What exactly causes acne?
This is a question on many of my client’s lips.
Sadly there is not a straight forward answer, simply because so much is going on within the skin.
But before we go any further, we feel we need to set the record straight.
That level of oiliness you see on your skin is hereditary.
That’s right, the number, size, and productivity of your sebaceous gland that produces sebum are determined by your genetics.
And whilst it’s true that hormones play a role in your oiliness levels, even your hormonal activity is influenced by hereditary factors.
Sebaceous gland anatomy
Sebaceous glands are found all over your body close to the skin’s surface, a membrane surrounds all of these glands which is where immature cells called sebocytes are formed.
Now, these cells are pretty active, and as they detach from the membrane and journey to the center of the sebaceous gland, they collect oil until they are almost completely converted into lipids. When the cells get full they disintegrate and all those lovely lipids are expressed directly into the sebaceous gland and up through the follicle coating the skin and hair,
All of this mixes with other surface lipids, to create a wonderful defense system on the surface known as the acid mantle.
What causes acne?
Well as if that’s not enough, oily, acne-prone skin types don’t seem to shed cells from the skin surface, or from the lining of the follicle in the same way as normal skin does.
In a normal follicle old cells are brought to the surface and shed via the hair shaft, the oil gland helps to orchestrate this turnover, by keeping the skin soft and well lubricated so that the old cells can move up and shed off.
Instead, with an acne vulgaris, a pile-up of dead skin cells builds up in the follicle – referred to in the industry as hyperkeratosis, which literally means cellular build-up. When the cells build up in the follicle like this they begin to thicken the lining causing congestion, which results in the formation of blocked pores, blackheads, and other impactions.
Sebum coats the build-up of cells in the follicle walls which also oxidizes and hardens into a mass of oil and dead cells, they then become sticky clogging the follicle. causing a vicious cycle in the skin:
- the more oil that produced the more blocked the follicle becomes
- the more bacteria thrive in this environment
- this causes inflammation, pimples papules and pustules to occur
- if the pimples are squeezed this sets off a whole cycle of infection, which is due to bacterial activity within the skin
Obviously the only way to nip this cycle in the bud is to treat it effectively which you can read all about here.
When treating acne, a dermatologist will grade your acne, so that you can put a correct treatment plan together that will get to the route of the problem both topically and systemically.