What causes acne?

Acne face

What causes acne?

One of the most common skin conditions seen by nearly all medical professionals is acne. While it is typically regarded as a disease that lingers only during adolescence, those who suffer from it know that the effects can last a lifetime. Not only are the papules and cysts that develop challenging to treat, but they can also cause severe scarring.

Acne most commonly occurs on the face, but it can also occur on the neck, chest, back, and arms. Typically, there is an increase in acne occurrence and severity during the teenage years, and it is estimated that this can last for 5-10 years. Teenagers aren’t the only ones affected though! Acne can occur at any point in life and affects both men and women.

What causes acne?

Acne tends to be multifactorial, meaning there are a combination of different factors that contribute to its development. There are four components that are believed to encourage acne development:

  1. Plugged follicles
  2. Increased sebum production
  3. Presence of Propionibacterium acnes
  4. Inflammation

Plugged Follicles: have you ever noticed all those tiny white hairs on your face? Sometimes people refer to it as “peach fuzz.” More technically, they are called vellus hairs. Each of those hairs is attached to your skin through a hair follicle.

Now, let’s complicate things a little more. Your skin surface is made up of layers and layers of cells, all stacked on top of each other. You can compare it to a wall of bricks. Now, your skin is constantly creating more cells (on the bottom layer) and shedding the old cells (the top layer). But, sometimes things get sluggish. And those cells don’t shed like they are supposed to. This is where you get those plugged follicles, or keratinization within the follicle. Once the hair follicles have become plugged this sets the stage for sebum production and bacteria to creep inside the skin and contribute to inflammation.

Increased Sebum Production: This increased sebum production further complicates matters. The sebaceous (oil) glands are overzealous, producing more oil than your body truly needs. Some people may simply have over active sebaceous glands. But sometimes it is due to harsh soaps and hot water. Many over the counter acne washes are designed to strip all the oil off your skin. Unfortunately when we do that our sebaceous glands compensate by producing even more oil. This increase in oil plugs the hair follicle, setting up a great medium for bacteria growth.

Proprionibacterium acnes: This little organism is typically present on many people’s skin. However, when given the right circumstances (plugged follicles and increased sebum production) it likes to proliferate, leading to an immune response in the body. This is why antibiotics are often used in cases of moderate to severe acne.

Inflammation: All the aforementioned factors contribute to inflammation. Inflammation is simply your body’s response to things it doesn’t like. Your body tries to fight off the bacteria by attracting white blood cells to the plugged hair follicle. This produces those classic signs of inflammation: redness, swelling, pain, and heat.

There are many other factors that can contribute to acne. Some of these include the use of certain medications, hormones, stress, cosmetics, and genetics. It is important to take a multi-faceted approach when combating acne because there are so many contributing factors! It is also important to remember that treating acne takes time and patience. There are no “miracle” creams or “quick-fixes.” Diligent daily care, in addition to professional treatments, is often used together to control acne.

Our professional staff will work with you to develop a comprehensive treatment plan to address your needs, whether you suffer from current acne or the resultant scarring. For more information, check out our treatments for acne: Fractora, Chemical Peels, and Professional Skincare products.

Written by: Chelsea Campbell, MSN, FNP-BC


National Institutes of Health. (November, 2015). Questions and answers about acne. Retrieved from: http://www.niams.nih.gov/health_info/acne/#tol
Bhatia A, Maisonneuve J.F., Persing D.H., (2004). Proprionibacterium acnes and chronic diseases. Institute of Medicine (US) Forum on Microbial Threats. Available from: http://www.ncbi.nlm.nih.gov/books/NBK83685/

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