What are the causes of an Acne?

March 13 22:20 2019 Print This Article

The etiology of acne is linked to the blockage of follicles.

1. The earliest change occurs by the hyper keratinization and a plug of keratin and sebum is formed. The sebaceous gland is enlarged and there is increased in the sebum production.

2. The androgen level also increases at adrenarche. There is an enlargement of micro comedo which forms a black head which is also known as the comedone. The open head is also known as the white head.

3. The sebaceous glands form the white head which are blocked with the sebum. It is naturally occurring oil and includes the dead skin cells. The commensal bacteria can occur naturally and cause the inflammatory lesions in the dermis. It occurs around the micro comedo or comedone. It causes redness and may lead to the scar formation along with the hyper pigmentation.

4. This disorder is mainly hereditary and it is multi factorial. The tendency to develop acne occurs in some families. The school age boys have other members in the family which have acne too. A family history of acne is associated with the occurrence of earlier acne and it also increases the retentional acne lesions.

5. There are few hormonal activities like menstrual cycles and puberty. In puberty there is increase in male sex hormones which are known as androgens. It allows the follicular glands to grow and make more sebum. There is an inflammation, skin irritation and scratching which activates the inflammation.

6. The stress and acne are inter related to each other. There is increase in the acne severity as the stress levels increases. The National Institute of Health in the USA lists stress as a factor that can lead to acne. The study done on adolescents in the Singapore showed a statistically significant positive correlation between the stress levels and acne.

7. There are hyper active sebaceous glands which are secondary to the hormone sources. The bacteria which are present on the pores are of anaerobic type. They cause acne and the common bacterium is P. acnes. The commonly used antibiotics have been increasing.

8. There is a use of anabolic steroids which leads to the acne formation. There is an exposure to few chemical compounds which also leads to the acne formation. The most common chemical compound is chloracne. It causes exposure to dioxins. There is a chronic use of amphetamine which can lead to acne.

9. There are many hormones which are linked to the acne. It includes the androgens like testosterone, bi hydro testosterone, insulin like growth factor and dehydro epiandrosterone sulfate. There is less development of acne in the later years in which the rosacea are quite common.

10. There are true acne vulgaris present in the young women which are the cause of underlying conditions such as pregnancy and other disorders like Cushing ’s syndrome and poly cystic ovary syndrome. The acne is also associated with the menopause which occurs due to the natural anti acne ovarian hormone like estradiol which fails at menopause. The deficiency of this hormone leads to the thinning of hair, hot flashes, wrinkles, vaginal dryness and these conditions predispose to the osteopenia and osteoporosis.

11. The diet plays an important role in the acne formation. The chocolate is the main causative agent. The scientific studies do not support it. There causative nature is due to the high glycemic nature of certain foods which are rich in carbohydrate. The chocolate has a low glycemic index. There are few epidemiological studies which have shown that the milk plays an important role in the acne formation. It is mainly the skimmed milk and the other items which included are the cottage cheese, sherbet, breakfast drink and cream cheese.

This association is mainly linked by the use of hormones such as sex hormones and insulin like growth factor. The iodine present in the milk also plays a crucial role in it. There is a strong debate whether there is a link between the diet rich in carbohydrates and acne formation. The previous studies were done by the use of chocolate and coco cola. Their method was not correct. The low glycemic hypothesis stated that the easily digested carbohydrate food increases the blood glucose which stimulates the production of insulin. It includes the use of soft drinks and sweets.

The insulin triggers the release of insulin like growth factor. The insulin like growth factor affects the pilo sebaceous unit and lead to the hyper keratosis and epidermal hyperplasia. It allows the formation of acne. The androgens are affected by the sugar consumption as it leads to the decrease in sex hormone binding concentration. A randomized controlled trial was done to support the hypothesis. In this a low glycemic diet was provided to the individuals and it reduced the acne and weight.

12. The activity of androgen and the insulin like growth factor binding protein levels are also reduced. The mild resistance of insulin and the high levels of insulin like growth factor are seen in the patients of acne. The polycystic ovarian syndrome also has high levels of acne and insulin. The low glycemic index in few countries may show the absence of acne in few non westernized countries.

13. The genetic reasons are more prominent for the absence of acne. The similar population does develop acne. It includes the South American Indian and Pacific Islanders. The populations which were studied consumed no milk products. There is a need of more research to establish that a decrease in the consumption of high glycemic foods can result in the increased insulin sensitivity. It increases the acne and in general high glycemic foods must be avoided. The junk food must be minimized so that the high fat and sugar intake can be controlled. Few studies have also shown that the patients with the acne have low levels of vitamin A present in their blood. These studies have also shown that the patients with the acne have low levels of vitamin E present in their blood.

14. The dirt does not give rise to acne. This is mainly mis understood from the fact that the black heads look like dirt stuck in the pore openings. The black color is not due to the dirt but is the oxidized form of keratin. The blockages of keratin can lead to the acne which is present in the narrow channel of follicle. It is very difficult to clean them. The failure of cells lining the ducts forms the plugs. The oil of the skin block the pores so the washing of the face is very helpful in removing the pore blocks.

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