What Causes Acne?

What Causes Acne?

What causes acne for you may be different that what causes acne for your friends. This is because acne comes in many forms and can have a variety of underlying causes. You may suddenly have a breakout, or you may have chronic acne. You may have bad acne or cystic acne, or you might just suffer from skin breakouts with stress or only have clogged pores.

Hormonal changes, skin cell buildup, inflammation, bacterial growth, and diet can all cause or worsen these different types of acne. In this guide, I’ll dive deeper into the main causes of acne and what you can do to treat it. These acne causes and treatment recommendations are based on your skin type, so if you do not yet know your Baumann Skin Type, take a minute to take the quiz before diving into the details!

There are many types and specific cause of acne.

Acne occurs when C. acnes bacteria becomes trapped inside pores, causing inflammation, redness, and sometimes pain.

To treat acne most effectively, use an acne-prone skin care regimen designed for your skin type.

What Is Acne?

Acne is an inflammatory condition of the hair follicle that results in clogged pores, pimples, papules, pustules and acne cysts. Acne can appear on any part of your face or body, but it is most commonly seen on the face, chest, back, and shoulders. While acne is often associated with teenagers going through puberty, it can affect people of all ages.

What Causes Acne?

A number of different factors or combinations of factors can contribute to acne. The main causes of acne include:

Skin cell buildup. Abnormal growth of skin cells leads to comedones (clogged pores), which can become pimples.

Bacterial growth. Cutibacterium acnes (a type of bacteria) colonizes (grows in) the blocked pores, making acne worse.

Inflammation. The hair follicle and surrounding area become inflamed, contributing to acne.

Hormonal influence. When androgens, a type of sex hormone, increase, skin cells grow faster, sebaceous (oil) glands grow, and oil production increases. All of these factors can contribute to acne.

Diet. Certain biochemical markers in the body, which can be influenced by what you eat, directly impact how severe your acne can become.

Skin Cell Buildup

The skin naturally sheds dead cells in a process called desquamation. However, in acne-prone skin, this process is sometimes disrupted due to abnormal growth of skin cells (keratinocytes), causing them to build up. These excess cells can accumulate on the surface of the skin and inside the pores, mixing with oil (sebum) and creating blockages known as comedones, or clogged pores. If the blocked pore becomes inflamed or infected with bacteria, it can develop into a pimple, pustule, or a cyst.

Bacterial Growth

Cutibacterium acnes (C. acnes), formerly known as Propionibacterium acnes (P. acnes), is a bacteria that lives on the skin. In healthy skin, this bacteria is harmless, but when it overpopulates the skin and becomes trapped inside clogged pores, it can multiply and cause acne.

C. acnes bacteria activates Toll-like receptor 2 (TLR-2) and causes inflammation. (Retinoids block activation of the TLR-2.)

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Inflammation

Inflammation happens when your body’s immune system responds to the clogged pores and bacterial growth, leading to the redness, swelling, and sometimes pain that are characteristic of acne breakouts.

Hormonal Influence

Hormones play a significant role in the development of acne, particularly androgens, which are a group of hormones that include testosterone. During puberty, pregnancy, or even due to conditions like polycystic ovary syndrome (PCOS), androgen levels increase, which triggers several changes in the skin that can contribute to acne:

Faster growth of skin cells (keratinocytes). When this growth happens too quickly, dead skin cells don’t shed properly and begin to accumulate on the skin and clog pores, which can lead to breakouts.

Growth of sebaceous (oil) glands. The size and activity of sebaceous glands increase in response to increased androgen. Enlarged sebaceous glands produce even more oil, creating the perfect environment for acne to form.

Increased sebum (oil) production. As noted above, overactive oil glands produce excess oil, which can mix with dead skin cells and get trapped in the pores, contributing to acne.

How Do I Know If Hormones Are Causing My Acne?

Diet

Recent studies show that diet can have a significant affect on acne. In particular, sugary foods, simple carbohydrates, and dairy products (specifically skim milk) have the highest correlation with acne.

For example, increased sugar in the blood triggers IGF-1 (insulin-like growth factor 1), which affect your skin in these ways:

Stimulating oil production.

Increasing the availability of androgens (hormones that can worsen acne).

Promoting the growth of skin cells that can clog pores.

Skin Care Habits That Worsen Acne

Certain skin care habits can also cause acne to worsen or not respond well to treatment. If you are struggling with acne-prone skin, avoid these skin care mistakes to help your skin heal:

Using the wrong moisturizer, leading to dehydration. When your skin becomes dehydrated, it does not dequamate properly, causing a buildup of dead skin cells. Bacteria the moves in and this leads to acne.

Over-exfoliation. When you over exfoliate, it also interferes with desquamation and dead cells build up. (I know you think you are removing them, but over exfoliating actually speeds up desquamation).

Using comedogenic ingredients. Comedogenic ingredients are those that are known to create comodones, or clogged pores. Avoid these ingredients in skin care and personal care products to help reduce clogged pores.

Touching skin with dirty fingernails or using dirty makeup brushes. These habits increase bacteria on the skin, which can lead to acne.

Cosmetic procedures like dermaplaning, laser treatments, or deep peels. These also disrupt the skin’s natural keratinization and desquamation processes.

Facials. If done incorrectly, extractions push debris deeper into the skin, causing the skin to react which can result in an acne breakout, acne cysts, or epidermal inclusion cysts.

Skin purging from retinoids. “Skin purging” refers to an acne flare when you begin using a new ingredient such as retinol. If you do not gradually introduce a new retinoid into your skin care regimen, it can lead to breakouts.

Controversies on Acne Causes

There are some current controversies on the causes of acne:

Increased sebum. increased sebum alone does not cause acne. Studies have shown that it might not be increased sebum production that is the issue as much as it is the lipids in the sebum change (3).

pH changes. There is much misinformation about pH and skin. The skin’s pH level is crucial in maintaining a healthy skin barrier and preventing acne. A lower, more acidic pH (around 4.5 to 5.5) supports the growth of beneficial bacteria and keeps harmful bacteria like C. acnes in check (4). However, factors such as harsh cleansers or certain skincare products can disrupt the skin’s natural pH, making it more alkaline. This disruption can weaken the skin barrier, leading to increased sebum production, clogged pores, and a higher risk of acne.

Oily skin is not necessarily more likely to have acne. People often misjudge how much sebum their skin produces, especially those with acne, who tend to believe their skin is oilier than it actually is. A study measuring sebum levels using a validated tool, the Sebumeter SM 815®, found that individuals with acne significantly overestimated their skin’s oiliness compared to objective measurements. This highlights the importance of using accurate, validated methods to assess sebum production rather than relying on subjective opinions. Interestingly, while there was a difference in sebum levels on the nose, there was no significant difference in overall objective skin types between people with and without acne, even though their perceptions of their skin types differed (4, 5).

How to Treat Acne

Now that you know what causes acne, you are probably wondering how to get rid of it. The first step to managing acne and getting clearer skin is to use an acne skin care routine personalized for your Baumann Skin Type.

Generally speaking, however, to treat acne, you need to:

Hydrate your skin if it is dry.

Soothe inflammation.

Clear pores.

Inhibit toll like receptor 2 (TLR-2) with retinoids.

Turn on retinoic acid receptors with retinoids.

Normalize desquamation.

For personalized advice on getting rid of acne, find out your Baumann Skin Type and choose products that are right for your skin.

Take the Quiz

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How Long Do Acne Treatments Take to Work?

Acne treatments take at least 8 weeks to work, assuming you are on the correct skin care routine for your skin type.

You can read here why you cannot clear acne fast.

Acne Skin Care Products and Treatments

Acne treatment products should be chosen based on which issues are causing your acne.

These are the 4 main issues that cause acne and the skin care products to target these issues.

1. Acne products that decrease oil production

No topical skin care products can decrease oil production. However, oil production can be reduced internally. Read more about that here.

Oily skin types can use a salicylic acid (SA) cleanser in the morning or a SA toner to can penetrate through the oil to clean out pores. Oily types can use a foaming cleanser at night to remove excess oil from the skin. if you have dry skin, salicylic acid may be too drying for your skin.

Choose a cleanser based on your Baumann Skin Type. Without knowing their skin type, most people choose the wrong cleanser which, can make it hard for you to use acne treatment products such as benzoyl peroxide and retinoids without getting side effects. The cleansers and moisturizers in your acne skin care routine will dramatically affect how well you tolerate any acne treatments.

Take the Quiz

2. Acne products that unclog pores

If you have comedones (clogged pores), make sure you avoid skin care products with comedogenic ingredients.

Salicylic acid (SA) cleans out clogged pores by removing the dead skin cells and sebum. Retinoids regulate the process of cells flaking off the skin, helping to prevent clogging of the pores. Benzoyl peroxide kills acne-causing bacteria that cause inflammation and clogged pores.

These skin care products to clear clogged pores can lead to dryness and flaking of the skin, but are an important part of acne treatment. It may be necessary to skip 1 to 3 days of these pore-unclogging skin care products if the skin becomes dry and irritated. These pore-clearing ingredients might not be right for your Baumann Skin Type, especially if you have dry or easily inflamed skin. Make sure you shop for acne products using your Baumann Skin Type.

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3. Acne products to decrease bacteria

These treatments decrease acne bacteria:

Oral antibiotics and topical antibiotics

Benzoyl peroxide (BP)

Topical (not oral!) silver

Blue light

The bacteria that causes acne reproduces every 18 hours, so an antibacterial acne treatment should be used twice a day.

Your skin care routine needs an acne treatment product such as these below in your am and your pm skin care routine.

4. Antioxidants

Antioxidants can neutralize free radicals that are caused by porphyrins made by C. acnes bacteria. Some antioxidants also have anti-inflammatory abilities that can calm inflammation in the hair follicle.

What is the Best Skin Care Routine for Acne?

The best acne skin care routine for you should be customized for your skin type because it depends upon these issues:

Sebum secretion rates

Integrity of the skin barrier

Presence of underlying inflammation

How active the melanocytes are

Bottom Line

There are many factors that can cause acne, including skin cell buildup, bacterial growth, inflammation, hormonal changes, and diet. The best acne treatment regimens will address these specific issues that may be contributing to your acne. However, the best way to effectively treat acne is to use a personalized acne-fighting regimen designed for your skin type.

Don’t know your skin type? No problem! Take the quiz now to find out.

DQH Knowledge drop: In your 20s, your skin cell turnover decreases. (Cell turnover is a key component in keeping your skin youthful.) You know what else slows down? Your collagen production. Starting in your 20s, collagen decreases by about 1 percent per year. Should you want to prevent fine lines and wrinkles, start by eliminating behaviors that contribute to premature aging. “If it’s bad for you, it’s bad for your skin,” says dermatologist Michel Somenek. “Cigarette smoking reduces blood flow to the skin and causes premature wrinkling and a dull skin texture. Making the repeated pursed motion to inhale can also cause smoker’s lines. Alcohol and recreational drugs are toxins for the skin that damage its cellular structure and DNA,” Somenek tells us. “The faster you eliminate vices while you are young, the better chance your skin and body have to recuperate.” Also, adopting an anti-aging routine in your 20s is key. After all, the best offense is a good defense. We spoke to Somenek and experts Joshua Ross and Audrey Kunin to find out more. Keep reading for the best anti-aging products for your 20s, according to skincare professionals. Sunscreen “We all know that the sun is the number one cause of skin aging and starting the prevention in your 20s is very important,” Ross says. “The majority of your sun damage won’t start to appear until you’re in your 30s, so don’t wait until you see it surface or you’ll be behind the curve. Stay ahead of it with a good-quality zinc-based sunscreen worn daily.” Farmacy Green Defense Daily Mineral Sunscreen An invisible sunscreen with SPF 30, plus botanical extracts meant to protect skin with tons of antioxidants. Bonus: It’s clean and fine to use under makeup. Bareminerals Complexion Rescue™ Tinted Moisturizer Broad Spectrum SPF 30 Although we recommend you use your SPF and moisturizer separately, we also understand moments when you don’t have time or energy for that extra step. For those times, this bareMinerals moisturizer is a great thing to have on hand. Vitamin C Serum “A great introduction to anti-aging is to start with a vitamin C serum in your morning skincare routine,” Ross says. “It’s a powerful antioxidant that will neutralize free radicals and brighten the skin.” He adds that it’s a great way to counteract the effects of the sun’s harmful rays, which, as previously mentioned, are among the biggest causes of premature aging. Drunk Elephant C-Firma™ Vitamin C Day Serum The Drunk Elephant C-Firma is a lightweight serum that promises to give skin a glow by combining the brightening powers of vitamin C with ferulic acid, l-ascorbic acid, and vitamin E. The included sodium hyaluronate is meant to replace hydration loss, so you shouldn’t have to deal with any irritation. Sunday Riley C.E.O. Rapid Flash Brightening Serum This potent serum is jam-packed with vitamin C (15 percent, to be exact), which means it’s a potential superstar at both brightening skin and dousing it in antioxidants. Peptides Using peptides on your skin has many benefits, says Somenek. “The skin barrier is what defends the body against pollution, UV rays, bacteria, and toxins. It can be damaged by several everyday factors. Using topical peptides aids in building a stronger barrier,” he says. “Peptides comprise elastic fibers, which are a type of protein. These fibers help to make skin appear taut and firm. Peptides can also help repair damaged skin, relieve inflammation, and even out skin tone. Some peptides can kill acne-causing bacteria that is common in 20-somethings.” Kunin agrees, saying, “Peptides are an excellent entry point for supporting collagen.” She recommends looking for face and eye treatments that contain these collagen-boosting powerhouses. Charlotte Tilbury Magic Eye Rescue Cream This Charlotte Tilbury super-emollient eye cream has a base of coconut oil and shea butter (read: it’s incredibly hydrating). Botanicals plus peptides are meant to help reduce dark circles and boost collagen, respectively. This creamy moisturizer serves up potent collagen-boosting peptides and pycnogenol, and antioxidant-rich vitamin C. “Instead of sitting on top of the skin, peptides penetrate the outer layer so they go deep. The ‘signals’ they send tell the cells to produce elastin and collagen, which are needed for youthful-looking skin,” explains Somenek. At-Home Peel Pads Remember that skin cell turnover fiasco we talked about earlier? One way to help support it is by exfoliating. “Exfoliation is important to help keep skin fresh and luminous,” Kunin says. She recommends using at-home peel pads as an easy and effective way to exfoliate. “The goal in your 20s is to fight the slowing pace of cell turnover. It is wise to use products that gently exfoliate, yet still remove oil and other impurities. Products that have Alpha Hydroxy Acids (AHA) or Beta Hydroxy Acids (BHA) are a good choice.” According to Somenek, you should only exfoliate two to three times a week. “People of all ages are guilty of over-exfoliating and that can be too much of a good thing,” he says. Dermadoctor Kakadu C Intensive Vitamin C Peel Pad A few swipes of this Derma Doctor powerful peel pad promise to leave your skin glowing and smooth, thanks to the seven (yes, seven) types of chemical exfoliants, including AHA and BHA. It also contains vitamin C via Kakadu plum extract for added brightening and antioxidant protection. KEY INGREDIENTS Kakadu plum extract is sourced from the Kakadu plum, a fruit grown in northern Australia. It contains vitamin C, which restores the skin’s natural barrier, increases collagen production, and soothes irritation. Dr. Dennis Gross Skincare Alpha Beta® Universal Daily Peel Pads These are the gold standard of peel pads, with a cult following and over 900 five-star reviews on Sephora. They’re easy to use and contain a blend of anti-aging exfoliating acids. Emollient Night Cream “In your 20s, you need to start upping the hydration in your skincare routine. You may have been cautious of over-moisturizing because of acne in your teens, but as you enter your 20s, your skin transitions and becomes drier,” Ross says. “I recommend an emollient night cream added into your evening skincare regimen.” “Twenty-somethings need to make sure that they are not using creams that will clog their pores and cause excess oil production,” says Somenek. Opt for non-comedogenic products. Cerave Skin Renewing Night Cream One great choice is the CeraVe Skin Renewing Night Cream, which is a non-comedogenic night cream that leaves skin soft and glowy. It combines the moisturizing powers of ceramides and hyaluronic acid. RoC Retinol Correxion Max Hydration Creme “The best night cream ingredients contain retinol, benzoyl peroxide, and/or salicylic acid or hyaluronic acid. The goal is to moisturize, yet remove excess oil,” says Somenek. This Roc Retinol Correxion cream fits the bill as it contains both hyaluronic acid and retinol so it promises to moisturize while also being non-comedogenic.

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