To better understand the causes of acne, it is useful to learn more about the sebaceous glands which play a key role in the condition’s development.
Sebaceous glands
Sebaceous glands are tiny glands found near the surface of your skin. The glands are attached to hair follicles. A hair follicle is a small hole in your skin which an individual hair grows out of.
The purpose of sebaceous glands is to lubricate the hair and the skin in order to stop it drying out. The glands do this by producing an oily substance called sebum. In acne, the glands begin to produce too much sebum. The excess sebum mixes with dead skin cells and both substances form a ‘plug’ in the follicle.
If the plugged follicle is close to the surface of the skin it will bulge outwards, creating a whitehead. Alternatively, the plugged follicle can be open to the skin, creating a blackhead.
Normally harmless bacteria that live on the skin can then contaminate and infect the plugged follicles, resulting in papules, pustules, nodules, and cysts.
The triggers of acne
Teenagers
Cases of teenage acne are thought to be triggered by increased levels of a hormone called testosterone which occurs during puberty. The hormone plays an important role in stimulating the growth and the development of the penis and testicles in boys, and maintaining muscle and bone strength in girls.
The sebaceous glands are known to be particularly sensitive to hormones, so it is thought that the increased testosterone sends the glands into ‘overdrive’, producing much more sebum than the skin actually needs.
Adults
In cases of adult acne, over 80% of cases occur in women. It is thought that many cases of adult acne are a result of the changes in hormone levels that many women will experience at certain points during their life.
Possible triggers for adult acne include:
- periods - some women experience a flare-up of acne just before their monthly period is due,
- pregnancy - many women experience symptoms of acne during pregnancy; usually during the first trimester (first three months),
- polycystic ovary syndrome - is a poorly understood, but common condition that can cause acne, weight gain, and the formation of small cysts inside the ovary, and
- side effects of medication - in some people, certain types of medication can cause acne - for example, steroid medication and lithium (which is often used to treat depression and bipolar disorder).
