Acne is not fully understood, but we do know some of the biology behind it. The main culprit is the excess production of an oily substance called sebum whose function is to keep skin and hair lubricated and supple. During adolescence, the body often produces excess amounts of sebum. The sebum combines with naturally occurring dead skin cells to block hair follicles which prevents the sebum from escaping.
The resulting block up of oil beneath the surface of the skin provides an ideal environment for bacteria. The bacteria multiply and the skin area becomes red and inflamed resulting in what is commonly called a pimple.
The excess production of sebum is caused by the male hormone testosterone. Testosterone is present in both males and females, but during puberty, the body changes the way it reacts to the presence of testosterone. It is this abnormal reaction, characteristically appearing during adolescence, that causes the skin (especially on the face and upper torso) to become excessively oily. By the early 20s, the body usually normalizes its reaction to testosterone and acne clears up.
Acne seems to be partly hereditary, but we don’t know exactly why some people are affected by it and others are not. Some of the factors which seem to aggravate acne conditions include stress, diet, skin irritation, certain medications, and hormonal activities such as menstrual cycles.
Medications that are associated with acne include anabolic steroids used for bodybuilding, lithium, barbiturates, halogens, and androgens. Dietary links seem to be mostly related to skim milk products. Many people associate food like chocolate and fast food with pimples, but there is no statistical evidence that this type of food causes or aggravates acne.
Recently, scientific attention has been focusing on the possibility that narrowing hair follicles could be at least partially to blame for acne. The hair follicles may become restricted due to several possible causes including excessive shedding of cells within the follicle, abnormal cell binding, or water retention which causes the skin to swell. The narrower hair follicles prevent dead cells from being expelled from the body, causing an excessive buildup underneath the skin, which combined with sebum creates the conditions for acne.
Many people are tempted to pop or squeeze their acne pimples, but this may only serve to spread the bacteria to the surrounding skin area making the condition even worse than before. Popping acne pimples may also lead to scarring which in severe cases can be permanent.
Simply touching the face can also make acne become worse. It is a difficult habit to overcome – most of us touch our faces repeatedly throughout the day. The problem for acne sufferers is that the hands also contain oils and bacteria which will exacerbate acne symptoms. In fact, all objects that come into contact with the face must be clean. This includes eyeglasses and telephone handsets.
Hair (especially long hair) also comes into contact with our faces so it is important to keep hair clean and oil free. Clothing accessories like headbands or hats should be avoided or used as little as possible.