What Causes Acne?
Acne is a result of an imbalance of two or more factors in skin physiology relating to the sebaceous gland and duct system. When our body physiology is working properly, small amounts of oil (called sebum) are produced in the sebaceous glands in the dermis or deeper part of the skin. These sebaceous glands share a duct or tubule that goes to the skin with a small hair. When either too much oil is produced or blockage of the tubule preventing the escape of oil occurs, the net result is acne. The most common causes of acne are an increased production of sebaceous material due to hormone imbalance or side effects of stress that cause an overproduction of sebaceous material.
However, almost always with the occurrence of acne, there is also a related phenomenon called retention keratosis. These two big words actually refer to the lining cells of the sebaceous duct not shedding properly and staying in place for a longer period of time. This builds up like rust in a pipe until the duct is closed or blocked. When this happens, it sets events occurring that proceed to inflammation or an irritation underneath the surface of the skin. If one imagines that the sebaceous duct were a small stream that got plugged up, it causes a backup of everything upstream from the direction of flow.
Another factor is the presence of several different types of skin bacteria that normally don’t cause problems. However, when trapped beneath the skin, the bacteria begin to react chemically with the sebaceous material causing it to break down into free fatty acids. Free fatty acids are quite irritating to the deeper structure of the skin and result in inflammation.
The first signs are redness, firmness, swelling, tenderness, and heat. On about the second or third day of inflammation, white blood cells increase in the area attempting to digest the bacteria and rid the body of them. This results in the formation of pustules and even more irritation extending sideways beneath the surface of the skin.
Does stress cause acne?
Stress does not cause acne per se. Stress does stimulate our body enzyme and immune systems to cause a stimulation of the oil glands. It has been proven that lowering stress levels certainly can help to decrease oil production, and thus decrease the symptoms of acne.
Do fried foods cause acne?
Fried foods in excess certainly can cause us to gain weight. However, fried foods have not been shown to be related to causing acne. In fact, there aren’t any specific foods that cause acne.
Of course, skin health is directly related to a well balanced diet, adequate rest and general personal cleanliness. Many people have told me that a good order of tasty french fries properly cooked seemed to lower their stress level.
What part do hormones play in acne?
Hormones play an indirect but active part in acne. The part they play is related to side effects of the hormones, rather than a direct effect. It’s interesting that the male hormones (androgens) have a greater effect on skin oil production (acne) than female hormones. This said, it’s important to say that male hormones and female hormones of the ovarian type are very similar in their structural configuration. One of the side effects of female hormones related closely to the ovarian monthly cycle in women is the stimulation of oil gland activity.
Is acne contagious?
Acne is a skin condition and certainly is not contagious to your friends or family or any other person. However, if you pick or squeeze an acne lesion with your fingernails and then scratch another area, you can contaminate a non-infected sebaceous duct with bacteria-infected material and cause a new lesion to arise.
Using the general principles of washing both hands and face on a regular basis and not picking at acne lesions will decrease the likelihood of new acne lesions developing.
Who gets acne?
From a medical standpoint, one who gets acne has a combination of factors working in concert. Two or more factors can cause a condition based on the anatomy and physiology of the skin itself to promote an inflammatory response that we call acne.
The factors include:
Increased oil – either production by the sebaceous glands or added (in makeup etc.)
Retention Keratosis - skin cells that are not shed properly and plug sebaceous ducts
Trapped bacteria under the skin’s surface – normally present and harmless as they are on the surface.
By and large, genetics can play a part in acne in that our genetic blueprint does influence thickness of skin, oily tendencies of the skin and basic hormone responses. However, just because one’s parent or another family member has acne, does not necessarily mean that you or I will have acne.
It most often occurs in the teenage years, but may appear a few days after birth. This is more often related to increased activity in the hormone processes within the skin. Older persons can develop adult acne, sometimes from different causes. Still basic factors of plugging an oil gland result in the development of an inflammatory process.
If my mom or dad had acne, will I?
If your mom had acne you may have a higher likelihood of developing acne at some time in your life than your best friend. This doesn’t necessarily mean that you will have acne. In fact you may never have acne. If your mom had acne, I’ll bet she can share some secrets with you of things she tried that may have helped the symptoms of her acne.
Do all ethnic groups battle acne?
Persons in every ethnic group may have acne. The genetic component is still in effect. Each parent’s family tree will have some effect in a specific persons acne. Significant factors still relate to whether or not the person’s skin is oily and the thickness of skin. Other factors such as sun exposure, makeup and skin care products used may influence breakouts as well.
Blue eyed, lighter complexion persons usually have thinner and more dry skin as a rule. That group probably has less acne problems than some other groups.
I'm 30 -- why acne now?
It is becoming more and more common for young women who had no problem during teen years to develop acne between age 30-35. There are probably many reasons. One significant reason is related to the use of birth control pills.
Birth control pills utilize two hormone groups that are synthetically made to mimic the ovarian cycle/ovulation processes that are normally at work only during pregnancy. Specifically, birth control pills trick the ovaries into thinking the lady is already pregnant and ovulation does not occur. These synthetic hormones in most birth control pills have strong Androgenic (male hormone) side effects on sebaceous gland production of oil in the skin.
Another possible reason for the 30 year-old onset of acne might relate to hormone adjustments after a pregnancy, nursing a child, or simply experiencing the stressful lifestyle so prevalent today with all the demands and time limits we impose on ourselves.
Men may still have acne symptoms at age 30, but it is unlikely that acne will develop then for the first time. We are all still subjected to stress, and men may skip the gentle cleansing of facial areas after sports, etc., so acne can still be a problem.
Does acne occur anywhere else besides the face?
Because acne is not a disease but a condition that exists in sebaceous glands, it is possible for it to occur anywhere on the body surface that has sebaceous glands. Obviously, there are some areas void of these oil glands, such as the palms, the soles of the feet and, interestingly enough, eyelid skin. These areas have sweat glands, but they are eccrine or water glands rather than sebaceous or oil glands.
Acne mechanica is a condition that occurs with athletes especially, such as football players in the hot summer months that wear shoulder pads or clothing that rubs continually on skin that is exposed to dust, perspiration, etc. Traditional acne does commonly occur on the chest, the back, arms and legs.
Will sun exposure help acne?
Small amounts of sunlight exposure to skin certainly is healthy. Sunlight is necessary for certain vitamins to function, such as Vitamin D. If any aspect of the spectrum of sunrays has a helpful nature to acne, it would be bands close to the ultraviolet spectrum of light. For this reason, dermatologists have tried in the past to improve acne using sun lamps for the ultraviolet exposure.
One problem with the exposure of the skin to ultraviolet light, however, is that ultraviolet light causes a damaging effect to the skin itself. For this reason, ultraviolet light therapy for acne has not been as popular in recent years as it was some years ago.
Another negative effect of sunlight on the skin is that sunlight itself can cause an increased production of skin oils which may actually make acne worse.
If I stop using acne medication, will the acne return?
The factors in life that predispose one to breakouts and acne probably will remain essentially unchanged. If an acne medication has been successful in controlling breakouts and then is no longer used, the acne certainly won’t instantly return. However, over time the factors and conditions may become optimum again for acne breakouts. Unless other changes occur in life some of those skin condition factors may cause acne to return.
The good news is that those medications that had worked well in controlling acne should work well again if acne returns.
Will acne cause scarring?
Any chronic wound or delayed healing process in the skin will cause scarring, whether it be from a surgical wound with complications, an embedded splinter that takes days, weeks or months to work its way out, or an acne pustule that cannot heal.
If we look at what is causing the acne inflammatory process and its relation to a clogged duct or a clogged pore, we get a picture of events trying to occur that can’t occur.
By this I mean that if acne persists for several weeks as a pustule or infected area that cannot heal because of fluid being trapped under the skin, the probability of scarring increases. It is for this reason that dermatologists actually extract comedones or sebaceous plugs in follicles. This is done in order to open the outlet for debris to exit the skin. In cases of deep acne cysts, actually incising and draining may be necessary to minimize future scarring.
Certainly controlling acne in its early stages to prevent the formation of fluid-filled pockets is the best way to prevent permanent scarring from acne.
Homepage