.  If they didn’t have a problem with insulin then donuts wouldn’t be an issue because there would be no underlying condition to trigger.  Well, think of the relationship between acne and hormones like the diabetic and the donut.  Without RH, there would be no underlying condition for hormones to trigger and this is evidenced by the fact that there are plenty of people who experience hormone fluctuations without ever getting a pimple.

Acne is a multifactorial disease so there is never one factor causing it

Even if hormones were the cause of acne, they still wouldn’t be enough to cause a breakout because acne is a multifactorial disease which means that it is always caused by a unique combination of multiple factors.  I think of acne like a puzzle-there are lots of different pieces that make up the big picture and hormones are just one piece of the puzzle.  There are dozens, even hundreds of other potential triggers including diet, medication, stress, laundry detergent, and hand soap.  

Calling acne “hormonal” is vague, ambiguous, and completely unclear

Finally, the last reason I hate the term hormonal acne is because it doesn’t really mean anything.  There are over 50 hormones and they are chemical messengers that are responsible for signaling pretty much every function in our bodies.  So of course hormones are connected to acne-they are connected to everything!  But which of the 50 hormones is it?  And which function is it signaling?  If you sign up for our e-course, we will be going over all of the potential acne triggers and the connection between acne and hormones in detail.

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Why sweat doesn't actually cause acne

Photo by Hans Reniers on Unsplash

I have SO many clients swear that sweat is causing them to break out.  You might be breaking out from certain triggers connected to your workouts like acne mechanica but sweat in and of itself is not one of them and here is why:

Sweat isn’t comedogenic
There are over a hundred ingredients called comedogenic ingredients that can clog and irritate pores but sweat doesn’t contain any of them.  Sweat is mostly composed of water and small amounts of electrolytes like sodium and chloride-none of which are toxic or comedogenic.

Sweat glands aren’t even connected to oil glands
The acne process takes place inside of your hair follicles and oil glands are attached directly to these follicles which is why oil plays an essential role in the acne process.  Sweat glands are completely separate and disconnected from both the hair follicle and the oil gland.  

Sweat does not flush out toxins
The popular misconception that sweat somehow detoxifies or flushes toxins out of our bodies is so silly.  If our sweat was toxic, our skin would probably melt off and we would be in trouble. The main role of sweating is to regulate our body temperature, not to flush out toxins. Our kidneys and livers are responsible for purifying and detoxifying our bodies so you don’t have to worry about toxins coming out of your skin and potentially causing a breakout.

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You actually can't make your pores smaller

Before we talk about pore size, let’s start with a little lesson on what a pore actually is because I’ve found that most people think they know but they actually don’t know what and where this basic skin structure is.  It’s not our fault we are so misinformed: we hear skincare companies say their products “clean deep down inside the pores” and see visuals in TV commercials that show products going into the “pore” and washing out debris.  But a pore is not the tube-like structure that extends beneath the surface of the skin where acne and debris form. That tube-like structure is called a follicle and the pore is just the opening to the follicle on the surface of the skin.  So you can’t actually “clean deep down inside the pores” because there is nothing deep about the pores-they are just a surface structure that acts like a gateway to all of the truly deep stuff like the sweat glands, oil glands, fat, nerves, and the follicles where acne forms.  In my post about how heat and steam are actually terrible for acne, I discuss how pore size is determined by what is inside of the follicle so the next two sections are taken directly from that post:

Only oil can stretch the pores open or closed
Pore size is mostly genetic and there isn’t anything you can do to significantly change it.  Pores don’t actually get smaller or bigger on their own: How big or small your pores are depends on the amount of oil your sebaceous glands produce because oil is what flows through the follicle and stretches the pores open, making it appear larger or smaller.  And oil production is determined by testosterone levels because testosterone is the chemical messenger that triggers the oil gland to get pumping among many other things. Testosterone levels are primarily biological. For example, we are born with biological clocks that signal our testosterone levels to surge during puberty, pregnancy, and the menstrual cycle.  There are certain dietary and lifestyle factors that are within our control like dairy, soy, and stress that can impact testosterone levels so if we can reduce the levels of testosterone in the body, we can reduce oil production, and maybe cause the pores to appear smaller because there is less oil stretching the pore open. This is a big maybe though and it’s unrealistic to expect poreless skin because all of humans have oil glands that are constantly producing oil throughout our lives.  I know this is not good news if you are a pore-hater but remember that oil and pores serve really amazing life saving functions so if you really had the choice, you wouldn’t want to close them up!

Topical products might help 
Some active ingredients in acne products like benzoyl peroxide can help absorb oil on the skin which might make pores appear smaller.  Other ingredients like alpha hydroxy acids can exfoliate and break up congestion in the follicles so pores might appear smaller as congestion gets purged out of the follicles.  Our Clearing Treatment contains benzoyl peroxide and our serums and peels contain alpha hydroxy acids and other exfoliating ingredients that help cut oil and clear the follicles from the inside out.  The holistic aspects of our program include dietary and lifestyle recommendations that aim to target and reduce oil production. We don’t promise that our program or products will deliver smaller looking pores because, as I mentioned, it’s largely biological and the changes we might be able to achieve will be minimal.  There really is no program or product out there that will give you flawless poreless skin but if you have a chance at minimizing your pore size at all, our program is probably your best shot.

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Oil Cleansing Is Actually Terrible For Acne

Oil cleansing is hailed by many wellness experts as the natural method for “clear, glowing, dewy-looking skin, free of blackheads, pimples, cysts, and other imperfections”.  Cosmetic companies capitalize on the trend by selling face cleansing oils that retail for over $100 which is crazy because I can promise you that there are very few oils, if any, on this earth that cost that much to manufacture.  Now, I get why oil cleansing has become popular. Acne sucks, I know. By the time I was 16, I was finishing up my second failed attempt at Accutane and I would’ve stuck my finger in an electric socket if you would’ve told me that would make the pimples go away.  Unfortunately, oil cleansing is one of those beauty trends that sound too good to be true because it is. 

The theory behind oil cleansing
Essentially, oil cleansing attempts to fight oil with oil. Reddit’s oil cleansing guide says that, “The basic idea behind oil cleansing is dissolution theory - or, more simply “like dissolves like” - oil is able to dissolve and remove substances with a similar chemical structure. Lucky for us, this includes stuff like dirt, oil, and makeup.”  In the world of acne treatments where harsh, prescription medicines and harmful side effects are the norm, the oil cleansing method attempts to counterbalance this by providing a natural, organic, solution for fighting acne.  The intention here is good and it makes sense to try something natural and safe if strong, harsh products aren’t working.  Unfortunately, the dissolution theory is just a theory and although there may be some acne sufferers that find their acne improves with oil cleansing, every single one of my clients and I personally have found that rubbing oil on our faces wreaks havoc on our acne-prone skin.   I have never actually met someone whose acne improved with oil cleansing but I never talk in absolutes when it comes to acne and there are exceptions to every rule so there are people out there who have been helped by oil cleansing which is awesome. Also, everyone’s acne puzzle is different so the only way to determine whether or not something is acne-friendly for YOUR skin is to test is and wait for the delayed reaction time.

Just because it’s natural doesn’t mean it’s good for acne
Out of all of the misconceptions my clients come in believing about acne, this is the hardest to deconstruct.  People just assume that if something is “natural”, it’s better for everything but this is absolutely not the case when it comes to acne.  There are many natural foods, products, ingredients, and methods that can actually exacerbate acne and oil cleansing is one of them.

Oil is one of the most potent acne triggers
You probably already know that oil is an essential part of the acne process.  The very first lesson in my E-Course, The 8 Steps To Clear Skin, is all about the acne process and I explain how oil is such a big deal because our sebaceous glands are connected directly to the follicles where acne takes place.  So when the sebaceous glands secrete oil, that oil gets pumped straight into the follicle where there is already a buildup of debris due to Retention Hyperkeratosis. Somehow, marketers have done a great job the past few years making us believe this backwards theory that rubbing oil on our faces is actually a good thing but Dr. James E. Fulton, the Dermatologist and medical researcher whose findings form the foundation of our program, states in his book, “Acne RX”, “...if the complex oils in sebum create such havoc in acne-prone skin, then rubbing more oils into the skin is the worst possible thing an acne sufferer can do…”.  

Acne is a multifactorial disease
I say this in almost every post and I will say it again: Acne is is a multifactorial disease in which genetic, lifestyle, environmental, and dietary factors must all collide to create a ‘perfect storm’.  To effectively and sustainably manage acne, all of these contributing factors must be addressed AT THE SAME TIME. So even if oil cleansing did work by magically reducing oil production, you would still only be addressing a single piece of a puzzle that has many other pieces including the sludging up of skin cells in the follicle, bacteria, inflammation, and hormones.

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Those aren't actually blackheads on your nose

The second most common skin concern that I hear after acne is from people wanting to get rid of the blackheads on their nose. Blackheads are a form of non-inflamed acne as I described in my post The Seven Different Types of Acne and although those dark colored dots on your nose look similar, they are actually sebaceous filaments.

What are sebaceous filaments?
Unlike blackheads which are mostly a combination of dead skin cells, oil, and maybe some comedogenic ingredients, sebaceous filaments are oil plugs that are created by the pore's natural sebum flow.  Our pore size is determined by how much sebum is flowing so the more oil, the larger the pore appears and the areas where oil glands tend to be most active are on our nose and our chin which is why these areas are where sebaceous filaments tend to be most prominent.

How do I tell the difference between a blackhead and a sebaceous filament?
Color: Blackheads tend to be a darker black color than sebaceous filaments which tend to be a lighter gray or flesh-color.

Pattern: Blackheads, like all other acne lesions, usually appear randomly and in no uniform pattern. Sebaceous filaments, on the other hand, tend to appear in perfectly even rows because they follow the pattern of our oil glands which are evenly distributed structures in our skin.

Texture: Blackheads usually have a slightly raised border but sebaceous filaments are generally smooth and flush with the skin.

What NOT to do with sebaceous filaments
DO NOT attempt to squeeze them out with your fingers or any other dirty tool in your bathroom because you risk turning it into an actual pimple and damaging the surrounding skin. Haven’t you ever squeezed them and turned your nose red and peely after?  Also, even if you squeeze it out, it will ALWAYS come back as we mention below.

How do I get rid of them?
Unfortunately, there is nothing you can do to get rid of sebaceous filaments permanently and any product that claims to do so is a LIE. There are pore strips and products that may help get rid of them temporarily and squeezing them is also a temporary solution but sebaceous filaments will fill back up in a matter of days because there is no way to shut the oil glands off. Everyone has pores that release sebum onto the surface of the skin and as much as we hate it, it plays a very important function in keeping our skin moisturized and protected.

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