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Acne Treatment & Care

Module 02

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2. Module 02: Causes of acne

Table of Contents

2. Module 02: Causes of acne ................................................................................................................ 1

2.1 Effect of Acne to lifestyle ........................................................................................................................... 2

2.2.1 Sun exposure ..................................................................................................................................... 2

2.2.2 Stress ................................................................................................................................................. 2

2.2.3 Picking blemishes .............................................................................................................................. 3

2.2.4 Over-scrubbing .................................................................................................................................. 3

2.2 Causes – Genetics ...................................................................................................................................... 3

2.2.1 Evidence that genes have a role to play in acne............................................................................... 3

2.2.2 How genes can influence acne ......................................................................................................... 4

2.2.3 Other factors ..................................................................................................................................... 4

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2.1 Effect of Acne to lifestyle

Though acne is generally not caused by minor lifestyle habits, if you are already prone to acne, certain

lifestyle choices and habits could aggravate your skin and make your acne worse.

2.2.1 Sun exposure

Opinions are divided on whether exposure to the sun improves acne or makes the condition worse.

Some sources say that short exposure to the sun (10-20 minutes per day for those of lighter complexion and

20-30 for those of darker complexion), may help with acne symptoms. Some people with acne have reported

that getting burned causes them to break out for up to weeks afterward, as the skin has been irritated and

is working to heal itself, while others report that after a burn or tan their acne has decreased.

Another theory which has gained support is that a vitamin D deficiency is the culprit behind the acne of some

sufferers. As vitamin D is a hormone, when it is low, it has the ability to affect other hormones in your body,

disrupting the oil production in your skin. Vitamin D also produces chemicals which reduce inflammation,

which can improve acne, which is an inflammatory disease. This vitamin also reduces the amount of oil

released by the sebaceous glands.

Many acne sufferers have reported up to 100% healing from acne when taking a vitamin D supplement,

while others prefer to get sun exposure directly.

2.2.2 Stress

Research has shown that acne can flare up because of stress. The Archives of Dermatology published a

Stanford University study which found that college students had flare ups of acne during exams. They

reported higher levels of stress during this time, and higher levels of acne than usual. As a result, researchers

concluded acne severity correlated strongly with higher stress levels. The results of this study were backed

up by a test of high school students in Singapore, who were found to have worse acne during exam periods

than in low stress times such as summer break.

At this stage, scientists are not entirely sure why stress makes acne worsen. The cells that produce oil do

have receptors for stress hormones, which indicates a strong link, but they are as yet unsure of exactly how

it works.

Originally it was thought that stress led to an increase in sebum production, causing more acne, but it was

found that psychological stress did not cause significantly more sebum to be produced.

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This has led scientists to conclude that there definitely is a link between stress and acne, but that the process

by which stress can aggravate acne is unclear biologically.

2.2.3 Picking blemishes

Picking blemishes can make acne worse, but it is something that many people with acne find themselves

doing. Dermatologists say that when people are anxious or stressed, about their acne, or about something

else, they are more likely to make their blemishes worse by picking them.

When someone picks their blemishes extremely frequently, even compulsively, because they’re

embarrassed by and worried about their skin, they have a condition known as acne excoriee. This

compulsion to pick acne means that they create scabs on their skin, which are likely to lead to scarring.

Most kind of picking at the skin makes healing take longer and increases the risk of permanent scars. In

addition, infected debris and material can get pushed deeper into the skin, which leads to more redness and

swelling. When a pimple is popped, the skin is left open to bacteria, which can lead to infection.

2.2.4 Over-scrubbing

Many people who have acne end up scrubbing their skin, but this can actually make the condition worse.

It is important to remember that acne does not come from dirt. Over-washing and scrubbing the face does

nothing to decrease acne, but actually worsens it, because it increases irritation and can compromise the

protective barrier of the skin.

2.2 Causes – Genetics

2.2.1 Evidence that genes have a role to play in acne

There are many studies that illustrate that genetics has a large role to play in the development of acne.

A study of 40 pairs of twins – 20 identical, and 20 non-identical, looked at how sebum production was

influenced by genetics. The study found that identical twins had exactly the same rates of sebum excretion,

but had different levels of acne. Non-identical twins had different levels of acne and of sebum production.

From this, it would seem that sebum production is under genetic control, but acne itself is not.

A study of around 1000 pairs of non-identical twins, and 450 identical twins, found that genetics accounted

for around 80% of acne, while 20% could be explained by other factors like diet and stress.

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In a study with around 200 acne patients and 150 people without acne, researchers found that having a first-

degree relative (child, parent or sibling) with acne, made it four times more likely you would also suffer from

acne.

2.2.2 How genes can influence acne

As shown in section 1.5.1, genes can affect how much sebum is produced by the skin.

In addition to sebum production, genetics determine how your immune system might respond

to bacteria, which can determine whether you’ll break out or not, and how severely, under

exposure to certain bacteria. Those with acnre-prone skin have a strong inflammatory response

to bacteria and minor injuries in the skin.

Genetics also play a role in how easily your pores become plugged and how many dead skin cells

are produced in your skin.

Another important influence genes have is over how sensitive your skin is to the hormones in

your body. Androgen hormones such as testosterone, have different effects on healthy skin as

opposed to acne-prone skin.

In people with darker complexions, acne may look less severe, because the color of the skin at

least partially hides the redness caused by inflammation. But when acne clears on darker skin it

often leaves a pinkish-brown spot, known as post inflammatory hyperpigmentation, which can

stay for months or even years.

2.2.3 Other factors

If acne runs in your family, it is likely you will suffer from it to a certain degree. But having genes

that make your skin acne-prone doesn’t mean you will automatically get acne or that there’s

nothing that can be done to prevent it or heal from it.

Many acne experts say that if you have a genetic predisposition to acne, it is likely you will have

to make lifestyle changes to prevent acne, even when other people would not. In the rest of the

modules in this course, we will be looking at various lifestyle changes and treatments that can

make the difference between suffering with acne and having clear skin.