The science behind acne breakouts and acne management

Acne is an incredibly common skin problem affecting almost everyone at some stage of their life. It's that unwelcome visitor that seems to pop up just when you least expect it, causing frustration and sometimes even embarrassment. But fear not, because understanding the science behind breakouts can help us deal with them more effectively.

 

The basics of acne: understanding the skin and hair follicles

 

First things first, what exactly is acne? Well, it's a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. Understanding the skin and hair follicles is crucial in comprehending how acne develops. The sebaceous glands in the skin produce an oily substance called sebum, which can mix with dead skin cells and bacteria to form acne lesions. As acne is a "polymorphic" disorder, it exhibits a series of diverse lesions: comedones, pustules, papules, nodules, cysts, sinuses and scars. [1] The type of acne depends on the severity of the clogging and inflammation.

 

The role of sebum production in acne development

 

Sebum, produced by sebaceous glands, plays a significant role in acne development. Sebum lubricates the skin to protect against friction and makes it more impervious to moisture. [2]
 
But excessive sebum can lead to the development of Cutibacterium acnes which in turn results in clogged pores and acne breakouts. Cutibacterium acnes is a member of the skin microbiota found predominantly in regions rich in sebaceous glands. [3] As it feasts on the sebum trapped in our pores, it produces byproducts that can irritate the surrounding skin, triggering inflammation. Factors like hormonal changes, genetics and certain medications may influence excessive sebum production.

 

Inflammation and acne: the connection explained

 

Inflammation plays a crucial role in the development of acne. When the hair follicles become clogged with oil and dead skin cells, bacteria on the skin can multiply and trigger an immune response, leading to inflammation. This inflammatory response can cause redness, swelling, and pain associated with acne lesions. Clinical studies indicate that inflammation occurs at all stages of acne lesion development. [4]

 

Hormonal influences on acne breakouts

 

Hormonal influences play a significant role in acne breakouts, especially in teenagers going through puberty and women experiencing hormonal changes during their menstrual cycle, pregnancy, or menopause. Hormones like testosterone can stimulate the sebaceous glands to produce more sebum, increasing the likelihood of acne development.

 

When the follicles are overflowing with sebum, it makes it harder for the dead skin cells inside the follicle to move to the surface and shed. Instead, the cells clump together with the sebum, forming comedones (otherwise known as blackheads and whiteheads). The clumps of oil and dead skin cells in comedones feed the bacteria that are normally present on the skin, one of which is C. acnes. Since there’s now an abundance of food, the bacteria proliferate. All that bacteria feasting on dead skin and sebum in the follicles sets up an inflammation cascade that results in a pimple or zit. [5]

 

Effective strategies for managing and preventing acne

 

In addition to understanding the science behind acne breakouts, adopting effective strategies for managing and preventing acne is essential. Eating a balanced diet, staying hydrated, managing stress levels, maintaining a consistent skincare routine and avoiding harsh skincare products can all contribute to clearer skin. Here are some effective methods by which you can manage acne and acne breakouts:

 

• Cosmeceutical products with ingredients like Bakuchiol, retinol, tea tree oil, glycolic acid, etc. can be used to incorporate in your skincare routine for acne management.

• According to Dr. Vanita Rattan’s book on ‘Skin Revolution’, some of the ingredients to look for while choosing a skincare product for managing acne include Benzoyl peroxide, Salicylic acid, Vitamin A, Antibiotics, Azelaic acid and Niacinamide. Hormonal treatments and spot treatments also can help in acne management for some individuals. [6]

• Skincare products which control excess oil production while promoting skin hydration can be used.

• Non-comedogenic makeup and creams can be used to avoid clogging of pores. Checking the ingredient information and back panel of a product is important while choosing a skincare or makeup product.

• Gentle face scrubbing can help in removing dead skin cells, unclogging pores and cleaning bacterial build-up over the skin. This is to be done occasionally, as frequent scrubbing can cause more irritation and can result in further skin issues.

• Taking a bath or washing the sweaty body parts is recommended as a good hygiene practice after a heavy workout.

• Most importantly, managing stress, eating a healthy diet and balancing hormonal levels is very crucial for avoiding acne breakouts.

 

References:

 

1. Albert M. Kligman, An Overview of Acne, Journal of Investigative Dermatology, Volume 62, Issue 3, 1974, Pages 268-287, ISSN 0022-202X, https://doi.org/10.1111/1523-1747.ep12676801. (https://www.sciencedirect.com/science/article/pii/S0022202X1544240X)

2. Makrantonaki E, Ganceviciene R, Zouboulis C. An update on the role of the sebaceous gland in the pathogenesis of acne. Dermatoendocrinol. 2011 Jan;3(1):41-9. doi: 10.4161/derm.3.1.13900. PMID: 21519409; PMCID: PMC3051853.

3. Mayslich C, Grange PA, Dupin N. Cutibacterium acnes as an Opportunistic Pathogen: An Update of Its Virulence-Associated Factors. Microorganisms. 2021 Feb 2;9(2):303. doi: 10.3390/microorganisms9020303. PMID: 33540667; PMCID: PMC7913060.

4. Tanghetti EA. The role of inflammation in the pathology of acne. J Clin Aesthet Dermatol. 2013 Sep;6(9):27-35. PMID: 24062871; PMCID: PMC3780801.

5. Hormones and Acne: What You Should Know (https://www.twssc.org/blog/hormones-and-acne-what-you-should-know)

6. Rattan V. Skin Revolution. Place of Publication: HarperCollins; 2021: 172-173.