Q: Why do acne treatments sometimes fail? 

Dr. Steve: Nodular and cystic acne are the most difficult to treat with online or over-the-counter products. But as for the other acne types — whiteheads, blackheads, papules, and pustules — I tell guys all the time, avoid these three fails and you’re on your way to clear skin: 

• Lack of consistency. Acne is a chronic condition we need to continuously address. Some guys just apply a cream a few times and wonder why it doesn’t clear their acne immediately. You need to stick to it for 90 days for results to kick in. 

• Too much product. Guys put a glob of product on their face hoping to knock out their acne aggressively. This usually causes more irritation than is normal and is another reason why guys abandon the program. 

• Too complicated. Many guys who come to me are carrying a bag with four different products they’re using. This mixing and matching causes more irritation than you really want or need. Plus, guys are spending a lot of money on these products and are disappointed when they don’t see results immediately. Get simple.

You don’t beat acne with a magical pill, drug, or cream. It’s done with a commitment to simplicity, consistency, and applying it correctly. That’s it. 

You want simple? Try Geologie’s two-step Essential acne treatment, with a face wash and a night cream. The face wash has salicylic acid to keep dirt and bacteria from plugging up your pores, while the night cream contains retinol, which reduces oil and increases healthy cell production.

Q: Can certain foods cause acne? 

Dr. Steve: The relationship between dietary habits and acne is weak. There are some studies that have looked at whey protein, dairy, sugar, red meat, and B12 vitamins, which have all been associated with worsening acne. And there are anecdotes from patients who say they eat ice cream or steak and they break out. I would say the overall data and evidence is not conclusive enough. 

But there is a plausible connection. It's interesting that in indigenous areas where Western diets have not touched, like Papua New Guinea and parts of Africa, there is no acne. If you think about it, acne happens in adolescence, when you have hormones that are addressing the anabolic building of tissue — growth hormones. And if you think about things like dairy, there are a lot of growth hormones in there that cows have ingested. But I think that it's hard for us to say “skip these foods and you'll never get acne.” I just don't want to extend too far beyond science. But there are certainly connections and there are certainly concerns.

I think acne is ultimately multifactorial — it's genetics, it's what you eat, it's where you are in your adolescence or development cycle, it's what environment you live in. That all contributes. There's no one smoking gun, certainly not diet.