4 Main Causes Of Acne

Did you know that there are several factors that play a role in acne? In a nutshell, acne is a result of inflammation within your hair follicles (aka “pores”). This inflammation can appear in many different forms – whiteheads, blackheads, pustules, papules, and nodes as well as cysts (these are the deep, painful bumps that never seem to form whitehead and also seem to take forever to go away). A given person can have only blackheads and whiteheads, or all of the above. 

 In any case, most experts agree there are four main factors that contribute to acne… all four work together, in different levels of severity for each individual, to produce acne. Also, many of these factors are often inherited from your parents (thanks, mom). Regardless, these factors are:

  1. Oil production (aka “sebum” or “oily skin”)
  2. Dead skin cells (aka “hyperkeratinization”)
  3. Bacteria party 
  4. Inflammation / Immune system response

Oil Production

Each of your hair follicles contain tiny glands (sebaceous glands) that produce a substance called sebum, which we call “oil”. People with acne often have more active sebaceous glands, resulting in oily skin. An abundance of oil in our pores creates a cohesive environment for debris that otherwise would go away (such as dirt and makeup). Not-so-fun-facts: androgen hormones – meaning testosterone in males and progesterone in females – trigger our oil production. Furthermore, because males have more androgen hormones compared to females, we often see more severe acne in males. 

Dead Skin Cells

Everyone’s cells (including their skin cells) are constantly replacing themselves. When old skin cells die, they typically “shed” to make room for new ones. In acne-prone people, these skin cells renew and shed more rapidly than others, and or they become “trapped” within the pore. This is one reason why people with dry, flaky skin can still get acne.  The trapped dead skin cells produce the first stage of acne: the “clogged pores”, commonly known as blackheads and whiteheads. A “blackhead” is an open clogged pore which appears dark because the surface has been oxidized where as a “whitehead” is closed. 

Bacteria Party

Our skin naturally includes all kinds of bacteria, including the one that causes acne. A clogged pore creates the ideal environment for acne bacteria to grow and multiply. In addition, the clogged pore is starved of oxygen, which allows this type of bacteria to thrive. Oxygen kills acne bacteria, which is why benzoyl peroxide is commonly used to treat inflammatory acne.  Another “fun” fact:  we used to call the acne bacteria “p.acnes bacteria”… the “p.” stands for “Propionibacterium”. Recently, scientists have isolated a more specific bacteria within this group that lives on human skin; this is named “Cutibacterium”. So, you may commonly see either c. acnes or p.acnes in language referring to the bacteria that causes acne. 

Inflammatory Responses

When bacteria invades in excessive amounts, the immune system kicks in with inflammatory side-effects to make things right again. This produces the white cells we see as “pus”, which are the “dead” white blood cells and bacteria. 

These factors are more-or-less constantly at work within every person’s skin… some or all of these factors are stronger in acne-prone people. After a pore clogs it can take up to eight weeks for an acne spot to appear, and a similarly long time for treatments to take effect. The jury is still out on the extent of effects other potential factors such as nutrition choices and immune systems have on our skin; we believe the answer is likely unique for each individual as well. This is one reason why a single treatment is rarely effective for acne. It typically requires a combination of treatments, often with trial-and-error, to manage and clear this problem. 

It is important that you feel confident in your own skin, and understanding what causes those bumps that drive us all a little crazy is just the beginning step in that. Taking the appropriate steps to help yourself is the next – book a free consultation with Clinically Clear to map out a treatment plan tailored specifically for you. Also stay tuned as next week on the blog we dive into the 4 ways to resolve and prevent acne.


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