What Causes Acne? by Dr. Anna H Chacon
The most effective way to treat a problem is to start by fully understanding it. Dr. Anna H Chacon is an Ivy League Educated, Board-certified Dermatologist, and below she reveals the needs-must knowledge on acne so that you can better equip yourself to beat it.
What is acne?
Acne is one of the most common dermatologic conditions that we have all suffered from at least at one point of our lives. While it is most prevalent in our pubescent years and blossoms during puberty and young adulthood, it may persist way into adulthood or occur as early as childhood.
It is defined by the hallmark lesion - a pimple - also known as a “comedone” which can look like a whitehead or blackhead. Papules, pustules, and even scarring may ensue. It can be classified as mild, moderate, or severe and can affect anyone, regardless of gender, age, or ethnicity. It is also one of the most common reasons individuals seek dermatological care, so sufferers should not feel alone.
What causes pimples/comedones?
Your body’s sebaceous glands produce an oily, waxy substance called sebum which is ordinarily released onto the surface of your skin through sebaceous follicles where it plays several important roles.
However, the presence of androgen hormones leads to an increase in the production of sebum from the sebaceous gland. Ordinarily, this would be okay and just lead to oily skin, however, a combination of sebum and keratin can form to create a plug at the follicle orifice, thus preventing the sebum from being released.
This sebum subsequently builds-up under the surface of the skin where it forms the perfect breeding ground for bacteria, notably a specific type of bacteria called P.acnes (hence why it's called acne!). The proliferation of this bacteria leads to an inflammatory response from your body and thus a pimple or inflammatory lesion is formed.
When and where do we get comedones?
Because sebum plays an important role in the root causes of acne this largely, therefore, dictates when we get it - sebum peaks in our sebaceous glands when androgen hormones are most prevalent during puberty and adolescence, therefore making acne more prevalent in this age.
But it is also important to understand that androgen hormones can increase in prevalence at many other times throughout our lives and for a variety of reasons. This is why some people suffer from acne at sporadic times in their lives, in their twenties, thirties, forties, and even fifties and beyond.
Where we get acne is no coincidence either, as sebaceous glands tend to be more concentrated, numerous, and larger in size on the face - forehead and chin, and the middle of the back.
How does sebum production change?
For the first 3-6 months after we are born, sebum resembles that of an adult individual, and then throughout the rest of our infancy and childhood, it reduces in amount and waxy content until it rises inevitably during puberty. Menstrual cycles also affect sebum production - it is actually slightly greater in the second half of the menstrual cycle. This is why many women notice a correlation between their menstrual cycle and an increase in breakouts.
What about blackheads?
It is a common misconception that blackheads are the result of dirt trapped in pores, but in reality, this is not the case. A blackhead forms in the same way as other comedones, only the pore is not closed. The black coloring forms as a result of melanin (a skin pigment) going through a process of oxidization.
Positively, this does mean that blackheads can also be treated through the regulation and reduction of androgen-induced sebum production.
Are you excited by natural supplementation as a treatment?
Studies into drug-free vitamin alternatives are leading to an exciting era of acne management that has very promising results and ideas on future applicability to many suffering from this common skin condition. The Anti-Acne Club supplement is ushering in an exciting new era of acne management through the utilization of natural supplementation.
How does the Anti-Acne Club Supplement work?
The variety of ingredients target each specific stage of the pathogenesis of acne providing complete coverage, and this approach is what makes it especially interesting and exciting.
What are some of these vitamins/minerals?
Studies have evaluated the plasma level of vitamins A, E, and also the mineral Zinc in relationship to acne severity and have found that supportive treatment with zinc and both of these vitamins in severe acne may lead to satisfactory results. (1)
Diet and nutrition are important in patients suffering from acne. In another observational study of 56 cases, changes in selenium, copper, zinc, and vitamins A and E were found to have a significant therapeutic benefit in patients with acne vulgaris. (2) Interestingly selenium concentrations were found to be decreased in the blood and plasma of patients with acne vulgaris. (3) In another trial, 29 patients were given selenium supplementation of 0.2 mg twice a day for 6-12 weeks and a good result was obtained particularly in those with pustular acne highlighting the potential of this mineral in acne treatment.(4)
Vitamin C is widespread in dermatology given its anti-inflammatory activity that can potentially benefit acne while promoting wound healing and preventing scarring or post-inflammatory hyperpigmentation. (5) Vitamin D is another key player in the role of the immune system given that its deficiency has been implicated in dermatologic conditions such as psoriasis and atopic dermatitis. Improvement of inflammatory acne lesions was noticed after supplementing vitamin D in patients with vitamin D deficiency.(6)
In subjects with mild to moderate facial acne, an orally administered pantothenic acid-based dietary supplement was evaluated for safety, tolerability, and effectiveness in men and women with facial acne lesions. After 12 weeks of administration, a reduction in inflammatory blemishes and total facial lesion counts was observed and the supplement was well-tolerated and safe.(7)
Coconut oil has skin protective and anti-inflammatory properties that are being investigated on their potential role on acne.(8) In coconut oil, one of its components known as monolaurin has additional significance as it displays antimicrobial activity by disintegrating the lipid membrane of Proprionobacterium acnes (the bacteria that colonizes sebum).(9) Black pepper extract has been shown to have strong anti-inflammatory activity, and its role on acne merits further exploration.(10)
Finally, Diindolylmethane has been shown to exhibit promising anti-androgenic characteristics which makes it an exciting component in the regulation of sebum production. (11)
1) Ozuguz P, Dogruk Kacar S, Ekiz O, Takci Z, Balta I, Kalkan G. Evaluation of serum vitamins A and E and zinc levels according to the severity of acne vulgaris. Cutan Ocul Toxicol. 2014 Jun;33(2):99-102. doi: 10.3109/15569527.2013.808656. Epub 2013 Jul 5. PMID: 23826827.
2) Xu HQ, Liang CR, Xi YP. [Changes in serum copper, zinc, vitamin A and E and their significances in patients with acne vulgaris--observation of therapeutic effect in 56 cases treated with zhenye baishecao]. Zhong Xi Yi Jie He Za Zhi. 1986 Mar;6(3):169-70, 133. Chinese. PMID: 2942302.
3) Michaëlsson G. Decreased concentration of selenium in whole blood and plasma in acne vulgaris. Acta Derm Venereol. 1990;70(1):92. PMID: 1967890.
4) Michaëlsson G, Edqvist LE. Erythrocyte glutathione peroxidase activity in acne vulgaris and the effect of selenium and vitamin E treatment. Acta Derm Venereol. 1984;64(1):9-14. PMID: 6203294.
5) Telang PS. Vitamin C in dermatology. Indian Dermatol Online J. 2013;4(2):143-146. doi:10.4103/2229-5178.110593
6) Lim SK, Ha JM, Lee YH, Lee Y, Seo YJ, Kim CD, Lee JH, Im M. Comparison of Vitamin D Levels in Patients with and without Acne: A Case-Control Study Combined with a Randomized Controlled Trial. PLoS One. 2016 Aug 25;11(8):e0161162. doi: 10.1371/journal.pone.0161162. PMID: 27560161; PMCID: PMC4999291.
7) Yang M, Moclair B, Hatcher V, et al. A randomized, double-blind, placebo-controlled study of a novel pantothenic Acid-based dietary supplement in subjects with mild to moderate facial acne. Dermatol Ther (Heidelb). 2014;4(1):93-101. doi:10.1007/s13555-014-0052-3
8) Varma SR, Sivaprakasam TO, Arumugam I, et al. In vitro anti-inflammatory and skin protective properties of Virgin coconut oil. J Tradit Complement Med. 2018;9(1):5-14. Published 2018 Jan 17. doi:10.1016/j.jtcme.2017.06.012
9) Lin TK, Zhong L, Santiago JL. Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils. Int J Mol Sci. 2017;19(1):70. Published 2017 Dec 27. doi:10.3390/ijms19010070
10) Thring TS, Hili P, Naughton DP. Antioxidant and potential anti-inflammatory activity of extracts and formulations of white tea, rose, and witch hazel on primary human dermal fibroblast cells. J Inflamm (Lond). 2011;8(1):27. Published 2011 Oct 13. doi:10.1186/1476-9255-8-27
11) Bovee TF, Schoonen WG, Hamers AR, Bento MJ, Peijnenburg AA. Screening of synthetic and plant-derived compounds for (anti)estrogenic and (anti)androgenic activities. Anal Bioanal Chem. 2008 Feb;390(4):1111-9. doi: 10.1007/s00216-007-1772-3. Epub 2008 Jan 11. PMID: 18188547.