Acne in College: Causes, Treatment, and Prevention

Jennifer E. Engen

College is a time of many changes, including new classes, new friends, and new freedoms.

But you might also find some old things, like your high school acne, stubbornly sticking around.

Acne tends to be more common, and often more severe, during adolescence. Research suggests it tends to peak earlier for females, generally between the ages of 14 and 17. For males, acne tends to peak between the ages of 16 and 19.

But for many people, acne doesn’t fully retreat until around age 25 — and sometimes not even then. Evidence suggests around 64 percent of adults still have acne in their 20s, while about 43 percent continue to experience acne into their 30s.

If you’re dealing with acne in college, you’ve more than likely had some pimples before. But your acne may seem more severe than you remember, or perhaps it’s made a sudden return after years of clear skin.

Trying to understand the mysteries of your college acne? In search of tips to help make it disappear? Read on for more details.

First, a refresher: Acne often happens when dirt and dead skin cells block pores in your skin. The blocked opening means your skin’s natural oil (sebum) has nowhere to go. As the oil builds up, it creates a great environment for the bacteria Propionibacterium acnes to thrive.

Your white blood cells quickly show up to shut down the party and duke it out with the bacteria. Their battle creates the pus and inflammation you know as a zit.

So, how does college contribute to all this? A few different ways, including:

Stress

One small but widely-cited 2003 study found university students tended to have more severe acne during stressful exam periods. The link between acne and stress remained strong even after controlling for how well the students slept and ate.

Stress alone doesn’t create zits, but it can worsen your acne or prompt a new breakout. According to the study, stress can affect acne in three ways:

  • increasing inflammation, which can increase swelling
  • prompting your skin glands to produce more oil
  • slowing down wound healing, which means your spots disappear more slowly

Communal living

When you live with a roommate, it may seem easy or less expensive to share supplies. Maybe you:

  • lend your roommate a makeup brush for an emergency touch-up
  • accidentally grab their washcloth instead of your own when washing your face
  • borrow their face wash and moisturizer when you run out

But any of these can play a part in acne. Microbes, oil, and dead skin cells can easily transfer from shared products to skin, causing a new outbreak of pimples.

Keep in mind, too, that skin care products don’t work the same way for everyone, so the brand your roommate swears by may not have the same beneficial effects for you — especially if you have different skin types.

Hormonal changes

Although you may legally reach adulthood your 18th birthday, that benchmark means nothing to your body, which continues to grow and change.

Your hormones are also still figuring themselves out. One particular hormone, androgen, prompts your skin to produce more oil, making pores fill up quicker. High androgen levels can lead to inflamed acne that’s hard to get rid of.

Estrogen, meanwhile, can reduce oil production and directly counter androgen’s effects. If you menstruate, you may notice acne breakouts right before starting your period — the point in your cycle where estrogen levels fall and progesterone and androgen levels rise.

Diet

When you go to college, your food intake may change. You may have less time and space to cook for yourself. You might also find yourself taking advantage of your new freedom to opt for foods that weren’t around when you lived at home.

Experts continue to debate whether the food you eat has any influence on acne. Some research suggests eating a lot of certain foods, including chocolate and certain dairy products, may prompt breakouts.

Researchers don’t entirely know why, but it’s possible that high fat and sugar levels in these foods may increase inflammation. Sugar can also cause your body to release insulin, which can, in turn, trigger the production of certain skin cells involved in acne.

Sure, knowing a little more about where your acne may have come from might be nice. But how do you make it leave?

The most effective acne remedies currently available include:

Topical medications

Topical medications can be a good first line of defense. These come in creams and gels you apply directly to your skin.

Common topical remedies include:

Oral medications

Oral acne medications might come in the form of a pill, capsule, or liquid. These medications may take longer to work than topical ones, but they can help address more severe breakouts when topical treatments aren’t effective.

A healthcare professional can prescribe short-term oral antibiotics like doxycycline (Monodox) or minocycline (Minocin). With these medications, you’ll often notice some improvement after about 12 weeks, give or take a few weeks. If you have severe acne, you may need to continue antibiotic treatment for up to 6 months.

Your care team will likely recommend using topical remedies alongside oral antibiotics. This combined approach to treating your acne can help reduce the amount of time you need to take an antibiotic.

You might wonder why you can’t take an antibiotic for several months, if it gets rid of your acne.

Antibiotics don’t just kill acne-causing bacteria. They can also kill helpful bacteria living in your gut. What’s more, taking an antibiotic for long periods of time can lead to antibiotic resistance, a serious public health threat.

In short, it’s important to follow your treatment plan. If you have any questions or concerns about a medication you’re using, your care team can offer more guidance.

If you menstruate, you can also treat hormonal acne with birth control pills that release estrogen. Estrogen can convince your skin to pump out less oil and tamp down spikes of androgen hormones.

Other approaches

While research on alternative remedies acne remains limited, some existing evidence suggests encouraging results.

Other approaches that may help with acne include:

  • Tea tree oil. This essential oil can help treat acne, and it may cause fewer side effects than medications like benzoyl peroxide.
  • Chemical peels. Glycolic acid and salicylic acid peels may offer short-term acne relief.
  • Photodynamic therapy. This type of light therapy can target acne-causing bacteria on your skin.

Once you get your current acne under control, you may wonder how to prevent future breakouts.

These tips can help you prevent pimples before they happen:

Consider your diet

A balanced diet can benefit your mind, your body, and your skin.

More specifically, 2020 research suggests eating plenty of fruits and vegetables may reduce your chances of experiencing acne That’s because fruits and vegetables have lots of fiber, which can help prevent the spikes of insulin that may contribute to acne.

Fish might also offer some protection against acne breakouts, since the omega-3 fatty acids in fish may help lower inflammation along with helping prevent insulin spikes.

Get more nutrition tips to help reduce breakouts.

Get plenty of sleep

All-nighters may be a college tradition, but they don’t do much for your skin. In fact, research has linked poor sleep and insomnia to increased acne.

A lack of sleep can increase your stress levels. Stress, in turn, can prompt the release of cortisol and other hormones that don’t play nice with your skin.

Making a habit of getting at least 8 hours of sleep can help prevent those zits from popping up.

Update your skin care routine

According to the American Academy of Dermatology (AAD), skin care products like makeup and sunscreen can sometimes clog your pores.

If you have product-related acne, you might notice tiny bumps on your cheeks, chin, and forehead.

Switching to products labeled “noncomedogenic” can help. Noncomedogenic simply means products are less likely to clog your pores and lead to acne breakouts.

It can also help to make a habit of cleaning your makeup brushes and sponges every week. If someone does borrow your makeup tools, it’s a good idea to wash them before using them yourself.

Even with effective skin care and self-care routines, sometimes acne can be too much to handle on your own.

Persistent acne can also happen with other health conditions, including:

  • Dermatillomania. This mental health condition can cause overwhelming urges to scratch and pick your skin, which can keep acne lesions open and spread bacteria across your body.
  • Hyperandrogenism. If your acne is accompanied by rapid weight gain or unexpected hair growth, you may have very high levels of androgen.
  • Hyperinsulinemia. High levels of insulin in your blood can cause your body to overproduce certain skin cells that contribute to acne.
  • Yeast infection. Some yeasts can cause pimples in your hair follicles, especially facial hair or body hair.

A dermatologist can help identify underlying skin conditions and prescribe medicine to help treat even severe acne. Connecting with a dermatologist may be a good next step if your acne:

  • feels very deep, swollen, or painful
  • spreads across your face and body
  • leaves behind extensive scars
  • persists for months
  • doesn’t respond to over-the-counter treatments

Even with professional treatment, acne blemishes won’t go away overnight. Still, it’s important to stick with your medication long enough to give it a chance to work.

If you don’t notice results after a few months, ask your care team about trying another medication.

Acne can affect mental health, too

Although acne is a skin condition, it can also deeply affect mental and emotional well-being.

According to research from 2012, a significant percentage of people who visit a dermatologist for acne treatment experience acne-related emotional distress:

  • 70 percent feel ashamed
  • 67 percent report a lack of confidence
  • 63 percent feel anxious or embarrassed
  • 57 percent say acne has affected their social lives

Many people blame themselves for their acne. You might, for example, think you’re causing it by not washing your face often enough, or by using the wrong cleanser, towel, or acne remedy.

But in reality, acne is a medical condition often caused by underlying physical factors like high androgen levels or inflammation. So, you can have great hygiene and still get breakouts.

If you’re finding it tough to cope with acne-related emotional distress, a therapist can offer more support.

Contrary to popular belief, acne doesn’t necessarily vanish when you leave high school. In fact, acne can be particularly prevalent in college due to things like extra stress, lifestyle shifts, and hormonal changes.

When it comes to acne remedies, you have plenty of options, including lotions, pills, and even lasers. You can also take steps to prevent future acne by eating a balanced diet, getting plenty of sleep, and changing your skin care routine.

If you have severe or persistent acne, a dermatologist can offer professional support with sleuthing out acne triggers and exploring helpful treatments.


Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.


https://www.healthline.com/health/acne/acne-in-college

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