If you’re someone with acne-prone skin, then you’re probably familiar with the triggers that cause your breakouts. Hormone fluctuations, stress and genetics are some of the most common causes of acne, but they aren’t the only ones that exist. Here, Dr. Ted Lain, Austin-based board-certified dermatologist, and Danielle Gronich, founder of CLEARstem Skincare and the San Diego Acne Clinic, share four other common causes of acne and what you can do to reduce your breakouts.Diet “A diet that tends to be rich in refined flours, saturated fats and animal protein is known to make acne worse,” says Dr. Lain. Dairy is also another culprit. “Dairy has tons of hormones that trigger acne,” says Gronich. “You will know if this is your trigger because blemishes will be concentrated on your chin,” she says. It can be difficult to know exactly what foods can be contributing to your acne without making dietary changes. “Changing the diet to one that is more focused on whole grains, vegetables and lean protein is a great first step,” says Dr. Lain. “If the acne does not respond after one to two months, then consider the other causes.”Over-ExfoliatingOver-exfoliating your face can cause skin dryness and as a result, acne. “Drying out oily skin using exfoliating products can paradoxically make acne worse,” says Dr. Lain. “Not only does the dryness lead to an impairment of the skin barrier, allowing bacterial infections to more readily occur and lead to acne, but also the dryness is a trigger for your skin to produce more oil, which could worsen acne.”  Dr. Lain recommends switching to products that contain ingredients that are both mildly exfoliating but also reduce the amount of acne-causing bacteria on skin. “Benzoyl peroxide is a tried and true acne ingredient which possesses these attributes,” he says. “I recommend using a cleanser with a low (CeraVe Acne Foaming Cream Cleanser is formulated with 4% benzoyl peroxide and moisturizing ceramides, making it a great choice because it will combat the acne while also repairing the skin barrier.” Vitamins and Supplements“A very common acne trigger we see at San Diego Acne Clinic is overdoing it on certain vitamins,” says Gronich. “Most of us take multiple supplements and vitamin blends in an effort to be healthy and help our skin, but if we accidentally get too much of certain vitamins, our hormones get affected, causing a surge in hormonal acne.” Excessive amounts of vitamin D can raise testosterone which Gronich explains is the primary hormone that exacerbates hormonal acne. While it is important to take your vitamins, the biggest issue is that many supplements contain higher percentages of vitamins than the recommended daily value. “Excessive vitamin D stores up in the body because it is fat-soluble, and is a very common culprit in cystic hormonal acne.” Similarly, another vitamin that can increase acne is B12, which, when taken in high doses, also has high levels of testosterone. Make sure to check your vitamins for excessive amounts of vitamin D, B12 and zinc. “If there is more than 100% of the recommended daily value then it's best to look for a different brand with lower levels, or ‘dose down’ by taking only half of the suggested serving,” says Gronich. In addition, “workout supplements, especially those with whey protein, can induce an increase in a hormone called Insulin-like Growth Factor-1 (IGF-1),” says Dr. Lain. Whey protein is derived from milk. “The skin's response to IGF-1 involves an increase in sebum production, which, in turn, may worsen acne,” he says.  Pore-Clogging Ingredients“The most common yet poorly known cause of acne is pore-clogging ingredients in skin-care,” says Gronich. She explains that the most common known ingredients that can cause clogged pores are coconut oil, coconut alkanes, algae, seaweed and ethylhexyl palmitate. “Ironically, many of these ingredients are in clean beauty products, which is why it's important to remember that ‘clean’ does not equal ‘acne-safe.” According to Dr. Lain, acne located primarily along the hairline indicates that your hair care products may be blocking the pores. Be sure to check your ingredient lists and look for the word “non-comedogenic” on the label. You can also try regularly exfoliating with a chemical exfoliant (but don’t overdo it!), like the CLEARstem Skincare Clearity serum, which can also help unclog pores and dissolve excess oil.  Photo: Chaunte VaughnRead More: 6 Acne Hacks That Actually Work, According to a DermatologistAcne Face Mapping 101: How to Decode Your Breakouts8 Potential Acne Triggers Behind Those Out-of-Nowhere Breakouts 
