Understanding exactly what is happening when you experience breakouts is the key component to preventing and controlling them. The formation of acne is a biological pathway and to fully understand this pathway we have to dive into this topic on a cellular level.
Acne, scientifically recognized as Acne vulgaris, is an inflammatory skin condition resulting from hair follicles becoming clogged with sebum and dead skin cells. How does your hair follicles become clogged? First, an over production of sebum is caused by genetic factors, hormonal changes, environmental changes, and stress. Second, the accumulation of dead skin cells is caused by hyperkeratinization, where mature skin cells are caught in the hair follicle instead of being pushed to the skin’s surface to be washed away. Lastly, poor hygiene and exposure to pollution in the environment can cause clogged pores. The combination of dead skin cells and sebum accumulating in the hair follicle create a favorable environment for the acne causing bacteria, Propionibacteriaum acnes (P. acnes).
Genetics and hormonal changes, both separately and simultaneously, are the main culprits in the formation of acne. Hyperkeratinization is a result of hormonal changes. Dihydrotestosterone (DHT), the androgen responsible for sebaceous glands producing sebum, levels are directly affected by genetics and hormonal changes. Either genetics or hormonal changes increase the levels of DHT which in turn, causes an overproduction of sebum.
Other factors that indirectly affect sebum production are the environment and stress. Environmental changes such as temperature affect the fluidity of sebum, in colder temperatures the fluidity of sebum is lower an can cause clogged pores whereas temperature with higher humidity levels causes sebum to have a healthy flow. Stress also plays a huge factor on the levels of hormone production, which in turn causes and overproduction of sebum, and the rate at which your immune system responds to foreign entities.
What exactly is happening…
As mentioned earlier, the environment where a hair follicle is plugged with both dead skin cells and sebum, is a favorable environment to the acne causing bacteria: Propionibacteriaum acnes. P. acnes thrives in low oxygen environments where the bacteria can rapidly colonize. The bacteria breaks down sebum into byproducts that are comedogenic, forming a micro-comedone that is not visible.
Now we all know, it’s BIOLOGY! And biology teaches us that our body comes equipped with all the mechanisms to heal itself. So of course, it responds to the presence of P. acnes and the byproducts residing in the hair follicle. The actual formation of a comedone is the result of an immune response when white blood cells rush to the site to combat the bacteria which results in the formation of pus in a new macro-comedone.
And let’s not forget those horrible acne scars that linger after the actual blemish clears up. The formation of acne scars is also a biological pathway.
Acne can be prevented and controlled with a consistent, natural skincare regimen targeting your skin's needs and by leading a healthy lifestyle free of stress and a diet that feeds the skin the essentials it needs.