Acne - What It Is and What It Isn't

Biology 101

While all of the exact details around what causes acne are still not fully understood, the biology behind it is known. The excessive production of sebum, the oil produced by the body to keep both skin and hair from drying out, combines with the naturally occurring dead skin cells to plug hair follicles (pores) thus preventing the oil from escaping. This provides an excellent environment for bacteria which then multiply and erupt on the surface of the skin in an inflammation. We generally call these eruptions pimples or zits.  During puberty the body changes dramatically and the way it reacts to testosterone - the male sex hormone which is present in both genders - causes the skin to become abnormally oily. As a rule, the body normalizes by the 20s or 30s, however, in some cases it doesn't and teen acne becomes adult acne.

Hormonal Conditions

There is some support for the idea that acne can be partly heredity and it is not known why some people are affected with the condition and others are not. There are some external factors which seem to aggravate acne however, they are not necessarily causes. Some irritants are stress, skin irritation, certain medications and hormonal activities in the body such as menstrual cycles and PCOS. These all have a chemical affect upon the body's hormone production which in turn can affect the eruptions on the skin.


There are medications which are associated with acne breakouts including anabolic steroids which are often used by bodybuilders and elite athletes. Lithium, barbiturates, halogens and androgens are also linked to acne occurrences. Recent scientific studies indicate the possibility that narrowing hair follicles could carry part of the blame for acne. Narrow hair follicles restrict the expulsion of dead skin cells from the body. They cause a buildup under the skin which, when combined with sebum creates ripe conditions for acne.

True or False?

Myths abound concerning causes for acne and most of them are incorrect. Poor hygiene is not to blame although simply touching the infected areas can make the situation worse. Hands contain oils and bacteria which can exacerbate the symptoms. It's worthwhile to be sure anything that comes close to the face or acne affected areas is clean; that includes hands, hair, eyeglasses and telephones.

There is no scientific connection between chocolate and acne, nor is there any connection between greasy foods and acne. It is a good idea to eat well though, regardless. There is some evidence that milk products aggravate acne and that foods high in iodine, like seafood, can also have a negative effect upon it.

Anything that affects hormone levels may also affect acne. Anger, stress and sexual activity all have some impact upon certain hormones and this can, in turn, have an effect on acne. By themselves, these emotional and physical triggers do not cause acne.

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