Understanding the Real Causes of Acne and How to Treat it

If you’re suffering from acne, having an understanding of the anatomy of acne is important.

Otherwise how can you begin to treat it successfully?

Many of my clients who suffer from acne, so I can sympathise, it is an extremely frustrating condition on a physical and emotional level.


  • Inflammation
  • Bacteria proliferation
  • Follicular desquamation
  • Thickening of the outer layer of skin
  • Abnormalities in sebum production

These are just some of the ways acne presents itself in the skin


  • 85% of adults will experience it at some point in their life
  • If affects 8% of those between the ages of 25 and 34
  • It affects 3% of 35 to 44 year old’s
  • It usually affects adolescent females earlier than males
  • Males will usually get acne far more more aggressively than females
  • Those with darker skin are at risk of developing post inflammatory hyper pigmentation, in conjunction with acne


Our sebaceous glands are found all over the body, close to the surface of our skin.

Surrounding these glands is a basal membrane, and it is here that immature cells called sebocytes are formed.

Once these cells becomes detached from the basal membrane they begin to collect lipids, this it does as it begins its journey towards the centre of the sebaceous gland, until it is almost completely converted into lipids.

Once full, the cell disintegrates and the lipids are expressed directly into the sebaceous gland, these secretions run up the hair shaft, through the sebaceous duct, coating the hair and the surface of the skin, mixing with other surface lipids.

These surface lipids help to create an ecosystem for the acid mantle, thus forming the skin’s defence barrier.

A large percentage of the lipids from the sebaceous glands are known as triglycerides.

P. Acnes Bacteria

As these triglycerides move up through the sebaceous duct to the skin’s surface, a change occurs in them, which is caused by the bacteria known as P.acnes bacteria.

Bacteria just loves oily environments, and the more oil produced, the more blocked our pores become and the more the bacteria thrive.

As you can imagine all of this creates a vicious cycle of inflammation, the only way to nip this in the bud is to treat the root cause, which will all depend on the grade of acne, this requires specialist advise from a dermatologist.

Acne Treatment

GP’s often prescribe antibiotics as an acne treatment, in order to attempt to reduce the level of P. acnes bacteria in the skin; this reduction helps to lower the rate of triglycerides, decreasing the inflammatory response.

The problem with antibiotics is that they only treat the symptoms and not the cause, which only has a limited effect on the bacteria, and the P.acnes becomes resistant to antibiotics.

For hormonal acne treatment birth control is often prescribed, I recommend consulting with a dermatologist or doctor regarding any concerns you may have, especially if you are currently on medication.

Previously, we wrote about hormonal acne treatment, which you may find useful.

Fatty Acids

Because Free Fatty Acids are pro inflammatory, antibiotics are not very effective for treating hormonal acne either.

I feel it makes more sense to start the treatment targeting the Fatty Acids, rather than destroying or reducing them, as they play a role in the skin barrier defence.

The Naked Truth

In order to prevent acne from occurring in the first place, it is really important to keep the acid mantle and barrier function completely intact.

Regular facials and a good daily home care routine is key, in order to keep the sebaceous glands free of blockages and moving all the time, this will prevent the build up of excess keratinisation.

It is also best to avoid wearing makeup, but if you feel you really can’t go without! Become familiar with the ingredients that go into formulations, so you know which comedogenic substances to avoid.

In order to live a life that is acne free, remember that we are all metabolically different, no two people will ever respond to a treatment in exactly the same way.

Treat your body holistically and become alert to any subtle changes within your skin, do as much research as you can on the subject, become your own physician.

Because ultimately no one knows your skin better than you.

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