What Causes Acne?

On Jan 15th 2018


For my first blog post I think it’s important to go over the real cause of acne because there is so much misinformation out there and it’s no wonder that many people are confused by their acne condition.

Believe it or not, acne is a genetic condition that effects the way the pores function. So I know some of you may be thinking, “but my parents didn’t have acne” or “none of my siblings have acne, it’s just me.”

The thing you have to realize is that there is no set pattern with acne. It doesn’t always skip a generation nor does it always effect every generation. In some cases you may be the only person in your immediate family with acne, but try to look outside of your immediate family. Do you see acne in your cousins or aunts and uncles on one particular side? For example, in my family, neither one of my parents ever had acne, but both my brother and I did. When I looked outside of my immediate family, I noticed that a good amount of those on my mom’s side had acne, but no one on my dad’s side did. So for me, I can pinpoint that I inherited acne from my mom, even though she never had it herself.

Now that you know acne is genetic, let’s talk about how this effects the functioning of the pores.

Our pores are constantly shedding skin cells and replacing them with newer ones. The average person that is not acne-prone can shed 1 layer of dead skin cells per day. Someone who is acneic however, can shed up to 5 layers of dead skin cells per day! That is a huge difference! These cells also do not slough off easily so they start to build up or clog the inside of the pore. The technical term for this process is called Retention Hyperkeratosis.

The second component to acne is sebum or oil. Most acne prone individuals tend to be more on the oily side of things, but I will say that sometimes we do see clients in our office that are acne prone but naturally more dry skinned, so you can still be dry and have acne. This is because whether you produce a lot of oil or a little bit, the quality of the oil in acne prone individuals will be slightly thicker than what it should be, so this thickened oil ends up mixing with the buildup of dead skin cells and just further clogs the pores.

Finally, the 3 rd component to acne is bacteria. There is a special type of acne causing bacteria that lives within the skin, known as Propionibacterium acnes, or p. acnes for short. It’s important to know though that everyone on earth has this bacteria, even those that don’t break out, however us acne prone people have a much higher population of this bacteria. And it’s specifically this bacteria that is responsible for inflamed acne lesions such as pustules and cysts.

The reason why acneic skin has a higher population of this bacteria is because of retention hyperkeratosis or the excess buildup of the dead skin cells that I mentioned earlier. This bacteria is anaerobic meaning that it survives in an environment without oxygen, so because the pore gets clogged by the buildup of excess dead skin cells, oxygen cannot reach inside to kill off the bacteria. Furthermore, the bacteria feeds itself on the fatty acids of sebum and because most acne prone individuals produce a lot of oil, the bacteria has an endless supply of nutrients to keep it going.

So to quickly recap, acne is a genetic condition that effects the functioning of the pores. The 3 components are excess build up of dead skin cells, oil and bacteria.