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What Causes Acne?

This content has been written and checked for quality and accuracy by
Dr. Giuseppe Aragona Doctor Published on: 14/12/2021 Updated on: 09/05/2022

Acne is a common skin condition that can affect anyone at any time of their life.

During pubery, acne is influenced by changes in hormone levels of testosterone and progesterone in men and women. Acne usually clears up after your teens.

Some people may continue to experience acne as an adult.

While it can be tricky to pinpoint the cause of acne in adulthood, there are some common culprits.

How does acne develop?

Acne starts to develop when a pore becomes clogged. This blockage prevents sebum from escaping.

Sebum is an oily substance which forms a protective barrier on the skin's surface. It is secreted from sebaceous glands, which lie just below the surface of the skin.

If a pore becomes blocked, the sebum has nowhere to go, so it builds up below the epidermis.

How acne develops under the skin

Bacteria, called Propionibacterium acnes, feed on this build-up of sebum and thrive. These bacteria excrete chemicals which irritate the surrounding tissues and cause inflammation.

Combined with the surplus of sebum, the inflammation causes red, swollen bumps to form on the skin. These can be painful, itchy or dry.

There is currently no strong evidence to prove that diet, poor hygiene or sexual activity causes acne.

Medicines

Acne can develop as a side effect to a medicine. You can check whether a medicine is likely to cause acne by checking the side effects listed in the patient information leaflet.

Medicines known to cause acne include steroids - particularly corticosteroids and androgenic steroids, lithium (for depression and bipolar disorder), and anticonvulsant drugs used to treat epilepsy.

In some cases, a treatment for acne can make your acne worse. This may be due to an ingredient that may aggravate sensitive skin, such as alcohol, or an allergic reaction. If you notice your symptoms of acne worsen during any treatment, inform your doctor.

Pregnancy

During pregnancy, the female body experiences a sudden influx of oestrogen, progesterone and androgenic hormones.

These hormonal changes can trigger acne, particularly during the first trimester. Much like acne during puberty, it can clear up as gestation continues and your hormones rebalance.

There is a common myth that acne during pregnancy means that you should expect a baby girl. The old wives tale that a baby girl would "sap your beauty" and cause acne is just that - an old wives tale.

Always speak to a doctor or a pharmacist before using acne treatments during pregnancy. Some treatments may not be suitable for pregnant women, and may pose a risk to you and your baby.

Menopause

Women may experience acne during the menopause. Just like acne during pregnancy, this is linked to the change in hormone levels after the menopause.

During the menopause, oestrogen levels fall and androgen levels rise. Sebaceous glands in the skin respond to these hormonal changes by producing more sebum that blocks pores, leading to acne.

Genetics

While there is no particular gene which causes acne, other genetic traits from your parents can contribute to acne. For instance, if your mother or father experienced particularly severe acne as a teenager, there is an increased chance that you too will experience severe acne.

A 2018 study from King's College London identified that people with severe acne shared similar genomes that played the role in the development of hair follicles. Research suggest that this could be a significant factor in the development of acne.

Cosmetics

Make-up, perfume, and other skincare products can cause or exacerbate acne. Hiding acne with make-up may mask the condition, but it might be causing more harm than necessary.

Check the ingredients on your cosmetics for the following:

  • Lanolin
  • Sodium laural sulfate
  • Alcohol (ethanol)
  • Salt (sodium chloride)
  • Coconut oil
  • Cocoa butter
  • Algae extract

The ingredients listed above can irritate the skin or clog pores, and can play a role in the development of your acne.

Consider swapping to non-comedogenic cosmetics, which are gentler on the skin and less likely to cause skin irritation. Remember to conduct a patch test before using a new cosmetic product.

How is acne treated?

In most cases, acne spots are small and go away on their own within a week or so.

But for some people, acne can be a severe and distressing condition that affects them both physically and mentally.

It's important to speak to a doctor about your condition, especially if your acne is particularly severe or causing you distress.

For mild acne, you may find an over the counter treatment, such as Clearsil or Acnecide, to be effective for you.

If over the counter treatments haven't been effective for you, one of our online doctors can discuss treatment options with you, and may even be able to prescribe a treatment for your acne.

We offer a range of treatments through our online prescription service, from antibiotics like Tetralysal (Lymecycline), to topical creams, ointments and gels like Epiduo, or Zineryt.

For women specifically, a doctor may prescribe an oral contraceptive. Certain contraceptive pills are effective for the treatment of acne in some women.

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