Acne (medically known as acne vulgaris) develops when hair follicles under the skin become clogged with sebum (oil), dead skin cells, and bacteria. However, this is just the basic mechanism — many underlying causes contribute to this process. Let's go deep into each one:
Understanding the different types of acne can help in identifying the appropriate treatment:
Whiteheads (Closed Comedones): Pores clogged with oil and dead skin cells that remain closed at the surface.
Blackheads (Open Comedones): Pores clogged with oil and dead skin cells that are open at the surface, causing oxidation and a black appearance.
Papules: Small red, tender bumps caused by inflammation or infection in the hair follicles.
Pustules: Pimples containing pus, appearing as red circles with white or yellow centers.
Nodules: Large, solid, painful lumps beneath the surface of the skin, caused by the buildup of secretions deep within hair follicles.
Cysts: Painful, pus-filled lumps beneath the surface of the skin, which can cause scars.
🔹 What Happens?
During puberty or hormonal fluctuations, the body produces androgens (male hormones present in both sexes). Androgens cause sebaceous (oil) glands to enlarge and produce more sebum, which clogs pores.
🔹 Common Triggers:
Puberty: Increases androgen levels
Menstruation: Hormonal shifts cause breakouts around periods
Pregnancy: Hormonal ups and downs can trigger acne
Polycystic Ovary Syndrome (PCOS): Common in women; leads to persistent acne
Stopping/starting birth control: Hormone fluctuations can cause flare-ups
🔹 What Happens?
Sebum is a natural oil that protects and moisturizes the skin. However, excess production can trap dead skin cells and bacteria, leading to clogged pores and acne.
🔹 Why It Happens:
Hormones (androgens)
Genetics
Heat and humidity (stimulates oil glands)
Use of oily cosmetics or skincare products
Normally, skin cells shed and are expelled from the body. But when dead cells aren’t shed properly, they mix with sebum and plug the follicle, forming comedones (blackheads or whiteheads).
🔹 Risk Factors:
Poor skin hygiene
Excessive sweating
Infrequent exfoliation
Using heavy or comedogenic makeup
🔹 What Happens?
The skin contains a bacterium called Cutibacterium acnes (formerly Propionibacterium acnes). When trapped inside blocked pores, it multiplies and causes inflammation, leading to papules, pustules, nodules, or cysts.
🔹 Consequences:
Redness
Pain
Swelling
Deep, cystic acne (severe cases)
🔹 What Happens?
Acne tends to run in families. If your parents had acne, you're more likely to develop it.
🔹 Genetic Influences:
Sebum production
Skin cell turnover rate
Inflammatory response
Hormonal sensitivity
🔹 What Happens?
Certain foods may influence acne by altering hormonal levels, especially insulin and IGF-1 (Insulin-like Growth Factor 1), which can stimulate oil glands.
🔹 Foods That May Trigger Acne:
High glycemic foods (white bread, sugar, soda)
Dairy products (especially skim milk)
Fast food and trans fats
Chocolate (in some individuals)
🔹 Helpful Foods:
Zinc-rich foods
Omega-3 fatty acids (fish, flaxseed)
Antioxidant-rich fruits and vegetables
🔹 What Happens?
Stress doesn't directly cause acne but exacerbates it by triggering hormones like cortisol, which can increase oil production and inflammation.
🔹 Stress Triggers:
Exams
Work pressure
Lack of sleep
Emotional distress
🔹 What Happens?
Using comedogenic (pore-clogging) products can block pores, leading to acne.
🔹 Harmful Practices:
Not removing makeup before sleep
Using thick creams or greasy sunscreens
Over-washing or over-exfoliating skin
Using alcohol-based toners (causes irritation and rebound oil production)
🔹 What Happens?
Certain medications can trigger or worsen acne as a side effect.
🔹 Common Culprits:
Corticosteroids
Lithium
Testosterone
Antiepileptics
Isoniazid (TB medication)
Anabolic steroids
🔹 What Happens?
Pollution and humidity can contribute to clogged pores and oil buildup.
🔹 Risk Factors:
Living in polluted areas
Wearing helmets/hats for long hours (friction and sweat)
High humidity climates
Exposure to greasy environments (e.g., kitchens)
🔹 What Happens?
Not cleaning the skin regularly or properly can lead to:
Bacteria buildup
Dirt and oil accumulation
Increased risk of breakouts
🔹 Examples:
Touching your face with dirty hands
Not changing pillowcases regularly
Using dirty makeup tools
🔹 What Happens?
Constant friction, pressure, or rubbing on skin can trigger mechanical acne.
🔹 Common Triggers:
Wearing tight clothes
Helmets, straps, masks (aka “maskne”)
Sports equipment pressing against the skin
hot and Humid Weather:
Increases sweating and oil secretion
🔹 Cold and Dry Weather:
Dries out skin, causing it to overproduce oil as compensation
This article is for informational and educational purposes only and is not intended to serve as medical advice. Always consult a qualified dermatologist or healthcare professional before starting any treatment for acne or any other skin condition. Individual results may vary based on skin type, underlying health conditions, and other factors. Home remedies mentioned in this article should be patch-tested before full application to avoid allergic reactions or irritation.