11 Sneaky Causes of Acne You Might Not Expect

From hair care products to unsuspecting lifestyle factors.

While certain age groups and skin types are more prone to experiencing acne compared to others, the reality is that anyone is susceptible to breakouts. In other words: Acne isn’t just caused by oily skin, poor hygiene, or a surge of teenage hormones. Ultimately, a handful of factors can ultimately lead to breakouts or worsen existing acne. Ahead, we’re zeroing in on 10 sneaky causes of acne so you can have a better understanding of what might be triggering your own breakouts. 


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Hair Products

Hair products are formulated for your strands, but they can often wind up on your face, neck, and back. This includes styling products such as gels, creams, oils, and sprays, and even your regular old shampoo and conditioner. If your acne tends to occur around the side of your face, across your forehead, on your neck, or back, then hair products could be the issue.

“Even if they are just put on the ends of the hair, [hair products] can lead to clogging of pores while sleeping,” notes Sandy Skotnicki, MD, board-certified dermatologist and advisor for Hims & Hers. She recommends wrapping your head in a scarf before bed. You can also switch to hair products formulated for acne-prone skin or avoid certain products altogether. 

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Your Diet

What we put into our body directly impacts us in a zillion different ways, and our skin is not excluded from the list! Every person is different and there’s still a lot of research underway, notes Erum Ilyas, MD, a board-certified dermatologist with Schweiger Dermatology Group. 

“With all that being said, foods that may be considered acne-promoting include foods with a high glycemic index, high glycemic load, dairy products, fatty foods, and chocolate,” she says. “It is not a bad idea to consider addressing diet directly to at least reduce the potential role of diet and acne.” 

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Hormonal IUDs

Hormonal IUDs, including the Mirena and Skyla, have been associated with acne. Dr. Skotnicki says, “If the timing of your new acne problem started several months after getting your hormonal IUD it may be the precipitant.” Reach out to your prescribing physician if the issue is persistent and frustrating you. They may recommend an alternative birth control option or offer some treatment options to counteract the acne. 

04 of 11

Your Cell Phone

When’s the last time you sanitized your cell phone? It’s seen a lot—that lunch you ate last week, the parking lot asphalt when you accidentally dropped it getting out of the car, the subway handles, and even the bathroom. When you press it up against your face to take a call or touch your face after using it, that grime transfers to your sensitive skin. Wipe it down at least once a day.

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Your Pillowcase

Similarly, pressing your face against unwashed bedding for six to nine hours a night can absolutely trigger breakouts. Your pillowcase and sheets are a harboring ground for dirt, sweat, skincare product residue, dead skin cells, and skin oils. Swap out your pillowcase and sheets for a fresh set weekly.

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That giant pimple and last week’s stressful load may very well be connected. Dr. Ilyas explains that stress directly impacts our hormone and cortisol levels, which are responsible for triggering breakouts. “Recognizing the role that stress can play on breakouts can be a reminder to take a moment and consider the role self care can play in your skin care routine,” says Dr. Ilyas.  

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Certain Medications

If your breakouts coincide with the introduction of a new medication, it’s possible the medicine is to blame. Dr. Skotnicki says, “Some seizure medications and drugs used to treat chronic inflammatory contains, called biologics, can also cause acne.” Acne.org states that corticosteroids, testosterone, and lithium medications can trigger acne, as well. 

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The Gym

Gym equipment and floors are notoriously grimy. Add in sweat and a propensity to touch your face during a workout and you’re talking breakout city. This isn’t an excuse to skip your weekly workouts, but to rather be more mindful while exercising. The American Academy of Dermatology (AAD) says to wipe down equipment before using it (if possible), avoid touching your face, and wash your hands well immediately following a workout. (Wash them before, too, as a courtesy for others!)

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Sweaty Clothing

On that note, the second you get home from a workout you should toss your gym clothes in the hamper and take a shower. Sitting in sweaty apparel increases your chances of developing body acne, and it’s generally irritating for your skin.

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Layering Too Much Skincare

Skincare products are meant to improve your skin’s appearance, but Dr. Skotnicki warns that layering too many can trigger a breakout. “One of the main issues with using multiple skincare and makeup products together is that they are tested individually or in a vacuum,” she says. “A product may be labeled non-comedogenic, but using multiple layered products together can lead to pore clogging and milia.” 

That said, a simplified “less is more” approach may be your best bet. Also do a bit of research to make sure any new additions play nicely with your existing products. 

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Hormonal Surges & Imbalances

It’s no coincidence that breakouts tend to occur during the high-hormonal era of teenagehood. However, hormone fluctuations and imbalances can still occur well into adulthood and may ultimately be the culprit for ongoing bouts of acne.

“True acne is the interplay of hormonal triggers to increase oil and sebum in our pores and a bacteria called Cutibacterium acnes that triggers inflammation,” explains Dr. Ilyas. If you suspect hormones are a culprit, speak with your physician. Certain medications, such as spironolactone, and other therapies can help counteract hormone-induced acne. 

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  1. Pakey J, Nassim JS, Reynolds RV. Hormonal intrauterine devices and acne. Obstet Gynecol. 2022;139(5):919-921. doi:10.1097/AOG.0000000000004765

  2. Garg V, Choi JK, James WD, Barbieri JS. Long-term use of spironolactone for acne in women: A case series of 403 patients. J Am Acad Dermatol. 2021;84(5):1348-1355. doi:10.1016/j.jaad.2020.12.071

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