A Dermatologist Explains: How to Prevent the Most Common Skin Disorder

Remember this: You’re never alone in your struggle with acne

There’s a good chance stress is to blame. Unsplash/Eddie Kopp

In this age of the constant selfie, people want clear, glowing skin more than ever before. Last month was Acne Awareness Month, so let’s dive into a somewhat sensitive topic and arm you with tips on how to keep in the clear.

As a dermatologist, I see patients struggling with acne every day. In fact, it’s one of my specialties. For how common it is, acne is also a very complicated disorder. It can be discouraging to fight what feels like a never-ending battle, but I can tell you from experience that it can be won—you just have to know what you’re dealing with.

Here are the three major causes of acne, and what you can do to prevent and treat your breakouts:

T-zone Acne

The most classic type of acne is something called T-zone acne. The T-zone is the area that encompasses your forehead, nose and chin. There are more oil glands here than anywhere else on the face—and, along with excess oil, the oil is very heavy. Our natural oils are supposed to be close to the consistency of water, but for those who break out, that oil is more like honey. It can become lodged in the pore, creating a blackhead. Bacteria gets trapped behind that blockage, which leads to bigger acne pimples and deeper cysts. All this trauma from a little blocked pore!

If you have acne only on the forehead, you should double check your hair styling product. Often they contain waxes and thick oils that block pores by seeping down from the scalp. Switching to oil-free hair gels may cure forehead acne.


One of the most frustrating causes of acne are hormones. In women especially, hormonal breakouts—which regularly occur along the jawline and chin—are both common and require unique treatment. They usually manifest as deep, painful cysts and can lead to permanent scarring. The skin does not like any sudden fluctuations in hormone levels, which is something that happens around the third week of your cycle, right before you have your period. At this time, estrogen and progesterone levels do a flip-flop, which turns on production of that acne-causing heavier oil. That’s why you get acne in that particular area during that particular time, like clockwork.

The discontinuation of birth control pills can also cause acne because this is another example of hormonal fluctuation. The longer you were on birth control, the longer your hormones will take to normalize.


As we’ve discussed before, one of the biggest victims of stress is your skin. Stress is a hormonal change in and of itself; when you are stressed, your body releases adrenaline and cortisol. When your cortisol levels are too high, they bombard the receptors in your oil glands causes and acne breakouts follow. The difference here from other hormonal acne is that it’s not limited to one place—if you are experiencing acne all over your face and body, there’s a good chance stress is the cause.


A great preventative measure is to switch to oil-free products. As I said, if you have dense, excess oil on your skin already, the last thing you want to do is put more oil on it. So be sure you are choosing products that say oil-free on the label. It should be on your moisturizer, sunscreen and makeup.

Two of the most effective ingredients to unclog pores are salicylic acid and benzoyl peroxide. While benzoyl peroxide is a very effective antibacterial ingredient, I find it to be a bit too drying and aggravating to the skin. Instead, I like a natural ingredient called farnesol, which is derived from a rose. I use it as the antibacterial agent in all of my acne formulas.

Acne products are notorious for being overly harsh. Contrary to popular belief, any ingredient that causes your skin to burn and flake is not going to be beneficial in the long run. You always want to keep your skin balanced. Products that cause redness or flakiness can worsen your appearance, and dead skin flakes can actually aggravate your acne by plugging the pores even more.

Rather than relying on spot treatments, which only help pimples already present, preventative products can stop acne from occurring in the first place. After all, you never know where exactly a pimple is going to pop up until it’s too late. I love alpha- and beta-hydroxyl acids—found in my Alpha Beta Peel pads—as a preventative treatment. They exfoliate dead skin and normalize that dense oil before they cause blockages in your pores. If you do get a large pimple that needs a spot treat, I recommend sulfur as an active ingredient because it draws the blockages out of the pores. My Sulfur Mask was developed as overnight mask to treat small or large problem areas.

And, if you’ve tried everything at home to no avail, don’t get discouraged. A trip to visit your dermatologist can help you fight stubborn acne, be it through antibiotics, prescription creams and, as a last resort, Accutane. Lasers used to treat acne and acne scars is a new exciting technology, my preference being Smooth Beam Laser which is FDA approved specifically for this purpose.

Just remember this: You’re never alone in your struggle with acne—you just need to find the right partner to help you manage it.

Board-certified dermatologist, dermatological surgeon and native New Yorker, Dennis Gross, M.D., founded his NYC practice in 1990 following extensive research at prestigious institutes, including Memorial Sloan-Kettering. He and his skincare expertise have been featured in publications including The New York Times Magazine, Elle, Vogue andHarper’s Bazaar. Find him on Instagram at @dennisgrossmd or www.dennisgrossmd.com. A Dermatologist Explains: How to Prevent the Most Common Skin Disorder