12 Things You Should Never Say to an Adult with Acne

We associate acne with our awkward, ugly duckling teenage years—it’s something we inevitably grow out of by the time we bloom into gorgeous, smooth-skinned swans. But for many of us (including myself), that’s just not the case. Whether you still suffer from your teenage breakouts or you woke up one morning in your 30s with hormonal cysts along your jawline, you know first-hand how vulnerable acne can make you feel—why does this thing that you can’t control have to be so highly visible to the world? And sometimes fielding advice from the peanut gallery can be downright demeaning. So, if you have a friend suffering from acne, here are 12 things she really doesn’t want to hear today.

Chances are your friend with acne is more regimented about her skin-care routine than someone with “perfect” skin. Why? Because acne sucks. It’s front and center, incredibly stubborn and has the worst timing—getting professional headshots today? Great! Your acne will come, too. In other words: I highly doubt it just didn’t occur to her to pick up a bar of soap.

Once again, not a helpful suggestion. If your friend’s dealing with hormonal or cystic acne, the cause is way more complex than a dirty face. (It’s so complex, in fact, that we don’t know where certain breakouts come from.) It’s also a question that could make your friend think that you think she’s unhygienic and dirty.

If you have a friend who rarely gets acne and woke up one day with a cluster on her left cheek, then sure, fair question. But if it’s a remark to a person who deals with chronic acne, this kind of question can feel invasive and accusatory. (And for the record, there’s no research that confirms that face sleeping has anything to do with acne.)

Notice the “maybe you’re just dirty” thread? Nix this one from your laundry list of questions.

While studies have found correlations between certain types of acne and diet, doctors still don’t know what exactly causes acne. Yes, it is generally agreed that changing hormone levels, certain medications, greasy beauty and skin-care products and genetic predisposition play a part, but according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, there are no hard and fast rules on direct cause and effect. In fact, NIAMS explains, “There are many myths about what causes acne. Dirty skin and stress do not cause acne. Also, chocolate and greasy foods do not cause acne in most people.”

Of course acne can get worse during certain phases of the menstrual cycle. But the truth is, everybody is different and your reaction to “that time of the month” is not a measure of what’s causing acne for your friend. Plus: RUDE.

You’d be stressed too if you had painful cystic acne that stayed for months and when it finally went away, left scars. Stress may induce acne, but acne begets stress. It’s a tough cycle to break out of.

No need to offer medical advice unless your friend explicitly asks for it.

For people who’ve suffered from cystic acne that didn’t respond to other treatments, this stuff (isotretinoin) is the closest thing to a miracle. But there’s a trade-off. Isotretinoin is a powerful drug that is associated with many side effects, include depression, anxiety and ulcerative colitis. It can also cause severe birth defects. Because of this, the FDA requires that women (yep, only women!) have to be on two forms of birth control if they intend to use it. It also may affect the liver, which is why monthly blood tests are mandatory during treatment. While I was on Accutane, I wound up on another prescription because it caused low cholesterol. So, I can tell you “just taking Accutane” is a really significant personal decision.

Let us remind everyone, adult cystic acne (or any kind of acne!) is not really a choice. The American Academy of Dermatology writes that “an estimated 80 percent of people between ages 11 and 30 have acne outbreaks at some point.” But because acne is a non-life-threatening disease (yep, it’s technically a disease) researchers believe that most cases go unreported, and when they are reported, it’s incredibly hard to categorize them. Bottom line: “adult female acne is commonplace, more prevalent than in adult males, and may persist beyond menopause,” writes a 2017 study published in the Journal of Clinical and Aesthetic Dermatology.

We commend you for trying to relate by sweetly displaying your large blemish, but c’mon people. If we complain, let us vent. If we don’t, keep your trap shut.

Just no.