The 4 Main Causes Of Acne

Understanding why you get acne is the first step in a successful treatment plan. After all, it’s easier to find an effective treatment when you understand how that treatment works. There are 4 main causes of acne that are consistently backed by science.

What is Acne?

First and foremost, it is important to understand what acne is. Acne is a common inflammatory skin condition that affects 90% of teenagers. Half of all teenagers affected by acne continue to experience the condition in adulthood. Acne can have serious psychological effects on a person and can cause scarring. In fact, approximately 20% of teenagers suffer facial scarring due to acne ^[1][2][3].

Acne is characterized by blocked and inflamed hair follicles and oil glands which result in lesions. These lesions can be inflammatory (i.e. blackheads) or non-inflammatory (i.e. whiteheads) or a mixture of both ^[4].

So what causes acne?

The 4 Main Causes Of Acne

Now, what actually causes acne? Well, the condition is caused by multiple overlapping factors. The development of acne is affected by excessive oil production, a build-up of dead skin cells, p-acnes bacteria, and inflammation ^[2][3][4][5].

Oil (sebum) is produced by the oil glands (sebaceous glands). The majority of oil glands are located on the face, back, and chest. This is why these are the most common areas for people to experience breakouts.

Hormones affect the way the oil glands work and can encourage excess oil production. Because of this, the majority of people experience some form of breakouts during puberty (a time with significant hormonal changes). It is also common for women to experience acne breakouts at certain points during their menstrual cycle ^[1][2][3].

Hormones also cause an abnormal build-up of skin cells. The excess skin cells block the hair follicles and trap the oil within the follicles ^[3][4].

P-acnes bacteria live within the oil glands and use the oils produced for energy. When hormones cause an excess of oil to be produced, the p-acnes bacteria are able to grow rapidly ^[2][3].

Furthermore, the rise in p-acnes bacteria causes inflammation in the follicle which causes the ‘red bump’ appearance. Your body responds to this inflammation by sending white blood cells (the body’s ‘fighter cells’) into the hair follicle to ‘fight’ the bacteria. Because of this, you end up with a build-up of dead white blood cells (pus) near the surface of the skin resulting in pustules ^[2][3].

Facial Hygiene and Acne

There is often a common misconception that acne is caused by poor facial hygiene, however, this is not the case. In fact, there is strong evidence to suggest that genetics play a role in the development of acne ^[6].

For example, one study looked at 458 pairs of identical twins and 1099 pairs of fraternal (non-identical) twins to determine the genetic and environmental influences involved in acne development. The study found that genetics were responsible for the majority of individual differences in acne (81%) ^[7].

Furthermore, this misconception can be psychologically damaging to people suffering from acne. The idea that acne is due to being dirty or unhygienic can intensify the shame, embarrassment, and low self-esteem experienced by people affected by the condition ^[8][9].

Overall, there are 4 main causes of acne. Therefore, you need to target each cause if you want an effective acne treatment. Specifically, you need to reduce the oil on your skin, remove built-up dead skin, and target the p-acnes bacteria.

Related Reading: Green Tea Serum For Acne

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References

1. Gollnick, H., Zouboulis, C., Akamatsu, H., Kurokawa, I. & Schulte, A. (1991). ‘Pathogenesis and Pathogenesis Related Treatment of Acne’. The Journal of Dermatology, 18, 489-499.
2. Dawson, A. & Dellavalle, R. (2013). ‘Acne Vulgaris’. British Medical Journal (BMJ), 346, 30-33.
3. Hywel, C., Williams, C., Dellavalle, R. & Garner, S. (2012). ‘Acne vulgaris’. The Lancet, 379 (9813), 361-372.
4. National Institute of Care and Excellence (NICE; 2018). ‘Acne Vulgaris’. NICE Clinical Guidelines. Available from: https://cks.nice.org.uk/acne-vulgaris#!topicsummary
5. Kraft, J. & Freiman, A. (2011). ‘Management of acne’. Canadian Medical Association Journal, 183(7), 430-435.
6. Gollnick, H. (2001). ‘Current perspectives on the treatment of acne vulgaris and implications for future directions’. Journal of the European Academy of Dermatology and Venereology, 15(3), 1-4.
7. Bataille, V., Snieder, H., MacGregor, A., Sasieni, P., & Spector, T. (2002). ‘The influence of genetics and environmental factors in the pathogenesis of acne: a twin study of acne in women’. Journal of Investigative Dermatology, 119, 317-322.
8. Pearl, A., Arroll, B., Lello, J. & Birchall, N. (1998). ‘The impact of acne: a study of adolescents’ attitudes, perception and knowledge. New Zealand Medical Journal, 111, 269-271.
9. Smithard, A., Glazebrook, C. & Williams, H. (2001). ‘Acne prevalence, knowledge about acne and psychological morbidity in mid-adolescence: a community-based study’. British Journal of Dermatology, 145, 274-279.