Acne
What Causes Acne?
The big question: Is it really your diet?
Contrary to popular belief, supersize-fries and chocolate bars don’t necessarily cause acne. If bad habits aren’t
the problem, then what is?
Acne blemishes will begin about two or three weeks before they appear in the mirror. So even if it seems as though you get a
pimple “overnight,” what’s actually happening is the final step in a longer process.
The tiny hole you know as a pore starts as a sebaceous hair follicle. At the base of each follicle, your sebaceous
glands work to produce sebum, the oil that keeps your skin moist and flexible.
Because your skin is a living organ, it’s always renewing itself. When the old cells die, they mix with the skin’s
natural oil and are sloughed off. Normally, these cells shed slowly, to make room for freshly minted skin.
However, this sloughing procedure can vary a lot from person to person. You might shed cells evenly—someone else may not.
Uneven shedding results in the dead cells sticking together to form a plug, much like the cork in a bottle. This plug, or comedo, traps
bacteria and oil inside the follicle.
The plugged follicle then swells because your skin is continuing its normal oil production. Your body attacks the bacteria with a
swarm of white blood cells, what we see at the surface as pus. The whole process takes two to three weeks, concluding with the dreaded
pimple.
Here are some of the factors known to cause acne:
Excess sebum
When androgens stimulate the sebaceous gland, it produces extra sebum. In its path up the follicle toward the skin’s
surface, the sebum mixes with skin bacteria and dead skin cells that have been sloughed from the lining of the follicle. Even though the
process is normal, the extra sebum in the follicle increases the risk of clogging, and can cause acne.
Follicle fallout
Normally, dead cells within the follicle are shed gradually and are released onto the skin’s surface. But if you have overactive
sebaceous glands, the dead cells shed more quickly. Mixed with the excess sebum, the dead skin cells will form a plug in the follicle,
preventing the skin from finishing the natural process of renewal. While not acne itself, this plug promotes the growth of acne bacteria.
Inflammation
When your body encounters unwelcome bacteria, it releases an army of white blood cells to attack the invaders. This process is called
chemotaxis or, simply put, inflammation. This is what causes a pimple to turn red, swollen, painful. The inflammatory response is
different for each person, but research shows that it’s particularly strong in adult women. This is why many women will continue to
experience acne even after their adolescent years.
Bacteria
The bacterium Propionibacterium acnes (P. acnes for short) lives on all skin types. It’s part of the skin’s normal
sebum protection plan. Once a follicle becomes plugged, however, P. acnes bacteria multiply quickly, starting the reaction we know as
inflammation in the follicle and nearby skin.
Hormones
For most acne sufferers, the problems begins at puberty, when the body begins to generate hormones called androgens. These hormones
cause the sebaceous glands to enlarge, which is a normal part of the body’s growth. However, acne sufferers have sebaceous glands that
are over-stimulated by androgens. This can continue through puberty. Androgens are also the factor associated with acne bouts during the
menstrual cycle and, on occasion, pregnancy.
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