10 Common Acne Triggers that Could be Behind Your Breakout

Bothered by persistent pimples, blackheads, bumps and cysts despite your best efforts to take care of your skin? Don’t stress (it’s bad for the complexion). While excess sebum, dead skin build-up, bacteria and hormones are known causes of acne1, there are also several lifestyle-related acne triggers that can play a role in starting – or exacerbating – your breakouts.

In Traditional Chinese Medicine, especially, we take a holistic view of the body’s systems and how the things you eat, think, drink and do can impact your skin. Read on to discover ten common acne triggers that can lead to isolated and persistent flare-ups – from both traditional and western perspectives. 

1. High stress levels

If you’ve ever had an angry pimple appear before an exam or after a breakup, you probably believe stress causes acne. And, according to Traditional Chinese Medicine (TCM), you’re (at least partially) right. 

“The stress hormone, cortisol, creates a pathway of inflammation and triggers acne and skin changes,” says Dr Vivian Tam, creator of Zilch Formulas. Why does this happen? “Stress leads to stagnation that results in inflammation and heat and toxin build-up. With nowhere to go, this build-up vents through the skin, much like the eruption of a volcano, and appears on the surface as acne.”

2. Change of skincare products

Changing your skincare products can affect your skin in many ways. And the same goes for haircare and laundry products. Firstly, the introduction of new ingredients and fragrances can result in a reaction or allergic response. The wrong type of product for your skin type, for example, a super-rich product on oily skin, may also cause breakouts or acne flare-ups. 

Another thing that often happens is skin purging, which mirrors acne symptoms but is actually a good thing – if you can ride out the adjustment period. Skin purging often occurs with the introduction of AHAs like glycolic acid, salicylic acid (BHA) and anti-ageing hero, retinol. As these ingredients speed up cellular turnover, they can bring pore blockages to the surface sooner – in the form of pimples, blackheads and whiteheads. 

This process will usually take around four to six weeks. Then you’ll start seeing fewer purge bumps and benefits including clearer, brighter, less congested skin.

3. Lack of sleep 

In western and Chinese Medicine, another lifestyle factor that can trigger breakouts is poor quality sleep. Why? Because the body does most of its repair work overnight and without adequate sleep, its ability to heal and nourish the skin is compromised. And when skin is not nurtured and is weak and stressed out, acne is more likely to take hold. 

Ever noticed that you feel freezing cold or hot and sweaty when tired? According to Dr Tam, lack of sleep can cause issues with body thermoregulation. From a Chinese Medicine point of view, imbalanced Yin and Yang in the body caused by insufficient sleep often leads to a build-up of heat that can trigger breakouts. They don't call it beauty sleep for nothing. 

4. Hormonal changes 

We probably don’t need to tell you hormones play a significant role in the formation of acne. “Whether during adolescence, around the time of menstruation or even during menopause, changes in hormone levels, such an increase in testosterone or drop in oestrogen, drive processes in the body that will cause or exacerbate acne,” says Dr Tam. 

An increase in blemishes is sometimes also seen in the early stages of pregnancy when an increase in androgens can cause the glands in your skin to grow and produce more sebum2 – setting the scene for clogged pores, bacteria breeding and blemishes. 

5. Your diet (especially sugar)

In the western world, there’s been a lot of debunking around the idea chocolate causes acne, but TCM takes a different view. “While it’s true that the odd chocolate bar won’t have serious consequences for your skin, too much may cause a breakout – especially if you’re pimple-prone,” says Dr Tam.

“This is because chocolate is a ‘heaty’ or ‘warming’ food which can make inflammation worse and trigger acne. The same is true for deep-fried oily foods and spicy foods.

Sugar and dairy should also be kept to a minimum if you’re plagued by pimples. These foods are Dampness-inducing. The easiest way to explain this is that when your body's digestive system is not 100%, it struggles to do its job – i.e. absorb nutrients and filter out waste. Damp is a byproduct of this struggling ‘filtration system’ and can make the body feel sluggish and heavy. Dairy and sugar only make this system struggle more and can contribute to breakouts by hindering the body's ability to filter and clean, causing toxin build-up.”

A sugar-heavy, high-GI diet is also viewed as detrimental in western medicine, with studies revealing spikes in blood sugar cause inflammation and insulin spikes that are also known to increase the production of sebum3

6. Your alcohol consumption

Think those Friday night cocktails aren’t having an effect? Think again. Like your hot and spicy ramen, alcohol is warming. And this means that it contributes to heat and toxin buildup in the body that can trigger or exacerbate acne.

Alcohol is believed to create an imbalance in hormone levels, increasing sebum production and leading to more frequent or severe breakouts4. And binge drinking also impacts our immune system so it’s easier for bacteria to take hold. 


7. Lack of movement 

When it comes to acne, move it and lose it is your new motto. “If you’re lacking regular exercise, the reduced blood circulation and lymphatic movement decreases the body’s ability to get rid of toxins and filter out the gunk,” says Dr Tam. 

However, if you are working up a sweat, make sure you jump in the shower soon after to wash away the sweat, dirt and bacteria that can block pores.


8. Skipping moisturiser 

A lot of people think they shouldn’t use oil on the skin if their skin is acne-prone, and a lot of people are incorrect. “What happens (when you skip moisturiser) is that your skin becomes dry which causes a negative feedback loop and signals to the body that your skin needs more oil, and so you overproduce. Overproduction of oil plus dry skin equals a clogged mess,” says Dr Tam. 


9. Excess sun exposure

The same goes for sunscreen. Despite what some would have you believe, catching some rays will not remedy your pimple problem – and excess sun exposure can instead be an acne trigger. While sun exposure may, temporarily, dry up oil and reduce redness, it will cause inflammation and can cause dehydrated skin to go into oil-producing overdrive. Not to mention putting you at risk of sun damage and skin cancer while accelerating ageing. 

10. Using the wrong makeup

If you’re battling breakouts, it’s natural to want to cover up with makeup. However, the use of heavy foundation will only clog your pores and make things worse. The key is to look for non-comedogenic (non-pore-clogging) formulas and always, always, remove your makeup before bed.

For acne-prone skin, Dr Tam recommends avoiding potential irritants including silicones, fragrance, lanolin, mica, talc and petrochemicals. “All-natural mineral makeup is ideal for acne,” she adds. “But make sure you read the label, as some products are marketed as ‘mineral’ yet contain as little as 5%.

Other acne triggers – and a supplement that can help

Aside from the above, other factors that can cause breakouts include certain medical conditions and medications – and of course genetics play a big part. If you’re looking to reduce blemishes, consider the information above and try to eat a balanced, nutrient-rich diet, move your body, manage stress and get enough good-quality sleep. 

You can also target the root causes of acne with Zilch Acne Formula. Created by Dr Tam, Zilch Formulas’ powerful combination of 17 Chinese Medicine herbs helps promote healing while addressing built-up heat, toxicity, inflammation and sluggish circulation. 

About Dr. Vivian Tam 

Dr. Vivian Tam is a Doctor of Chinese Medicine and the founder of Zilch Formulas. She has a passion for healing, without harmful effects and believes most in empowering her patients through education and providing them tools to feel confident on their own health journey.

She is an industry expert in Chinese Medicine Dermatology and is also Melbourne’s leading Cosmetic Acupuncturist. Dr Vivian Tam is a highly respected leader and educator, running seminars across Australia to educate practitioners and students. 

Dr. Vivian Tam is a registered practitioner with the Australian Health Practitioner Regulation Agency and an accredited member of the Australian Acupuncture and Chinese Medicine Association.


  1. The relationship of diet and acne (2009)
  2. 6 All-Natural Pregnancy Acne Remedies (2018)
  3. Can the right diet get rid of acne?
  4. 5 Foods That Cause Acne and Breakouts - The Dermatology Specialists

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