Even with all the research that has been conducted about acne the debate still rages about the causes of acne. The exact causes of acne are not entirely known and subsequently because of this there is no actual cure for acne. At the moment experts believe that acne results from several related factors.
The related factors that trigger acne can be broken down into two general categories: intrinsic and extrinsic. Intrinsic factors are genetics and the body’s response and sensitivity to hormones. We have no control over these issues. For example hormonal fluctuations around a woman’s period can lead to breakouts. Hormones both affect oil productions, and the body’s hormonal levels fluctuate both at different points of the month and over a person’s lifetime. And anything can raise your hormonal level – stress, your period, pregnancy, or nursing. Genetics can play a significant role in acne formation. Genetics can be responsible for creating a defective oil gland, a pore lining that does not shed dead cells properly, and even for the production of abnormal sebum.
There are multiple extrinsic factors that cause acne. Extrinsic factors are a large and diverse category of factors that we have much more control over. This category can include medications, external stress and emotions, and products used on the skin and hair. So for example the over use of topical corticosteroids can lead to acne just as using oily make-up can. Another extrinsic factor that contributes to acne is the misuse of skincare products. For example the natural balance of the skin can be upset by the misuse of skincare products, especially harsh and strong skincare products, thus destroying the outer layer of the epidermis and kicking into high gear a series of processes that lead to acne. If the skin is irritated or overly dry because of the use of harsh and drying skincare products then skin starts to produce more oil to make up for the lack of it thus continuing to perpetuate a cycle of breakouts. I should point out that not all experts agree about that last point. Over drying or stripping your skin of moisture by over washing it or using too harsh products could perpetuate a cycle of breakouts because dead skin cells (or kerantinocytes) clog your pores instead of being removed. Or since your skin senses it is damaged or under stress because of the excessive dryness an inflammatory stress reaction kicks in and you end up with more pimples in the end.
Figuring out exactly what causes you to breakout can be a daunting task especially when there are so many factors to consider. In his book Healing Adult Acne Richard G. Fried devotes an entire chapter to helping the reader identify their “acne triggers” (chapter 3). He presents his readers with a 15 point questionnaire that includes such questions as:
- “I seem to break out more when I am feeling stressed”
- “I seem to break out more when I am eating more milk products”
- “I seem to break out more the week before my menstrual period”
Fried makes the important point that there is no one size fits all generalization for finding the cause of one’s acne. For this reason he made up his acne trigger questionnaire so that acne sufferers would take the time to find the very personal factors that cause their acne. Though there are many acne causes that are so prevalent that they may even be called universal, each individual needs to determine what triggers their own acne breakouts. Finding your personal acne triggers helps you find the right treatment for your acne. As already mentioned above, one person’s acne may clear up by simply changing hair or make-up products while another person might need medication that controls their hormone fluctuations in order to find acne relief.
Stress and Acne
Many acne sufferers and doctors are convinced that stress plays an important role as an acne trigger. Stress, which is caused by many psychological and physical occurrences, has a deteriorating effect on the body including the skin. Stress can cause acne in several ways. Stress can affect the ovaries, testes, and adrenal glands leading to the increased release of androgens throughout the body which causes an increased production of sebum or oil in the body. Additionally stress can release more inflammatory chemicals into the body leading to more inflamed acne. Furthermore, stress produces heightened levels of cortisol in the body that can both aggravate existing blemishes and can cause an inflammatory reaction in the hair follicles that lead to microcomedones (blackheads) developing into papules and pustules. If you are stressed out sleeping and eating habits are adversely affected which leads to a disruption in positive habits such as exercise, healthy eating, and good skincare routines all of which can trigger an acne outbreak. Feeling that you have no control over your breakouts can lead to more stress and more breakouts creating a vicious cycle that is difficult to break.
If you have tried numerous acne treatments to no avail I would highly recommend trying to figure out what your acne triggers are. Chapter three of Richard Fried’s book is an excellent guide to helping you discover those triggers and hopefully finally find relief from your acne.
Sources and Further Reading:
- 100 Questions and Answers about Acne by Doris Day – pages 13 and 14
- Dr. Susan Taylor’s Rx for Brown Skin: Your Prescription for Flawless Skin, Hair, and Nails – page 180
- Breaking Out: A Woman’s Guide to Coping with Acne at Any Age by Lydia Preston – pages 140-141
- Healing Adult Acne: Your Guide to Clear Skin And Self-confidence by Richard Fried – chapter 3
- Simple Skin Beauty: Every Woman’s Guide to a Lifetime of Healthy, Gorgeous Skin by Ellen Marmur – page 53
- The Beauty Bible, 2nd edition by Paula Begoun – chapter 10