What really causes Acne?
Acne is a common skin condition that affects millions of people worldwide. It can be a source of frustration and self-consciousness, especially for teenagers, which can persist into adulthood. To effectively address and treat acne, it’s crucial to grasp its underlying causes. Acne isn’t solely linked to hygiene or genetics; it results from a multifaceted interplay of factors. In this article, we will delve into the key contributors to acne, emphasising that it typically arises from a combination of these factors rather than a single cause. By addressing these factors and adopting a comprehensive approach to skincare, you can manage and reduce acne breakouts effectively.
Excessive Sebum Production
Sebum, a natural oil produced by the sebaceous glands in the epidermis, is essential for maintaining skin health. However, when the body produces excessive amount of sebum together with an accumulation of dead skin cells and bacterial proliferation leads to inflammation that causes acne breakouts. When the hair follicles on the skin’s surface become clogged, it creates an ideal environment for acne to develop. This blockage can result from the accumulation of dead skin cells, sebum, or external factors like makeup, sunscreen, or pollution. When these pores are clogged, they create the perfect breeding ground for acne-causing bacteria. The skin is naturally populated with bacteria, including Cutibacterium acnes. These bacteria are typically harmless but can multiply rapidly when the hair follicles become clogged. As they multiply, they produce substances that cause inflammation and redness, leading to the formation of acne.
Hormonal Fluctuations
Overproduction of androgenic hormones like testosterone and dehydroepiandrosterone enhanced sebaceous gland activity in the skin. Excess sebum production leads to decreased linoleum acid concentration, irritating skin cells and promoting acne development.
Insulin-like growth factor 1 (IGF-1) and insulin play crucial roles in stimulating sebum production and skin cell growth. When insulin levels are chronically high our cells become resistant to it, this is what we call insulin resistance state. Increased levels of insulin also enhance sebum production.
So hormonal fluctuations cause an increase in sebum production that Propionibacterium acnes bacteria love to feed on and thrive in anaerobic conditions that are provided by clogged pores perfect environment for acne.
Genetics
Having one or both parents with a history of acne may render you susceptible to the condition, but it’s important to recognize that your dietary choices and lifestyle have a more pronounced impact on its development. Although there isn’t a specific gene identified as the direct cause of acne, certain genetic factors can influence your skin’s hormone regulation, the efficiency of dead skin cell shedding, and your susceptibility to inflammation.
Diet
Highly inflammatory foods like processed food with refined oils, additives and preservatives exacerbate acne. Also, sugar and high-glycemic-index foods, which cause a rapid increase in blood sugar, can lead to increased insulin production. Consumption of dairy products is the biggest contributor to acne due to their hormonal content. Studies have shown that milk and other dairy products can increase inflammation and IGF-1 levels, which can worsen existing acne or trigger it by increasing sebum production.
Gut-skin axis
The state of our digestive tract has a significant impact on our overall health, including our skin. When there is an imbalance in the bacteria in our gut microbiome, it may lead to a condition known as ‘leaky gut syndrome’. In this condition, the intestinal lining becomes more permeable, which allows harmful substances to enter the bloodstream and cause inflammation. The loss of diversity of good bacteria can lead to pathogenic strains taking over and altering the inflammatory responses through the interaction of bioactive metabolites.
Stress
Stress triggers the production of hormones like cortisol in your body, which can stimulate the sebaceous glands and result in increased production of sebum. Furthermore, stress can weaken your immune system, making it difficult for your body to fight off bacterial infections.
Sources for this article:
Baldwin, H. and Tan, J. (2020). Effects of Diet on Acne and Its Response to Treatment. American Journal of Clinical Dermatology, [online] 22(1).
Deng, Y., Wang, H., Zhou, J., Mou, Y., Wang, G. and Xiong, X. (2018). Patients with Acne Vulgaris Have a Distinct Gut Microbiota in Comparison with Healthy Controls. Acta Dermato Venereologica, 98(8), pp.783–790.
Dréno, B., Dagnelie, M.A., Khammari, A. and Corvec, S. (2020). The Skin Microbiome: A New Actor in Inflammatory Acne. American Journal of Clinical Dermatology, 21(1).
Heng, A.H.S., Say, Y.-H., Sio, Y.Y., Ng, Y.T. and Chew, F.T. (2021). Gene variants associated with acne vulgaris presentation and severity: a systematic review and meta-analysis. BMC Medical Genomics, 14(1).
Kim, H., Moon, S.Y., Sohn, M.Y. and Lee, W.J. (2017). Insulin-Like Growth Factor-1 Increases the Expression of Inflammatory Biomarkers and Sebum Production in Cultured Sebocytes. Annals of Dermatology, [online] 29(1), pp.20–25.