WHAT IS THE ROOT CAUSE OF ACNE? WHY DO SOME PEOPLE HAVE IT MORE?

The root cause of acne, also known as acne vulgaris, is the bacterium known as Propionibacterium acnes. Those with acne have been found to have higher levels of this bacterium versus those without acne. Everyone has levels of P. acnes to some degree in the skin. However, it is when the bacterium colonizes the duct of the sebaceous gland that an immune response is triggered. When this happens, an inflamed acne pustule is formed.

Inflammation not only occurs in such late stages of acne development, but also in the early stages too. And recent research shows that acne may also develop in the lack of presence of P. acnes. Other possible causes of acne vulgaris, in their early stages of research include the pro-inflammatory cytokines interleukin-1 beta, 8, 12, and 19.

Some people may struggle with acne more than others due to a variety of factors that may differ from person to person. Some risk factors of acne include:

• Excess oil production
• Hair follicles clogged by oil and dead skin cells
• Excess activity of hormones such as in puberty; or taking medications that contain hormones such as androgens, corticosteroids, or lithium.
• Family history; especially if both parents had acne.
• Exposure to greasy skin care products or grease in the workplace.
• Friction or pressure on the skin such as holding a phone against your face a lot or wearing a helmet frequently.

Stress is not a direct cause of acne but can make any acne that you have worse. In terms of the brain-gut-skin axis, any anxiety you feel may start to imbalance your gut microbiome, and in turn cause inflammation in the skin. Therefore, relaxation breathing, meditation, yoga, or talk therapy may be helpful in managing stress and lowering your risk of acne.

Research is also starting to reveal a possible link between diet and inflammation. Carbohydrate-rich foods, dairy products, and sugary foods may increase risk of acne lesions. Therefore, stick to anti-inflammatory foods such as antioxidant rich fruits and vegetables as well as omega-3 rich foods like avocado, nuts, seeds, and olives.

References:

Arck, P., et al. (2010). “Is there a ‘gut–brain–skin axis’?” Experimental Dermatology, 2010; 19: 401–405. 

Askari, PhD, N., et al. (February 2017) “Association between Acne and Serum Pro-inflammatory Cytokines (IL-1α, IL-1ß, IL-1Ra, IL-6, IL-8, IL-12 and RANTES) in Mustard Gas-Exposed Patients: Sardasht-Iran Cohort Study.” Archives of Iranian Medicine, 20(2): 86-91.

Mayo Clinic (accessed July 3, 2018) “Acne.” Mayo Clinic Online.

Mochtar, M., et al. (2018) “The Difference in Interleukin-19 Serum on Degrees of Acne Vulgaris Severity.” International Journal of Inflammation, Volume 2018, Article ID 4141579, 4 pages.

Tanghetti, MD, E.A. (September 2013) “The Role of Inflammation in the Pathology of Acne.” 6(9).