what causes acne?

There is no precise cause of acne; rather, it is a result of many factors coming together to create an acne situation. Those who are prone to acne often have skin that is oilier than average. Excess oil can easily become trapped within the pore, creating an impaction.

Acneic skin also produces more dead skin cells than is normal, and those skin cells are not being shed properly (a condition called retention hyperkeratosis). These dead cells stick to the surface of the skin and inside the follicles, mixing with excess oil and creating a comedo.
When the pore becomes blocked by cellular debris and oil, a bacterium that is normally present within the pore grows unchecked. Propionibacteria acnes (P. acnes) are found in great numbers on acneic skin, causing inflamed breakouts.

There are three major factors that contribute to acne development, and they have nothing to do with skin care or lack thereof. The result of these factors coming together is a formation of acne breakouts. All three factors must be present in order for acne to occur.

1. Overactive Sebaceous Glands

Sebaceous glands create sebum, or oil, needed to lubricate the skin's surface. Those who are prone to acne have oil glands that produce more sebum than is necessary. Excess oil remains in the pore, blocking the sebaceous duct and creating a blockage within the follicle.
According to information by the International Dermal Institute, the sebum of those who suffer from acne is also different in its makeup. It has higher levels of squalene and wax esters than typical, with lower levels of free fatty acids, and linoleic acid. This composition creates a favorable environment for acne causing bacteria.

2. Abnormal Shedding of Skin Cells

The epidermis is constantly shedding dead skin cells through a process called desquamation. Dead skin cells fall away from the stratum corneum and are replaced by new cells. In acne prone skin this process goes awry, with four to five times more skin cells being produced than in normal skin.
There are also less Lamellar granules in the skin of acne sufferers. Lamellar granules are found within the cells of the stratum corneum. They are responsible for releasing enzymes that digest the substance that that holds cells together. Simply speaking, acne prone skin produces more dead skin cells than is typical, and the skin cells are not being shed properly. Instead, the cells remain suck inside the follicle creating a comedo.

3. Proliferation of Bacteria

Propionibacteria acnes (P. acnes) are bacteria routinely found on most skin. In those with acne the P. acnes population grows out of control. The plug of dead cells and oil within the pore creates an anaerobic environment where oxygen can't get into the pore. P. acnes thrive in this environment and their population grows.The P. acnes digest the oil trapped within the pore, producing a fatty acid waste. This waste irritates the pore lining, causing redness and inflammation. It is important to recognize that cleansing cannot wash P. acnes away. Its presence does not point to a lack of hygiene in any way.

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