What causes acne?

How common is acne?

Skin specialists say that approximately three-quarters of 11 to 30 year-olds will get acne at some time. Acne can affect people of all races and all ages. It most commonly affects adolescents and young adults, although there are people in their fifties who still get acne. According to Brown University, USA, approximately 17 million Americans are estimated to have acne at any one time.

Although acne affects both men and women, young men suffer from acne for longer - probably because testosterone, which is present in higher quantities in young men, can make acne worse.

What causes acne?

Nobody is completely sure what causes acne. Experts believe the primary cause is a rise in androgen levels - androgen is a type of hormone. Androgen levels rise when a human becomes an adolescent. Rising androgen levels make the oil glands under your skin grow; the enlarged gland produces more oil. Excessive sebum can break down cellular walls in your pores, causing bacteria to grow.

Some studies indicate that a susceptibility to acne could also be genetic. Some medications that contain androgen and lithium may cause acne. Greasy cosmetics may cause acne in some susceptible people. Hormone changes during pregnancy may cause acne either to develop for the first time, or to recur.

Four main things that cause acne:

• Oil production
• Dead skin cells
• Clogged pores
• Bacteria

Acne typically appears on your face, neck, chest, back and shoulders. These areas of skin have the most oil (sebaceous) glands. Acne occurs when hair follicles become plugged with oil and dead skin cells.

Hair follicles are connected to oil glands. These glands secrete an oily substance (sebum) to lubricate your hair and skin. Sebum normally travels along the hair shafts and through the openings of the hair follicles onto the surface of your skin.

Factors that may worsen acne

These factors can make the acne become worse:

• Hormones. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. And low amounts of androgens circulate in the blood of women and can worsen acne  .

• Certain medications. Drugs containing corticosteroids, androgens or lithium can worsen acne .

• Diet. Studies indicate that certain dietary factors, including dairy products and carbohydrate-rich foods — such as bread, bagels and chips — may trigger acne . Chocolate has long been suspected of making acne worse. A recent study of 14 men with acne showed that eating chocolate was related to an increase in acne . Further study is needed to examine why this happens or whether acne patients need to follow specific dietary restrictions.

• Stress. Stress can make acne worse.

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