What Is Acne? Its Common Causes

Acne is a disease that affects skin's oil glands, which open to outside through small pores in the skin. These glands make an oily substance called sebum. The pores connect to the glands by a canal called a follicle. Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows out through the follicle. When the follicle of a skin gland clogs up, a pimple grows.

Soon, everyone has a pimple or pimples in life. Most pimples are found on the face, neck, back, chest and shoulders.

It occurs mostly during adolescence, about 20% of all cases occurring in adults. It commonly starts during puberty between the ages of 10 and 13 and tend to be worse in people with oily skin. Teenage acne usually lasts for five to 10 years. It occurs in both sexes. Teenage boys tend to have different forms but girls have mild to moderate forms, which may tend to persist in their 30s and beyond.

Its causes –

Three things are required for acne to occur: overproduction of sebum, irregular shedding of dead skin and buildup of bacteria in the pores. Some common causes are enumerated below:

Hormones – Acne can be considered a hormonal disease. During puberty, an increase in androgen (male hormones) levels takes place both in males and females, which signals the body to produce more sebum. The surplus sebum seems to be instrumental in clogging hair follicles where bacteria grow, causing acne pimples and blemishes. In women, acne symptoms fluctuate cyclically due to estrogen hormone levels during menstrual cycles. About 63% of acne prone women experience the premenstrual flares, which usually strike about seven to 10 days before the sunset of a period and then subside as soon as bleeding begins.

The effects of hormonal changes on acne can also be seen during pregnancy, use of oral contraceptives and to a lesser degree menopause.

Bacteria – Excess sebum blocks the openings to hair follicles and bacteria can grow in these clogged follicles. This results in blackheads or whiteheads, also known as comedones, on the skin's surface. Sometimes, the clogged follicles break open, resulting in leaks of sebum into nearby tissues, due to which papules or pustules are formed. This is called inflammatory acne. Larger, tender pustules are called nodules.

Diet – There seems to be an association between diet and acne but this needs to be substantiated further. Due to our modern diets and Western style of living, achieving sustainable relief of acne from changes in diet alone remains an elusive goal. Many argument that increased calorie take results in higher male hormone (androgen) levels, that worsening acne symptoms. This needs further validation by more studies. Eating a more balanced ratio of Omega-3 and Omega-6 fats can help modulate inflammation in the human body. Since acne is an inflammatory disease, it makes sense that anything that can reduce inflammation would also help reduce acne.

Researchers have found that hyperinsulinemia – a condition having higher insulin levels in blood – elicits a hormonal response that supports unregulated epithelial growth and increased sebum secretion. This condition can also be induced by unhealthy diet.

Recent research suggests that diet certainly does have an effect and a low-glycemic, Mediterranean-style diet may provide one of the safest options in the management of the condition.

Chocolates have no link to acne as they are mostly blamed for, nor do other frequently blamed foods such as pizza and potato chips, the caveat being that they should be consumed within limits.

Stress-Stress causes an inflammatory response in the body. Under stress, the adrenal glands go into overdrive due to which the production of androgens increases. Higher androgen levels can lead to more acne. The adrenal glands produce a much larger percentage of androgens in women than men. This may explain why stress seems to affect women more than men when it comes to acne. Stress also produces excess of cortisol, which may also exacerbate existing acne. But stress connection needs to be investigated further.

The bottom line –

Acne is a common disorder that causes considerable distress in people who have it. Most acne specialists have argued that there is no clear association between acne and foods such as chocolate or other sweets. But some newer studies suggest that acne may be linked to diet, although the benefits of dietary modification to reduce the incidence or severity of acne are not well established at present.