What causes acne?

Acne is a common skin condition that can have several causes. These causes are often linked to hormonal, genetic and environmental factors.

Excessive sebum secretion plays a key role in the development of acne. The skin's sebaceous glands produce an oily substance called sebum, and when this secretion is excessive, it can clog the skin's pores, creating an environment conducive to the multiplication of acne-causing bacteria.

What's more, when dead skin cells accumulate, they can combine with sebum to clog pores. This creates an environment conducive to the proliferation of Cutibacterium acnes bacteria (formerly known as Propionibacterium acnes), which are naturally present on the skin. When these bacteria proliferate in clogged follicles, they trigger an inflammatory response in the body, which can lead to the appearance of pimples, blackheads, whiteheads and other acne lesions.

Dead skin cells play a key role in the acne formation process, contributing to the clogging of skin pores. For this reason, regular skin exfoliation, which helps remove dead skin cells from the skin's surface, is often recommended as part of acne treatment to prevent its development.

 

In short, acne can result from a combination of factors, including excessive sebum secretion, bacterial proliferation and clogged pores. Hormonal and genetic factors can also play a role in predisposition to acne.

As far as hormonal factors are concerned, hormones have a considerable impact on acne formation. More specifically, androgens, which are male sex hormones present in limited quantities in women too, influence sebum production by the skin's sebaceous glands. Overproduction of androgens can stimulate these glands, leading to excessive sebum secretion. Hormonal fluctuations during periods such as puberty, menstruation, pregnancy and menopause can thus trigger acne outbreaks due to these hormonal variations.

Hormonal contraceptives are sometimes used to regulate hormones in some acne sufferers. These contraceptives contain synthetic hormones that help balance hormonal levels and reduce sebum production, thus helping to alleviate acne symptoms.

As far as genetic factors are concerned, studies have shown that there is a genetic component in the development of acne. If members of your family have suffered from acne, it's possible that you have a genetic predisposition to this skin condition. However, it's important to note that genetics don't necessarily determine this dermatological condition, but they can increase your likelihood of suffering from it.

Hormonal and genetic factors interact to influence sebum secretion, bacterial proliferation and skin inflammation, all key elements in the development of acne.

The different types of acne

There are several types of acne, each characterized by its own characteristics and levels of severity. Here are some of the main types of acne:

• Acne Vulgaris

Acne vulgaris is the most common form of acne, affecting millions of people worldwide. It is characterized by a variety of skin lesions, including pimples, blackheads (open comedones), whiteheads (closed comedones), pustules (pus-filled pimples) and sometimes cysts. These lesions generally form on the face, neck, back, chest and shoulders. Blackheads are the result of clogged pores caused by excess sebum, dead skin cells and bacteria. Pustules form when bacteria proliferate inside clogged pores, causing inflammation.

• Acne Comedones

Comedonal acne is a form of acne dominated by comedones, which are non-inflammatory lesions. There are two types of comedones: blackheads (open comedones) and whiteheads (closed comedones). Blackheads are caused by an accumulation of sebum and dead skin cells in an obstructed pore, which oxidizes on contact with air, turning black. Whiteheads form when sebum and dead skin cells clog a pore, but the surface remains closed. Although these lesions are not inflammatory, they can develop into pustules or papules in the event of bacterial infection.

• Acne Papulopustularis

Papulo-pustular acne is a mild to moderate form of acne characterized by the appearance of swollen red pimples (papules) and pustules. Papules are the result of inflammation of clogged pores, while pustules are pus-filled pimples. This form of acne can cause itching and discomfort, but generally does not leave permanent scars and is not considered severe acne.

• Cystic Acne

Cystic acne is a severe form of acne characterized by deep, painful cysts that form under the skin. These cysts can be tender to the touch and are often associated with significant inflammation. Cystic acne can leave permanent scars if not treated effectively. Because of its severity, it often requires more intensive medical treatment, including local and oral medications and dermatological procedures.

• Nodular acne

Nodular acne manifests itself as nodules, which are hard, painful lesions located under the skin. These nodules can be large and swollen, causing considerable discomfort. Nodular acne is considered a serious form of acne, and is prone to scarring. Medical intervention is often necessary to effectively treat nodular acne.

• Acne Conglobata

Acne conglobata is an even more severe form of acne, characterized by the presence of nodules, cysts, abscesses and extensive inflammation. It can be devastating to the skin, and can leave deep, permanent scars. Because of its severity, acne conglobata often requires specialized dermatological treatment and powerful medications to control it.

Each of these types of acne has specific characteristics and may require a different treatment approach. The choice of treatment will depend on the severity of the acne and the patient's individual needs. It is essential to consult a dermatologist to assess the acne and develop a suitable treatment plan.

Which skin types have acne?

Oily skin is often more prone to acne due to a genetic predisposition to overproduction of sebum. The skin's sebaceous glands, responsible for sebum production, are particularly active in these individuals. This overproduction of sebum can clog pores, creating an environment conducive to the formation of pimples and blackheads. These individuals often have acne-prone skin.

However, other skin types are not immune to acne. Combination skin, characterized by an oily T-zone (forehead, nose, chin) and other drier parts of the face, can also be prone to acne. The T-zone is particularly prone to breakouts due to the overproduction of sebum, while drier parts of the face may also occasionally develop pimples.

Sensitive skin can also develop acne, although this is often more delicate to treat. Aggressive acne products can cause skin irritation, so choosing the right products is essential to avoid aggravating the problem. Local acne treatments should be gentle enough not to cause irritation.

Dry skin is not as commonly associated with acne, but it is not completely immune to this skin condition. These people can develop pimples and inflammation, although less frequently than those with oily skin. In addition, taking certain medications can sometimes lead to acne breakouts.

So, while acne is more common in people with oily skin, it can affect a variety of skin types, and each skin type may require specific treatment approaches for acne, depending on its characteristics and sensitivity. Choosing the right skin care products and treatments for your skin type is therefore essential for effective acne management.

Who does acne affect?

Acne isn't just a concern for teenagers, as it can affect adult women too. The relationship between adult women and acne can be significant for several reasons:

• Hormonal factors: Hormonal fluctuations play a major role in the development of acne in adult women. Hormonal variations linked to the menstrual cycle, pregnancy, menopause and the use of hormonal contraceptives can all contribute to acne flare-ups.
• Premenstrual syndrome (PMS): Many adult women report worsening acne before or during their periods, due to hormonal changes during the menstrual cycle.
• Late-onset acne: Some women never experienced acne during adolescence, but may develop it later in life. This is called late-onset acne, and can be linked to hormonal, genetic or environmental factors.
• Stress: Chronic stress can trigger or aggravate acne in adults, as it can lead to hormonal imbalances and increased sebum production.
• Use of cosmetics: Inappropriate cosmetics and skin care routines can clog pores and contribute to acne in adult women.
• Genetic factors: A genetic predisposition to acne can also play a role, meaning that if other family members have had acne, an adult woman may be more likely to suffer from it.

It's important to note that acne in adult women can be different from that in teenagers, and may require specific local treatment approaches, including hormone treatments, topical medications and tailored skin care. A consultation with a dermatologist can help determine the underlying cause of acne and develop an appropriate effective treatment plan.

Does hygiene play a role in the appearance of acne?

Acne is not exclusively caused by poor hygiene, but poor hygiene can contribute to its development or worsening in some cases.

In fact, poor hygiene, and in particular the failure to clean the skin regularly, can lead to the accumulation of sebum and dead skin cells, which clog pores and encourage the formation of pimples and other acne lesions. That's why it's so important to take good care of your skin with the right cleansers and exfoliants.

Poor hygiene can also contribute to the excessive proliferation of bacteria, and the use of aggressive cleaning products can cause irritation, aggravating acne symptoms.

However, it's essential to note that acne is a multifactorial condition. Having good skin hygiene, including regular, gentle cleansing, is important for maintaining healthy skin, but it doesn't necessarily guarantee acne prevention, especially in cases where other factors come into play.

What are the acne-fighting ingredients?

When it comes to choosing cosmetics for anti-acne treatment, it's important to look for specific ingredients that are known to be effective in fighting acne breakouts. Here are some of the ingredients commonly used in acne skin care products:

• Salicylic acid: Salicylic acid is a fat-soluble chemical exfoliant that effectively penetrates skin pores. It has the ability to dissolve lipids, making it particularly useful for removing dead skin cells, reducing inflammation and unclogging pores. By removing dead skin cells, it promotes cell renewal, which can help prevent clogged pores and reduce the appearance of pimples.

• Probiotics: Probiotics are beneficial micro-organisms that help maintain a healthy balance of bacteria on the skin. They limit the proliferation of the Cutibacterium acnes bacteria responsible for acne. In addition, probiotics strengthen the skin barrier by promoting a balanced skin microbiome. A healthier skin barrier limits transepidermal water loss, helping to keep skin hydrated and prevent irritation.

• Retinoids: Retinoids, derived from vitamin A, are powerful compounds for the treatment of acne. They work by preventing pore clogging, promoting cell renewal and reducing inflammation. Retinoids help normalize the skin's desquamation process, preventing the accumulation of dead cells in hair follicles.

• Glycolic acid: Glycolic acid is an alpha hydroxy acid (AHA) that gently exfoliates the skin. It promotes cell renewal by removing dead cells from the skin's surface. It can also reduce the appearance of acne scars by smoothing skin texture. However, it's important to use glycolic acid with caution, as it can make skin more sensitive to the sun.

• Niacinamide: Niacinamide, also known as vitamin B3, has anti-inflammatory properties. It helps reduce skin inflammation, which is particularly useful for people suffering from inflammatory acne. In addition, niacinamide regulates sebum production, which can help reduce skin shine in people with oily skin.

• Hyaluronic acid: Hyaluronic acid is a moisturizing ingredient that can maintain the skin's optimal moisture balance. Unlike some moisturizers that can clog pores, hyaluronic acid hydrates the skin without causing clogging. This is essential for maintaining balanced skin, as adequate hydration can help regulate sebum production.

• Tea tree oil: Tea tree oil is known for its antimicrobial and anti-inflammatory properties. It can help reduce the proliferation of acne-causing bacteria, while soothing skin inflammation. However, it should be used with caution, as excessive use can cause skin irritation.

It's important to note that everyone reacts differently to products and ingredients. It is advisable to consult a dermatologist to determine the best cosmetic treatment for your skin type and the severity of your acne. In addition, it's essential to follow product instructions and monitor your skin for any adverse reactions. Not overloading the skin by using too many products at once is also important to avoid further skin irritation.