What are 5 Causes of Acne?

Acne is a common skin condition that affects people of all ages. It occurs when hair follicles become clogged with oil and dead skin cells, often causing pimples, whiteheads, blackheads and cysts to form on the face, back, chest and shoulders. Acne can range from mild to severe, and while it primarily affects teenagers and young adults, it can persist well into adulthood.

Understanding the underlying causes of acne is key to successful treatment and prevention. Here we will explore the 5 main causes of acne and how they contribute to breakouts.

1. Excess Oil Production

Excess oil production is one of the leading causes of acne. The skin contains tiny holes called pores which have small glands called sebaceous glands underneath. These glands produce an oily substance called sebum, which helps keep the skin moisturized.

In those prone to acne, the sebaceous glands can become overactive and produce too much sebum. This excess oil mixes with dead skin cells and clogs the pores. Inside the clogged pores, bacteria grow and cause inflammation, resulting in pimples.

Hormones play a key role in regulating sebum production. During puberty, rising androgen levels cause the sebaceous glands to enlarge and make more sebum. This is why acne typically begins or worsens during the teen years. Fluctuating hormone levels before a woman's period can also trigger breakouts.

2. Excess Skin Cell Shedding

Along with excess sebum, increased shedding of dead skin cells within the hair follicle contributes to clogged pores and acne development. This accumulation of cells is known as keratinization.

Normally, dead skin cells rise to the surface and shed. But in acne-prone skin, cells shed more rapidly and clump together. The dead cells and sebum join forces and plug up the follicle. This plugged follicle provides the ideal environment for acne-causing bacteria to multiply.

Factors that speed up cell shedding include hormonal changes, medications, friction, and skin irritation. Genetics also play a role in how quickly skin regenerates. Those with overactive cell turnover are more prone to clogged pores and acne.

3. Bacteria

The bacteria known as Propionibacterium acnes, or P. acnes, contribute to acne by growing inside clogged follicles. These bacteria thrive in a pore blocked with oil and dead skin.

P. acnes bacteria feed on fatty acids present in sebum. As they rapidly multiply, their metabolic byproducts trigger inflammation. This inflammation damages the follicle wall and allows the follicle's contents to spill into the skin. This chain of events produces visible pimples.

Those with acne tend to harbor higher levels of P. acnes bacteria compared to those with clear skin. While bacteria alone do not cause acne, they play an important role in the development of inflammatory lesions.

4. Hormones

Hormonal fluctuations are a root cause of acne breakouts in adolescents, women, and those with endocrine disorders. The androgens typically responsible are testosterone, dihydrotestosterone (DHT), and insulin-like growth factor 1 (IGF-1).

Androgen hormones increase sebum production and promote skin cell shedding. During puberty, rising androgens drive excess oil and cell buildup in the follicle. In women, monthly hormonal changes related to the menstrual cycle can trigger acne.

Conditions that increase androgen levels, like polycystic ovarian syndrome (PCOS) in women and steroid abuse in men, often cause or worsen acne. The use of hormonal medications like testosterone or anabolic steroids leads to acne as a side effect as well.

For women, pregnancy, menopause, and starting or stopping birth control pills can also influence acne due to shifting hormone levels.

5. Genetics

Genetics are a factor in acne development, especially severe and treatment-resistant cases. Those with a family history of acne are more likely to struggle with recurrent breakouts.

Studies suggest genetics regulate how sensitive the skin is to androgens. People genetically predisposed to acne tend to have androgen receptors in greater numbers. This amplifies the skin’s response to normal hormone fluctuations.

Specific acne-related gene mutations are tied to abnormal immune responses in the skin that drive inflammation. Other genetic defects impair the development of the skin barrier. A weak barrier allows external acne triggers like bacteria and allergens to penetrate deep into the skin more easily.

Genetics also control sebum production and skin cell shedding rates. Excess activity in either of these areas can clog pores based on genetic programming.

Treating Acne Through Lifestyle Changes

While we can’t alter our genetics or hormone levels directly, there are lifestyle measures that can help control acne by addressing oily skin and clogged pores.

Cleanse gently. Use a mild, non-abrasive cleanser twice daily to remove excess oil and dead cells without stripping the skin. Avoid scrubbing or picking which can worsen inflammation.

Choose oil-free cosmetics and sunscreens. Greasy products can clog pores, so read labels and avoid coconut oil, cocoa butter and heavy emollients.

Shampoo regularly. Letting hair products and oils run onto the skin can lead to breakouts on the forehead, neck and back.

Watch what touches your face. Change pillowcases regularly and clean phones, glasses and headphones often to minimize bacterial transfer and pore-clogging oils.

Avoid excessive sun exposure. While some sun helps acne, too much can provoke further inflammation. Wear an oil-free sunscreen daily.

Manage stress levels. High stress increases inflammation and androgen production which worsens acne. Try relaxing activities like yoga, meditation and deep breathing.

Exercise and sleep well. Regular exercise and 6-8 hours of sleep per night help balance hormones. Avoid wearing workout gear or sleeping on dirty sheets which can cause body acne.

Eat a nutrient-dense diet. Limit processed carbs, sugar and dairy which are linked to increased sebum production and inflammation. Focus on antioxidant-rich fruits, vegetables, lean proteins and healthy fats instead. Stay hydrated with water.

Take targeted supplements. Vitamins like zinc and niacinamide (B3) help reduce oiliness. Fish oil and probiotics fight inflammation. Discuss options with your doctor.

See a dermatologist. For moderate to severe acne, prescription medications like retinoids, antibiotics and birth control pills help control breakouts by targeting oil production, bacteria and hormones. Procedures like photodynamic therapy also help unclog pores.

Key Takeaways: Top Causes of Acne Breakouts

In summary, the 5 leading causes of acne are:

• Excess sebum production triggered by hormones
• Buildup of dead skin cells and keratin in the follicle
• Bacterial growth (P. acnes) inside clogged pores
• Hormonal fluctuations related to puberty, periods and medical conditions
• Genetic factors that amplify abnormal responses in the skin

Understanding the root causes of breakouts based on these factors allows for targeted, multi-pronged treatment strategies. A combination approach is needed to address the oily skin, abnormal cell shedding, bacteria, hormones and inflammation driving acne development.

While acne can be frustrating to deal with, you have more power than your genetics. Following a customized skin care routine, making dietary changes and seeing a dermatologist for advanced care can help minimize future breakouts.

Frequently Asked Questions on What Causes Acne

Acne is a common skin condition that most people will experience at some point in their lives. It can affect people of all ages, genders and ethnicities. Understanding what leads to acne is key to treating it effectively. Below we answer some of the most frequently asked questions on the underlying causes of acne.

What is acne?

Acne occurs when hair follicles become plugged with oil and dead skin cells. This allows acne-causing bacteria called Propionibacterium acnes (P. acnes) to grow inside the plugged follicle. The bacteria trigger inflammation, leading to pimples, nodules, cysts and other blemishes. Acne most often affects the face, back, chest and shoulders.

What are the main causes of acne?

There are 5 leading causes that contribute to acne formation:

• Excess sebum (oil) production
• Buildup of dead skin cells inside follicles
• Bacterial growth (P. acnes bacteria)
• Inflammation
• Hormonal fluctuations

These factors work together to clog pores and create the ideal environment for breakouts to occur. Genetics also play a role in acne development by programming how sensitive the skin is to normal hormone changes.

How does excess oil cause acne?

The sebaceous glands in the skin produce an oily substance called sebum. This helps keep the skin moisturized. In those prone to acne, these oil-producing glands can overactivate and produce too much sebum. The excess oil mixes with dead skin cells and clogs pores, leading to breakouts.

Hormones drive sebum production, which is why acne often begins or worsens during puberty. Adolescents produce more androgens like testosterone which enlarges the sebaceous glands and increases oil secretion.

Does bacteria cause acne?

The P. acnes bacteria do not directly cause acne. However, they play a role in the development of inflammatory acne lesions like pimples and cysts. P. acnes bacteria feed on the excess oil inside clogged follicles. As they rapidly multiply, the bacteria release enzymes and other byproducts which damage the follicle wall. This allows the follicle's contents to spill into the skin, resulting in visible pimples.

Those with acne have higher levels of P. acnes compared to those with clear skin. By promoting inflammation, the bacteria make acne worse than it would be with oil and dead cells alone.

Can hormones cause acne?

Yes, hormonal fluctuations are a common trigger for acne breakouts. Hormones like testosterone, dihydrotestosterone (DHT) and insulin-like growth factor 1 (IGF-1) increase sebum production and promote skin cell shedding which leads to clogged pores.

The hormonal changes of puberty explain why acne often begins in adolescence. In women, monthly menstrual cycle hormone shifts can trigger breakouts known as cyclic acne. Conditions like polycystic ovarian syndrome (PCOS) that increase androgen levels also cause acne. Starting or stopping birth control pills can lead to acne as well due to hormone level changes.

Does stress cause acne breakouts?

Stress alone does not directly cause acne. However, high stress levels can make acne worse in those already prone to breakouts. Stress increases inflammation and ramps up production of androgens like testosterone which leads to more oil production. This can worsen clogged pores and inflammation.

Stress also impairs wound healing. This can lead to more severe acne lesions instead of minor comedones. Managing stress levels through relaxation techniques may help reduce acne by lowering inflammation and hormone shifts.

Can genetics or family history cause acne?

Genetics play a significant role in acne development, especially severe cases. Those with a family history of acne are more likely to struggle with recurrent breakouts. Genes regulate how sensitive the skin is to hormones, as well as sebum and skin cell production rates.

Certain mutations lead to amplified inflammatory responses and increased androgen receptor activity in the skin. This overactivity leaves those with a genetic predisposition more prone to clogged pores, bacteria growth and inflammation. However, lifestyle choices can help offset the effects of acne-related genes.

Do certain foods cause acne?

Despite rumors linking foods like chocolate and fried foods to breakouts, studies show no evidence that specific foods alone cause or worsen acne in most people. While poor dietary choices alone don't directly cause pimples, an overall nutrient-poor diet high in refined carbs and sugar may negatively impact skin health.

There are a few exceptions where diet can contribute to acne. In those sensitive to dairy products, lactose and whey proteins found in milk may trigger inflammation. High glycemic index foods like white bread may also worsen acne by increasing androgen secretion. For severe acne, working with a dermatologist and nutritionist to identify potential dietary acne triggers can help.

How can I prevent acne breakouts?

While acne cannot always be prevented entirely due to genetic causes, the following measures can help reduce breakouts:

• Gently cleanse skin twice daily with a mild, non-abrasive cleanser
• Use oil-free cosmetics and sunscreen
• Shampoo regularly to keep hair oils from transferring to the skin
• Avoid excessive sun exposure and wear sunscreen
• Exercise and get adequate sleep to balance hormones
• Manage stress through relaxing activities
• Eat a balanced, whole foods diet and stay hydrated
• Take supplements that reduce oil production and inflammation
• See a dermatologist for prescription medication if needed

A combination approach addressing excess oil production, clogged pores, bacteria, inflammation and hormone fluctuations is best for controlling acne long-term.

When to seek medical care for acne?

See a dermatologist for care if over-the-counter products are not helping, if scarring develops, or if acne is causing significant emotional distress. Symptoms like deep painful nodules and cysts, recurring breakouts, and acne not responding to prescription topicals also warrant a visit to the dermatologist. A doctor can prescribe stronger retinoids, oral antibiotics, hormonal agents or in-office procedures to better treat moderate to severe acne cases.

Key Takeaways

• The main acne causes are excess oil, dead skin cells, bacteria, inflammation and hormones that clog pores.
• Bacteria like P. acnes worsen inflammatory acne but don't directly cause it.
• Hormones drive increased oil production during puberty and menstrual cycles, leading to breakouts.
• While stress, diet and family history influence acne, they don't directly cause it.
• Preventive measures like gentle skin care, oil-free products and medication can help reduce acne.
• See a dermatologist for advanced treatment options if over-the-counter remedies fail to control breakouts.

Understanding the underlying causes of acne is the first step toward clearer skin. With the right treatment plan tailored to your specific acne triggers, most cases can be managed for better skin health and appearance.