All You Ever Wanted To Know About Acne - The Definitive Guide (Part 2)

What causes acne?

The principle behind acne is well understood by scientists but doctors continually address the consequences of acne and not the cause. Roaccutane and even the contraceptive pill Dianette go some way to correcting the cause but because they are taken orally then their effect is on a much wider basis and can influence other functions including mental attitude in the case of Roaccutane.

Acne is fundamentally caused by a change in hormonal balance.

At times of our lives our well known hormones etc can fluctuate away from the normal and the skin becomes 'aware' and sensitive to a hormone known as DHT which it normally pays no heed to.

- Through puberty and teenage years to approx. 22 on average
- When pregnant or on the pill
- As a result of long term stress
- During the menopause
- And at other times for example, certain medical conditions

DHT sensitivity causes fatty acid depletion in the skin which is very hard to replace orally as very little reaches the skin. As a consequence of this depletion, the oil producing glands in the skin respond by increasing oil production.

Typically the skin starts to thicken (called keratinisation) and skin shedding slows (called hyper cornification). In many, (not all) the cell linings of the internal walls of the hair follicle duct where the oil produced by sebaceous glands comes out of, thickens and so the tube narrows in diameter, so you have more oil trying to get out of a narrower tube. Also skin cells become stickier and clump together, so the rate at which we naturally shed skin slows down, resulting in the buildup of surface skin debris which in conjunction with excess oil forms a 'plug' in the duct opening which is closing as a result of skin thickening. This creates a blockage.

So far you don't have acne; you do have comedones or pimples. However skin bacteria which prefer a low oxygen environment such as p.acnes build up under the 'plug' in this oxygen deficient environment and start to digest the plug which creates by-products, which cause inflammation. Bacteria are therefore not the primary cause of acne but their response to the changes in the skin which leads to spots. So if you can control the underlying sensitivity then the bacteria will not be such a problem. Also you must control the p.acnes bacteria without attacking the healthy skin bacteria like Staph epidermidis which can induce resistant bacteria and may well be a leading cause of hospital super bug resistance The by-products produced cause inflammation and damage to surrounding cells resulting in a spot, and now you have a pustular acne lesion or 'yellow head'.

The skin returns to normal once hormonal levels balance out and the skin becomes 'unaware' of DHT and acne free. However in a significant number of people they are left with a residual local sensitivity to DHT, even with a normal hormonal balance and this can cause long term spots and acne and the infamous T Zone.

So acne is not caused by bacteria, they are a secondary cause which results in the painful unsightly spot.

HORMONES + INCREASED SEBUM + DEAD SKIN CELLS + BACTERIA = ACNE