Acne, Part 1: The Causes of Acne

You may consider ACNE a dirty, 4-letter word, and you would literally be right.  Those unsightly, irritating and embarrassing pimples on the face, back, neck and shoulders are all called acne and they are actually rather common.  Approximately 17 million Americans suffer from acne at some point, including an estimated three-quarters of people between 11 and 30 years old.  According to the American Academy of Dermatology, acne is the most common skin disorder in the U.S.

What is Acne?

Normally, sebaceous glands that are connected to hair follicles will carry oil up the hair shaft to lubricate, moisturize and protect the surface of skin.  Acne occurs when oil and other substances clog hair follicles and create inflammation, bulging or ruptures.  These pores get clogged by excess oil, dead skin cells and environmental dirt and debris, creating a breeding ground for bacteria.  Just like the nasal cavity gets congested when we produce too much mucus that cannot cycle through our sinuses, skin pores get congested too.  But rather than a stuffy nose, we end up with acne.

There are several types of acne pimples that appear differently on skin:

Papules:  Pink inflamed bumps from blocked hair follicles that are visible on the skin’s surface.

Cysts:  A visible bulb filled with pus that can easily leave scars.  These are like papules but are more deeply infected within hair follicles.

Pustules:  Bumps that are red or pink at the base with pus in the tip.

Blackheads:  Plugged pores open to the surface that may appear dark and create a small raised bump.  The dark color is not dirt itself, but rather oil and bacteria that turns brown with air exposure. 

Whiteheads:  Small clogged follicles that bulge beneath the surface and create tiny white bumps.

Nobules: Deeply embedded, large, solid pimples that are clearly visible on the surface of skin.

The Causes of Acne

Scientists and dermatologists are still studying the causes of acne but have identified several probable culprits:

Hormones, especially androgen, are a major contributor to acne, hence teenage-onset acne.  Puberty and other hormonal changes, such as those during pregnancy, create an enlargement and surge in the sebaceous glands.   This results in more sebum oil that can clog skin cells by breaking down cell walls and allowing bacteria to grow.  Likewise, medications that contain hormones create changes in hormones, like  contraceptives or steroids, can cause acne. 

Diet contributes to acne as well.  Diets that rely heavily on dairy and carbohydrates may lead to acne-prone skin.  Chocolate is also believed to cause an increase in acne.  Contrary to popular belief, eating greasy foods does not cause acne, but cooking around grease and oil that becomes airborne may stick to skin and clog pores.  A diet rich in vitamins, minerals, antioxidants and anti-inflammatories is great for skin.  It keeps cells healthy and happy, and encourages the rejuvenation and hydration of new skin cells. 

Harsh, synthetic and greasy skin care products and cosmetics can cause acne.  When skin care products and cosmetics such as heavy creams, lotions and foundations absorb into skin, they contribute to plugged pores.  When added to natural oils and dead skin cells, acne may result.  Also, cleansers, moisturizers and toners that include abrasive and toxic ingredients may leave skin irritated and more susceptible to acne.

Stress and genetics play a role in acne.  Unfortunately, if parents have had acne, their children are likely to get it at some point in their lifetime as well.  And as stress creates chemical changes in the body, skin reacts negatively.  Stress alone may not cause acne but with other risk factors or if someone already has acne, stress exacerbates the condition.

Pressure from items like mobile phones, backpacks and shirt collars can create friction on acne-prone areas of skin.  Also, these surfaces tend to carry bacteria from coming into contact with a variety of environments, which then transfers onto skin creating acne infections. 

Knowing the causes of acne is the first half of the battle to reducing it’s affects on skin.  The next step is learning treatments for acne that will reduce and prevent its occurrence.


Erin Stieglitz
Erin Stieglitz

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