Field Notes · October 12, 2025 · 5 min · By Emeka Balogun
Acne is not a hygiene problem
Why scrubbing harder makes it worse, and what actually drives a breakout.
The most persistent myth about acne is that it comes from dirty skin. It does not. A pimple forms when a pore clogs with dead skin cells and oil, the resident bacteria Cutibacterium acnes multiplies inside it, and the immune system responds with inflammation. Hormones drive oil production; genetics set the baseline. Dirt is not in the chain of events.
This matters because the hygiene myth pushes people toward harsh cleansing, astringents, and scrubbing, all of which strip the skin barrier, trigger more oil, and inflame existing lesions. The result is redder, more reactive skin and the same number of breakouts.
The effective approach is almost boring: a gentle cleanser twice daily, an evidence-based active (a retinoid, benzoyl peroxide, or a topical antibiotic depending on the type), and consistency measured in months, not days. Acne is a medical condition with real treatments, not a character flaw to be scrubbed away.
Related reading: Hormonal acne in adult women and Diet and acne: what the evidence actually says.