Have you ever looked in the mirror and uttered these words under 
your breath, 'Why am I still breaking out'? Did you wonder why, even in 
your adult years, you still have to put up with acne? The idea that acne
 should be a thing of the past - a teenage problem - can leave adults 
frustrated not knowing what is causing their skin breakouts. Here are 14
 things you should know to help you identify the causes of your 
flare-ups and ways to prevent them.
#1 Blame it on the hormones
Androgens,
 like testosterone, are male hormones (present in women too) which are 
responsible for causing acne. Women undergo sharp hormonal changes more 
often than men, so women are twice as likely as men to be afflicted with
 acne during adulthood. Given this fact, it is no wonder why acne can 
strike anytime in a woman's life - during puberty, ovulation, 
menstruation, pregnancy, menopause, and even after menopause. Female 
acne can also be a symptom of Polycystic Ovarian Syndrome (PCOS) which 
is a disorder caused by hormonal imbalances; however, usually, these 
individuals are overweight, have fertility issues, do not have regular 
periods and grow excess hair in unwanted areas, such as the upper lip, 
chin and chest (more manly distribution of hair). In addition, some 
people who have thyroid problems may also have trouble with acne. It is 
also interesting to know that although men are at a lower risk for adult
 acne, men are more prone than women to have more severe forms of acne 
because of the higher levels of testosterone naturally circulating 
within a man's body.
#2 Quit smoking
Did you ever notice the 
complexion of a longtime smoker? It is not supple and often looks dry, 
rough and leathery. Recent studies have discovered a phenomenon labeled 
as 'smoker's acne'; the acne in smoking individuals is non-inflammatory 
(bumps with no swelling or redness), commonly known as blackheads and 
whiteheads. Inflammatory acne, on the contrary, is when the spots are 
red, pus-like and swollen. Research shows that for people who had acne 
as teens, the probability of suffering from adult acne is four times 
higher in smokers than non-smokers. According to a British Journal of 
Dermatology, a study of 1000 women aged 25 to 50 found that 42 per cent 
of smokers had acne compared to only 10 per cent of non-smokers. It is a
 good idea to kick the habit, not only for health reasons, but also for 
the reason that smoking has long been associated with premature aging of
 the skin, wrinkles and a bad complexion.
#3 Check skin products
Sometimes
 the products you are applying on your face can trigger breakouts so pay
 close attention to your cosmetics, shaving creams, cleansers, 
moisturizers and makeup. Steer away from products with an oil-base which
 can block pores resulting in acne. Allow your skin to breathe and only 
put oil-free (noncomedogenic) products on your skin.
#4 Side effects of drugs
Since
 hormones are the main cause of acne and most acne cases are not 
drug-related, do not stop using your medications. However, bear in mind 
that some medications can cause acne breakouts. Phenobarbital 
(medication used for seizures), steroids (prescribed and illegal use in 
bodybuilding), lithium (medication for bipolar disorder), isoniazid and 
rifampin (medication used in tuberculosis), DHEA supplements (marketed 
as the extremely controversial anti-aging pill which causes serious side
 effects and has not been proven to work), hormone therapies and certain
 birth control treatments can cause or worsen acne. Again, talk to your 
doctor before discontinuing any medication.
#5 Your skin is what you eat
Although
 skepticism still exists in the dermatology community linking diet with 
acne, some people swear that certain foods cause them to break out. 
Until more solid evidence is out, the link between certain foods causing
 acne remains to be controversial. With that said, if you notice 
something you eat causes you to break out in pimples, avoid the food; by
 the same token, there is no guarantee that avoidance will necessarily 
cure your acne, but it is worth a try.
-Nuts: Although nuts are 
healthy snacks that calm our hunger pangs quickly because they are 
satiating, they can provoke acne in some individuals. 
-Dairy: Recent
 studies have shown that milk and dairy products may trigger acne. It is
 not recommended to stop dairy as a means to improve your skin until 
more studies are conducted. Calcium is abundant in dairy products and is
 crucial for osteoporosis prevention. If your dairy intake is low, make 
sure to take dietary supplements to keep your bones strong. 
-Chocolate:
 Some people experience pimples when they eat chocolate while it may not
 even faze others. It is not proven that chocolate causes acne and some 
claims have gone as far as saying 'a bar a day keeps the spots away' 
suggesting that chocolate can even cure acne!
-High glycemic foods: 
There is some evidence that foods with high-glycemic indices (sugared 
drinks, sweets, white bread and carbohydrate-rich foods) produce a quick
 spike in blood sugar which may aggravate acne. Although debate still 
exists in the scientific community around the notion that greasy and 
fatty foods worsen acne, many still carry the belief that it is 
definitely a contributor to acne. It has also been proposed that 
switching to a plant-based, low-fat, high-fiber diet can reduce acne 
flare-ups since vegetables and fruits are natural anti-oxidants and have
 anti-inflammatory properties. Eating more fish may also pave the way 
for clearer skin as they are rich in omega 3-oils which is known to 
reduce inflammation.
-Acne-fighting foods: Essential fatty acids 
(flax seeds, fish), Vitamin A (carrots, green leafy vegetables, sweet 
potatoes), zinc (whole grains, spinach), Vitamin E (green leafy 
vegetables), Vitamin C (citrus fruits, green peppers) Vitamin B-complex 
(brown rice, bananas), chromium (whole wheat breads, broccoli) and 
selenium (fish, lean meat, garlic, barley) are a sample list of foods 
that are rich in acne-suppressing vitamins and minerals. It is best to 
get these nutrients by eating enriched foods; do not take supplements 
without consulting a medical professional as overdosing can occur.
#6 Stay regular
Constipation
 can trigger acne by keeping toxins in your body. Eating a diet rich in 
fiber, drinking water and maintaining an active lifestyle will help 
prevent constipation and may be just what you need to clear up your 
skin.
#7 Stress-management
Stress-induced acne has been a 
highly debated topic and, recently, numerous studies have proven that 
stress does, in fact, worsen acne. Stress causes acne by lowering our 
immune system's ability to heal and causing androgens and cortisol to be
 activated which are acne promoting hormones.
#8 It is in the genes
Your
 genes may control your skin type. Adults with oilier skin are more 
prone to acne breakouts; also if acne runs in your family, chances are 
you will develop acne in your adult years. People who have the 
'perfect-skin gene' should really know how lucky they are.
#9 Climate
Does
 the weather affect acne? It is not hard to believe that hot and humid 
weather may cause more break-outs due to excess sweating; however, 
sweating alone does not clog pores, rather the mix of sweat with 
exposure to oils and polluted air provides a better environment for acne
 to erupt. It is also important not to use the sun to dry out your acne 
as over-exposure will prematurely age the skin, darkens spots and may 
flare up acne, let alone the cancerous effects of the sun's harmful 
ultraviolet rays. How about the cold weather? Winter tends to worsen 
acne since cold weather causes the skin to dry out and the pores to 
shrink, leading to more clogging of pores. It is essential to 
moisturize, year-around, to help keep acne from worsening. Just because 
the weather is cold, does not mean you should skip the sunscreen since 
the sun's rays are still strong and can penetrate even on a cloudy day 
or through the windshield while driving. Sunscreens should, not only be 
used in the summer, but also in the winter.
#10 Pressure and Friction
Adult
 acne can be caused by certain types of constant physical pressure to 
the skin, such as tucking a phone under the chin, or the friction from 
the straps of a backpack or purse. Tight clothing and undergarments, 
such as tight bra straps, and even excessive phone use can contribute to
 acne.
#11 Dehydration
Not only does too much sun exposure and 
cold weather worsen acne by drying out the skin, but dehydration from 
lack of fluid intake can also cause breakouts. Hydrating the skin by 
hydrating the inside of your body will help prevent clogging of pores. 
Any caffeinated drinks, such as soda, tea and coffee, are dehydrating 
because they have diuretic properties (increase urination) so limit 
their intake. Water is the best fluid for your skin.
#12 Dirt
Clogged
 pores cause acne. Acne strikes when bacteria, excess oils and clogged 
pores are present. Although, dirt itself does not cause acne, it is 
essential to maintain a daily hygienic skin regimen in order to remove 
dead cells, dirt and excess oils to prevent blockage of pores. Avoid 
touching your face because your fingers have oils that can exacerbate 
acne. Dirty, oily hair touching your skin can also clog pores.
#13 Work out
There
 is strong evidence suggesting that exercise may clear up skin by 
lowering stress levels. Sweating is a normal bodily function and does 
not directly cause acne; nonetheless, it is still recommended to pull 
your hair away from your face during exercise to avoid oils from your 
hair touching your face and wash away or towel off sweat when you finish
 working out.
#14 Get good sleep
Not getting enough sleep 
increases stress which can lead to acne. In addition, studies have shown
 that sleep deprivation increases inflammation, thus exacerbating acne.
Sometimes,
 more than one factor may be causing your acne and it is not always easy
 to figure it out. Achieving clear skin may be as simple as switching 
your facial cream to a complex problem that requires a specialist. You 
might be surprised that just by lowering your stress, your complexion 
might improve. Remember sometimes, you might feel worse than your face 
actually looks and, without a doubt, you are your own worst enemy. Keep 
in mind that a natural glow comes from within, not just from an absence 
of pimples.