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Acne vulgaris, commonly referred to as acne, is a prevalent skin condition affecting millions of people globally, impacting individuals of all ages. While often dismissed as a teenage concern, acne can persist well into adulthood.

Understanding the root causes of acne is crucial for developing effective treatment plans. Here, we delve into the key factors that contribute to acne breakouts:

  • Sebaceous Gland Overactivity:  The sebaceous glands are tiny factories embedded within our skin, responsible for producing sebum, an oily substance that lubricates and protects the skin. Androgen hormones, such as testosterone, act like messengers, stimulating these glands. In acne-prone individuals, androgen levels can be elevated or the sebaceous glands may be hypersensitive to normal hormone fluctuations. This leads to excessive sebum production. This oily buildup clogs pores, creating a perfect environment for acne development.

  • Corneocyte Shedding Disruption: Our skin is constantly renewing itself. Skin cells at the surface mature, die, and are naturally shed to make way for new cells. However, in acne-prone individuals, this process can become disrupted. Dead skin cells (corneocytes) accumulate on the surface instead of shedding effectively. This sticky layer mixes with sebum, further contributing to pore blockage and fostering a pro-inflammatory environment where acne-causing bacteria can thrive.

  • P. acnes ColoniSation: Propionibacterium acnes (P. acnes) is a bacterium naturally present on the skin. In healthy individuals, P. acnes populations are kept in check by the skin's microbiome. However, in acne-prone individuals, the clogged pores filled with sebum create a breeding ground for P. acnes. These bacteria feed on sebum and trigger an inflammatory response. This response manifests as the visible pimples, pustules, and nodules associated with acne.

  • Hormonal Fluctuations: Hormonal changes throughout life can significantly impact sebaceous gland activity. Androgen levels rise during puberty, often leading to the onset of acne in teenagers. Similarly, women may experience hormonal acne flare-ups around their menstrual cycles or during pregnancy due to hormonal shifts. Additionally, certain medications or medical conditions that alter hormone levels can also contribute to acne development.

  • Genetic Predisposition:  Genetics play a role in acne development. If you have a family history of acne, you are more likely to experience it yourself. This is because genes can influence various factors like sebum production, skin cell turnover rate, and the immune response to P. acnes bacteria.  Some genes may also affect the sensitivity of sebaceous glands to hormonal stimulation.

It's important to understand that hormonal changes, disruption to corneocyte shedding and sebaceous gland activity can all be triggered by internal drives- think: gut health, thyroid & liver function. Therefore it's crucial to have a holistic approach to treating acne using internal & external techniques to ensure the root cause is being addressed.

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