How Acne Happens

To treat acne effectively, it’s important to understand how acne forms and what causes it. The most important thing to remember about acne is: It's not your fault. Contrary to popular belief, acne is not caused by external factors such as what you eat, how often you wash your face or exercise. Acne is caused by a combination of physiological factors at work far beneath the skin’s surface that are beyond our control.

The Secret Life of a Pimple

Causes of Acne

When it comes to acne, there is no one "cause" but many factors at play which are beyond our control, such as:

• How often you shed skin cells which can change throughout your life.
• The amount of sebum that your skin produces which is affected by your hormone balance, which is often in flux — especially for women.
• Research has shown that genetics play a big part in the development and persistence of acne, so your family history can also give you a good idea of how likely it is that you will develop acne.

The Five Main Causes of Acne

Your best weapon in the fight against acne is knowledge. The more you know about the causes of acne, the more you can work out the best plan of attack.

There are five main causes of acne. Each of these factors can vary dramatically between individuals and while you can’t control them, understanding these factors can help you find the most effective acne treatment.

Hormones

For most acne sufferers, skin problems start at puberty, when the body begins to produce hormones called androgens. These hormones cause the sebaceous glands to enlarge, which is a natural part of the body's development.

In acne sufferers, however, the sebaceous glands are overstimulated by androgens, which can sometimes persist well into adulthood. Androgens are also responsible for acne flare-ups during the menstrual cycle and, for some people during pregnancy.

Extra sebum

When the sebaceous gland is stimulated by androgens, it produces extra sebum (oil).

As the sebum makes its way up the follicle towards the skin’s surface, it mixes with common skin bacteria and dead skin cells that have been shed from the lining of the follicle.

While this process is normal, the presence of extra sebum in the follicle increases the chances of clogging which can cause acne.

Follicle fallout

Dead skin cells within the follicle usually shed gradually and are dislodged onto the skin’s surface. In people with overactive sebaceous glands — (including almost everyone during puberty) — these cells are shed more rapidly.

When this happens, the dead skin cells mix with the excess sebum and form a plug in the follicle, preventing the skin from finishing its natural process of renewal.

Bacteria

The bacteria Propionibacterium acnes, (P. acnes) exists in all skin types; it’s part of the skin’s natural sebum maintenance system.

Once a follicle is plugged, however, P. acnes bacteria multiply rapidly, creating the chemical reaction that results in inflammation in the follicle and surrounding skin.

Inflammation

When your body comes in contact with unwanted bacteria such as P. acnes, it sends an army of white blood cells to attack the intruders. This process is called chemotaxis; or, the inflammatory response.

This response is what makes pimples red, swollen and painful. The inflammatory response is different for everyone.

What can I do?

Fortunately, there are options! There are many kinds of acne treatments available. But first, you need to know the type and severity of your condition. Acne, varies dramatically from person to person — it can take many forms, and have very different responses to treatment. The more you know about your specific form of acne, the more likely you are to find a treatment that works for you.