WHAT IS ACNE, REALLY?

Much to contrary belief, acne isn’t a byproduct of bad hygiene, greasy foods, or too much chocolate (phew). No, no. Acne is a complex, chronic disorder with many triggers. 

Let’s start at the very beginning (a very good place to start, according to Julie Andrews).
With puberty, our bodies start producing testosterone. Then, an enzyme in the skin called 5 alpha-reductase converts testosterone into dihydrotestosterone (DHT). This wakes up the sebaceous glands to begin producing sebum. All good until here - everyone goes through this process. Yet, not everyone ends up with acne. Now, let’s trace the chain of events that lead to acne for some of us.

Retention Hyperkeratosis.
“RH” for short, is the result of a genetic mutation where we overproduce skin cells. People with non-acne prone skin have a properly functioning system: they produce new skin cells and flush out dead skin cells at a matching pace. For the acne-prone folks, things are a bit different. A particular genetic mutation makes us overproduce skin cells. Yet, we don’t  flush them out at the same increased rate, and dead skin cells accumulate in the follicles. This condition is called retention hyperkeratosis (RH), and can be an underlying reason for chronic acne. While RH is a predisposition to getting acne, DHT still needs to trigger it to set it off. Hence, why acne starts at puberty.

Clogged pores. Fresh pimples.
Increased oil in the follicles (thanks to DHT) plus accumulating dead skin cells start clogging pores. This creates the perfect setting for c.acnes bacteria to thrive. And boom - a microcomedone, the beginnings of a pimple, is born. From here, whether this microcomedone turns into an inflamed or non-inflamed acne, it will become visible in up to three months. Putting an end to acne starts with preventing the microcomedone from forming in the first place. But how?

Ultimately, what breaks us out are excess sebum, thriving c.acnes bacteria and clogged pores. There are many things that might trigger these (learn more in part 3). To make matters more complex, we all have different acne triggers. A good place to start is getting to know which ones apply to you the most. That way you can minimize them with actionable lifestyle tips. An equally important part of prevention is to address acne’s root causes and soothe angry skin with a targeted skincare regimen.