"The development of acne is multifactorial," says Camp. "It involves follicular hyperkeratinization (exfoliating or shedding skin cells form a plug within a pore,) hormonal influences (androgens or sex hormones that signal sebum or oil production,) and inflammation related to bacteria." To put it simply, acne symptoms, like red, raised lesions can occur when too much oil and dead skin cells or bacteria clog a pore, which initiates an inflammatory response from the body, resulting in breakouts. More detail, below:
- Excess sebum: Sebaceous glands, which are located at the end of a hair follicle, or pore, produce sebum, which is an oily substance designed to keep the skin healthy by hydrating it, and protecting it from external stressors. Sometimes, these glands can go into overdrive and produce too much oil, which can result in clogged pores, and eventually, breakouts.
- Hormones: Those sebaceous glands become triggered mainly by hormones. â€œAcne tends to be hormonally driven,â€ says Kraffert. "The same hormones that drive acne also tend to promote more oily skin." Which hormones are mostly responsible for increased oil production? â€œAndrogens are the main drivers of acne," Kraffert adds. "Androgen levels tend to rise in adolescence and, especially in women, early adulthood."
- Dead skin cells: Itâ€™s not just oily skin that leads to acne symptomsâ€”debris like dead skin cells can contribute to clogged pores, causing breakouts.
- Diet: While highly disputed as an official cause, many believe that what they eat has a direct impact on the condition of their skin. "A high glycemic index diet is thought to be related to acne," says Camp. "These types of foods cause large increases in blood sugar levels, which leads to the release of hormones that may promote acne formation." Some examples of high glycemic foods include white bread and sugar.
Implementing a skincare routine is no different than working out or learning a new languageâ€”if you want to see results, consistency is key. "Those with acne- prone skin should commit to a consistent skincare routine daily, not just when the breakouts show up," recommends Garshick.
Acne breakouts donâ€™t form over night, and they wonâ€™t go away so quickly either. "Donâ€™t give up on acne products too soon," advises Camp. "I tell patients that topical acne medications should be used for 8-12 weeks before they 'declare' themselves as effective or not. It doesnâ€™t help to cycle through products rapidly." And while youâ€™re waiting, do your best to keep your hands off of your skin. "While tempting, it is not a good idea to pick or pop acne," he adds. "Doing so ruptures the follicle and widens the area of inflammation. This could lead to a larger area of discolored skin. It also increases the risk of scarring and may lead to a bacterial infection."
Know When to Consult a Professional
For stubborn acne symptoms, over-the-counter remedies may not provide relief, in which case, a medical professional may be your best bet for finding a solution that works. With any prescription, apply right after cleansing and exfoliating to try to allow for maximum absorption. In addition to topicals, specialized treatments can help address issues and repair the skin. â€œIn-office treatments that can help address acne include steroid injections, acne surgery, peels, blue light and red light therapy, photodynamic therapy, microneedling, and lasers,â€ says Camp.
To sum it all up, acne breakouts can occur when extra oil and dead skin cells or bacteria form within a pore, which causes the body to react as it would when any infection disrupts its system. A skincare regimen can absolutely reduce symptoms, or even prevent new ones from forming, but the exact routine will depend on you, your skin type, and the severity of your acne symptoms. For the most part, however, dermatologists recommend cleansing, regular exfoliation, moisturizing, and spot treating as needed, along with practices that contribute to overall skin health, like using retinol in the evening, and SPF every day.
American Academy of Dermatology Association. Skin conditions by the numbers.