Sleep, Chocolate, or Stress? Here’s What Really Causes Pimples

Pimple Causes - Sleep, Chocolate, and Stress Explained

If you've ever struggled with inflammation, redness, or acne, you’ve likely thought about any specific habits you've done to cause all that facial drama or even make acne worse.

And it doesn't help that there are so many myths and rumors about what actually causes acne and redness out there, making it even more confusing and frustrating for you to figure out if what you're doing is actually causing pimples on your face.

And is there anything you can do to prevent acne? How can you reduce inflammation or eliminate the amount of acne and blemishes you deal with?

We’re going to cover all these questions and more, so buckle up.

Types of Acne – Breakouts Don’t Discriminate

types of acne

Most of us have experienced acne at some point in our lives, whether it's was mild acne, severe, or just some surprise occasional pimples. 

If you’ve been lucky enough to avoid acne for most of your life until now, you might be feeling stressed. A new battle with acne – or even occasional blemishes – can feel overwhelming and stressful, for sure. Especially if you’re new to treating and preventing acne.

But don’t sweat it. Almost everyone deals with skin conditions like annoying breakouts at some point in their lives. In fact, it’s estimated that up to 50 million Americans struggle with at least some form of acne. 

On top of that, The American Academy of Dermatology has confirmed that acne is the most common skin condition in the United States. This provides a huge benefit because we’ve got plenty of data to go off of, and it’s been a focus for board-certified dermatologists, estheticians, and doctors around the world. So science is on your side.

There are a lot of different types of acne, so before we get into what causes it, let’s define the different ways acne can manifest. 

Blackheads & Whiteheads – Pores Filled with Oil and Dead Skin

Blackheads and whiteheads can be grouped together since they form in a similar way. These types of acne get their name from how they appear on the surface level of the skin.

Blackheads Vs. Whiteheads

How they look: Small white or black dots on the surface of the skin. May be slightly raised.

How they form: Both start with an excess of oil production from your oil glands and dead skin cells not shedding properly. Normally, your pores excrete the perfect amount of oil but certain changes can affect more sebum production.

The sebum (oil produced by the pores), dead skin cells, and bacteria combine and clog pores. When it rises to the surface of the skin, this is the distinguishing factor: 

Whiteheads look white because the pore is closed, trapping it under the surface. 

Blackheads, however, are open pores – still clogged, but exposed to oxygen which creates a dark hue, causing it to appear black.

Inflammatory Papules – Blocked Pores Causing Small Inflammed Bumps 

Papules are similar in how they initially develop but are different in one specific way.

How they look: Small red or pink bumps that are solid to the touch and have no pus or liquid to extract.

How they form: Papules start with an excess of oil, skin, and bacteria. Instead of rising to the surface, the blockage becomes so severe that the pore walls break.

Pustules – Blocked Pores With A Pus-Filled Center

How they look: Similar to whiteheads, there is usually a white tip on the surface of the skin. But different from a whitehead, pustules have redness around the white center, indicating inflammation. They can vary in size.

How they form: Similar to a papule, it begins with too much oil in being produced in the oil glands, dead skin cells, and bacteria. The combination results in a clogged pore that ruptures the walls of the pore. The pus that develops rises to the top layer of the skin.

Be careful with pustules – they can cause scarring if they are picked or scratched.

Fungal Acne – An Overgrowth Inside the Pore Causing Irritation

How they look: Small, even shaped bumps that are itchy and red. 

How they form: When your body develops an overgrowth of yeast inside the hair follicles of your pores, it causes inflammation and itching. There is an imbalance of bacteria and fungi that your body normally regulates.

Nodules  – Deep Pimples Sensitive to the Touch

How they look: Oftentimes these are large, red, and painful pores. They are solid beneath the skin and there is nothing on the surface of the skin to extract. 

How they form: A bacteria that lives on the skin gets trapped inside the clogged pore. This can lead to an infection that causes deeper layers of the skin to react. The oil, dead skin, and bacteria burry deep within the skin and create hard bumps.

Cystic Acne  – Deep, Painful Pimples Filled with Pus

How they look: Pus-filled pimples that start deep within the skin, are extremely sensitive and hard to the touch.

How they form: Like most acne, cystic acne occurs from excess oils and dead skin cells. The difference is the volume of build-up beneath the skin. The rupture underneath the skin is highly inflamed and often leaves acne scars. 

Myth Busting: Here’s What DOESN’T Cause Acne

These days, there’s information everywhere about your health. But is that information always accurate?

Sadly, no.

Let’s take a look at some of the most common myths about what causes acne -- from severe acne to the occasional pimple -- and get into the science of what really does.

Chocolate & Greasy Food

does greasy food cause acne

You heard it here first: your favorite junk foods are not what's putting you at increased risk for developing acne.

While a nutritional and balanced diet is recommended by any board-certified dermatologist, skin expert, or nutritionist for overall health, it’s okay to indulge every once in a while.  

The idea that chocolate or greasy food is linked to acne development is simply a myth – there’s no scientific evidence to directly link the two. 

Do Other Foods Affect Acne?

To be clear, yes, there have been studies to suggest some foods and dietary factors could make you more prone to develop acne. Some of the biggest hitters are high-fat and high-sugar foods, especially when combined. 

But the health of your body – and your skin – are about much more than just the type of foods you’re eating. It’s important to have a well-rounded perspective for taking care of your body. Everything in moderation is usually fine. Just don’t overdo it. 

If you’re going to be indulging in these types of foods occasionally and are concerned you might be putting your skin at risk for acne, try incorporating a holistic skincare routine.

A holistic routine is great for acne because it respects the natural properties of your skin, promotes healing, and provides preventative care for clear happy skin – naturally.

The bottom line about food and your skin: Maintaining your health is all about balance. You don’t have to completely restrict yourself from things you enjoy. Keeping a clean diet and a generally healthy and mindful lifestyle helps combat acne, but no need to cut out your favorite treats completely.

Oily Skin

We all have different bodies, different skin, and different needs. Hormonal changes can also account for a change in the amount of natural oil your skin produces. So while at some point in your life you may have had dry skin, it's entirely possible that your body is going through changes to produce more or even excess oil.

The amount of oil your skin produces doesn’t automatically trigger acne, however.

It may just be the normal levels of oil production your body requires to care for and protect your skin.

Despite the bad rep oil gets, especially around acne, it’s a natural, healthy function of your skin. Your skin would honestly be in terrible shape without it. 

And while excessive oil can contribute to acne development, it’s not the sole cause. 

If you are prone to oily skin, just remember to keep your face clean, free from bacteria and germs, and keep a solid daily skincare routine.

Actual Causes of Acne

So now that we've hashed out what doesn't cause acne, it's time to help dig into the science of what actually does so you can learn how to control acne and feel empowered in your skin again.

Do keep in mind, however, some of these are controllable, and some are considered out of your control, check out some of these causes and risk factors of pimple production.


Hormones aren’t just about women – male hormones are very real, too!

Everyone experiences a surge of hormones as a developing adult. The Cleveland Clinic explains it perfectly: 

“Acne is largely a hormonal condition that’s driven by androgen hormones, which typically become active during the teenage and young adult years.

Sensitivity to these hormones — combined with surface bacteria on the skin and fatty acids within oil glands — can result in acne.”

And while men and women are both susceptible to acne at any time in their life, women are particularly prone to breakouts around their time of menstruation.

Fluctuating hormone levels and normal hormonal changes can cause unwanted blemishes, inflammation, and acne.

Keep this in mind as you get older and may experience adult acne, despite never experiencing any other form of breakouts earlier in your life.

Picking at Sores & Touching Your Face

Sometimes it’s just so tempting. But popping your pimples and acne sores is never the answer. Avoiding touching your face is actually one of the best things you can do to help control surface bacteria that doesn't necessarily help your skin condition.

Picking, popping, and touching an area of irritation will only worsen acne and lead to damaged skin, to increased irritation, acne-causing bacteria, and acne scars.

Think about how many items your hands touch throughout the day, and then every time you touch your face, you transfer all of that to your face. Yikes.

Even if you’re an avid hand-washer, there’s no way to completely eliminate the germs and bacteria that end up on your hands that could worsen acne.

If you really need to touch your face, we recommend doing it only after you’ve washed your hands – and preferably your face too. Touching your face may deposit dirt, pollutants, and any additional oily substance on your hands directly onto your face. 

Being mindful of cleaning your hands before touching your face helps prevent breakouts and acne. It keeps unwanted bacteria out of your pores and supports healthy, clean skin.

Air Pollution

As the world develops, technology gets smarter, and the factories get bigger, our air quality is quickly dropping. Studies have shown air pollution can directly affect the development and severity of acne on our skin. 

And it should go without saying, dirt and pollution in the air aren’t the best for clean skin – or our planet. Choosing sustainable beauty products means you’re actively supporting a better future for all of us – including your skin.


We all know stress can significantly affect our health, and that we need to find ways to reduce it in order to live our healthiest and best life. 

And like you might have guessed – stress does, indeed, have a direct impact on our skin and acne levels.

When you’re stressed or anxious, cortisol levels spike, and it could cause more severe acne. If you’re already struggling with acne, or prone to acne flare-ups, stress is not your friend. 

Understanding how to manage stress and anxiety is beneficial for more than just your skin. Your whole body benefits from lower stress levels. Self-care is a beautiful, relaxing way to show your skin some love, pamper yourself, and reset.


Like many things about your body, your genetics and hormonal changes can dictate your predisposition to acne. If your parents struggled with acne, you’ll be at a slightly higher risk for blemishes and inflammation too.

Even if your parents may not have struggled with breakouts at a young age, but experienced adult acne later in life, you may still be at a higher risk.

But not to worry – the power of science is on your side.

Many dermatologists, estheticians, and skin experts have developed incredible products and methods to help reduce acne and fight genetic tendencies for breakouts.

And it never hurts to be proactive, taking all the necessary precautions, and living mindfully, in tune with your body. Genetics are just part of life – it’s not your fault. Give yourself some grace.

Some Medications

It is true that some medications may cause acne breakouts to spike. 

One of the most common medications that can interfere with acne is hormonal contraceptives (birth control).

Birth control pills are known for both treating – and causing – acne. This might sound weird, but it all depends on the type of hormones included and the way your body processes the medicine. 

If you think your medication might be affecting your skin, consult your doctor to see how they can help. Sometimes a simple swap is all you need.

Owning Your Skin Journey

Whether you're simply looking to treat moderate acne or more severe cases, always remember that everyone’s skin is different.

Everyone will experience clogged pores at some point, it’s nothing to worry about. But there are ways you can be prepared. 

First and foremost, it's important to understand your skin type and how to best treat it. Sensitive skin, dry skin, oily skin, and so on shouldn't be treated the same when it comes to how you approach your skincare routine to prevent acne.

A good place to start, however, is with mild soap to help clean up dirty skin. After that, when looking for a solution for treating acne -- like hormone therapy, oral antibiotics, or acne creams -- make sure you're finding credible, medically reviewed information and consulting a doctor or dermatologist.

Acne treatments also affect everyone and everyone's unique skin type differently, so always be sure to do your research.

And remember – not everyone has the same skin journey. Your timeline is unique to your body and your lifestyle. So do what you can, and be informed, but don’t let it run your life.

You’re worth much more than the quality of your skin.

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