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Last Updated Nov 14, 2023

What causes acne?

Author
|
Dermatology Resident
Dr. Jesse Dewey

The main causes of acne are sticky skin cells, excess oil production, bacterial overgrowth, and inflammation.

#1: Clogged pores

Your skin is organized like a layer of bricks stacked on top of each other. When a new set of cells grows in from the bottom, the layer of cells at the top should slough off. In individuals with acne, skin cells are a lot stickier (cohesive) and do not slough off as easily. This causes dead skin cells (corneocytes) and oil to get trapped in your pores.

#2: Excess oil production

The purpose of oil glands in your pores are to secrete oily substances to combat skin dryness. However, if skin cells are too sticky and do not slough off appropriately, then it traps the oil underneath the skin. This can lead to little pools of oil that form a pimple, also known as a comedone.

#3: Bacterial overgrowth

It is normal for some bacteria to live on the surface of the skin. However, when clogged pores trap oil underneath the skin, acne-causing bacteria (cutibacterium acnes) use that oil as fuel to grow. This leads to a buildup of bacteria in the pores that triggers the immune system to produce inflammation.

#4: Inflammation

When your immune system recognizes the overgrowth of bacteria living in your pores, it sends immune cells to attack that area to kill the bacteria. The end result is a big, red, painful pimple.

Doctor's Note

There are four main causes of acne: Sticky skin cells, Excess oil production, Bacterial overgrowth, and Inflammation. 

The best treatments for acne will target the underlying causes above.

The Research

Acne vulgaris: new evidence in pathogenesis and future modalities of treatment. PMID: 31393195

Dr. Jesse Dewey

Dermatology Resident

Dr. Jesse Dewey

Dermatology Resident

Dr. Jesse Dewey hails from the beautiful state of Utah where he completed
both his undergraduate and medical school training. Currently, he is
completing his dermatology residency in Wilmington, North Carolina
where he also plans on completing a surgical fellowship. Dr. Dewey
loves dermatology and enjoys helping people obtain and maintain
beautiful and healthy skin. Outside the clinic, Dr. Dewey finds joy in
spending quality time with his family, exploring the east coast, and
indulging in his favorite TV shows.

Location: Wilmington, North Carolina

Doctor's Note

There are four main causes of acne: Sticky skin cells, Excess oil production, Bacterial overgrowth, and Inflammation. 

The best treatments for acne will target the underlying causes above.

The Research

Acne vulgaris: new evidence in pathogenesis and future modalities of treatment. PMID: 31393195

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