What Causes Acne?

Acne is a skin condition that forms when hair follicles become blocked with oily sebum and dead skin cells. Whiteheads, blackheads, pimples, and similar blemishes can all be classified as acne. A significant amount of misinformation still surrounds this problem, but understanding its true causes can make prevention much easier.

Genes

A person’s genetics have a significant effect on acne development. Acne is extremely inheritable, though its inheritance pattern is somewhat unusual. Research shows that acne susceptibility is due to the influence of several different genes, making the condition polygenic. Additionally, acne may be associated with certain genetic disorders, such as Apert’s syndrome.

Hormones

Major hormonal changes are also potential acne triggers. Events like puberty, menstrual cycles, and pregnancy can all induce hormonal shifts that are responsible for breakouts. During puberty, an increase in androgens causes the hair follicle glands to grow and produce more sebum, resulting in acne. Researchers believe that androgen hormones are necessary for acne to occur, as people with complete androgen insensitivity syndrome do not develop acne.

Inflammation

Inflammation from any source can contribute to acne. Health experts once believed that an infection was necessary to trigger acne-causing inflammation. However, modern findings suggest acne may begin as an inflammatory condition and could be treatable with anti-inflammatory drugs. The location where the inflammation occurs can also determine what type of lesion or blemish forms.

Diet

Numerous studies link acne and diet. Carbohydrate-rich foods like bagels, bread, and chips may worsen acne. Several trials and studies have found that a low-carb diet could reduce acne. There is weak evidence that dairy milk could contribute to acne, but this requires further research. Excess vitamin B12 may trigger outbreaks similar to acne or actively worsen acne.

Mental Health

Many people believe that stress and issues like depression or anxiety increase the risk of developing acne. There are not many high-quality studies that confirm the connection between mental health and acne. Currently, most experts believe that a person’s mental health can worsen, but not cause, acne. Some people report a cycle of developing acne, which causes stress, which then worsens the acne.

Climate

In some cases, the environment contributes to acne breakouts. For example, some people notice that their acne gets worse in hot, humid climates. This condition, known as tropical acne, is usually the result of new bacteria that can only survive in warm, moist environments. In general, conditions like acne are far more common in hot regions than in cold, dry ones.

Infection

Some bacterial species contribute to acne, but experts do not fully understand the processes behind these events. The species Cutibacterium acnes has links to moderate or severe inflammatory acne, though it is unclear if the species is acquired or if it develops on the affected person. Studies also show that the parasitic mite Demodex may trigger acne development, but it is unclear if removing the parasite resolves breakouts.

Medications

Medications sometimes include acne among their lists of side effects. In most cases, these medications contain corticosteroids, lithium, or testosterone. When acne results from anabolic-androgenic steroids, it is usually called steroid acne. Contraceptives like birth control pills and similar options reduce circulating sex hormone-binding globulin, which can trigger acne in women.

Health Issues

Many health conditions and diseases can be responsible for acne. Some notable examples include polycystic ovary syndrome, andro-secreting tumors, and congenital adrenal hyperplasia, which all affect hormone activity. Issues that affect stress levels, such as premenstrual syndrome or treatments for conditions like cancer, may also trigger breakouts. Several autoinflammatory syndromes also have links to acne.

Myths

Several myths about acne and its causes have persisted for many years. Despite popular belief, there is little to no evidence that chocolate or greasy foods affect acne. Cosmetics generally do not worsen acne, as long as the wearer removes them properly, though some makeup can clog pores and irritate the skin. Additionally, excessive washing with soap or chemicals can make breakouts more severe. Thus, it is important to use hypoallergenic products during an acne outbreak.