What causes acne?
The causes of acne are complex reflecting a combination of multiple factors.
Age: Acne is most common in the teenage years and early 20s. It becomes less common with age but can come on for the first time in older individuals.
Genetic factors: Acne can run in families, and severe acne is more common when other family members have been affected. This reflects an inherited tendency rather than a specific acne gene.
Hormonal factors: The production of sebum is increased by hormonal changes that occur at puberty and this is an important factor in the development of acne. Acne can fluctuate with the menstrual cycle and, where women also have irregular periods and/or excessive hair growth the diagnosis of polycystic ovary syndrome (PCOS) should be considered. These cases are often referred to as hormonal acne.
Propionibacterium acnes: This is a common bacteria found on healthy skin, however in individuals prone to acne it can cause infection of hair follicles and worsen the condition.
Drugs: Certain medications including the progesterone only pill 'minipill', steroids and certain novel targeted cancer treatments can trigger the development of acne so it is important to tell your dermatologist about all medications that you are taking. The use of topical steroids, for example for the treatment of eczema on the face can also worsen acne.
Thick or greasy moisturisers or make up can block the opening of the hair follicle triggering the development of acne breakouts.
Sustained pressure, for example from a mask, motorcycle helmet or from a weight bench in the gym can compress the openings of hair follicles triggering acne.
Diet: In most cases, diet does not play a significant role in the development of acne however some studies have shown an association between a diet high in milk or high glycaemic index foods.
How can I help
I see patients in person in central London. An in person consultation allows me to examine the skin directly including features that are difficult to capture in a photograph such as 3-dimensional changes and textural change. This is the better option where the diagnosis is uncertain, where previous treatment has not been effective, or where a procedure is being considered. For more straightforward conditions such as acne and rosacea a remote consultation with clear photographs can be a good option.
Related Articles
- What is acne?
- What causes acne breakouts?
- Does acne run in the family?
- What treatments are effective for hormonal acne?
