Hair follicles cover the whole body and each follicle does have an oil gland which secrete oil/sebum. Acne occurs when skin cells clog up these follicles and sebum gets trapped inside, the C. acne bacteria starts to grow inside the pores, this overgrowth causes an immune system response, the white blood cells that come to fight the overgrowth of acne bacteria damage the wall of the hair follicle leading to inflammation.
There are 2 main types of acne:
Non-inflammatory: this type of acne is just clogged up pores (comedones) and the causes are hormonal imbalance, over cleansing, dehydration and using unsuitable skincare products. Closed comedones either blackhead or whiteheads can be controlled by regular cleansing, reducing sugar and dairy intake and OTC treatments such as Salicylic Acid and Benzoyl Peroxide.
Inflammatory: Although sebum contributes to inflammatory acne, acne bacteria plays a huge role in this type of acne. It could be caused by hormonal imbalance, PCOS, weak immune system, vitamin D deficiency. Inflammatory acne can cause scarring! Benzoyl peroxide could be used to kill the C.acne bacteria, and Salicylic Acid to regulate oil, and Retinoids to accelerate cell turnover. Adopting a proper skincare routine and a healthy diet (limit dairy, sugar, process food, red meat intake) is a must! Depending of the cause of inflammatory acne, medications such as Spironolactone, birth control pills, Antibiotics or Accutane might be needed. Doctor care is crucial in this case!
** A new topical acne treatment called WINLEVI has been approved by the FDA in August 2020. WINLEVI is the first acne drug with a new mechanism of action in 38 years; the last one was Accutane!
Diet plays an important role in causing acne. Three main reasons why diet may cause acne:
1. Some foods may trigger inflammation and inflammation leads to acne.
2. Consuming some foods result in high Androgen levels and excess Androgen leads to overproduction of sebum.
3. Some foods increase the growth hormones levels; these hormones stimulate cell growth and excess of them result in accumulation of skin cells and clogging pores.
Main foods that trigger acne:
High glycemic index and refined carbohydrates, such as sugar, flour, refined cereal products, white potatoes, and fruit juice, are prime suspects in causing acne. These “fast carbs” are rapidly digested and absorbed into the bloodstream, causing insulin levels to surge. High insulin levels increase risk of acne because they Promote inflammation, cause overgrowth and accumulation of skin cells, and raise androgen levels.
Dairy products Milk and most milk products contain two main types of proteins: casein and whey. The proteins in dairy products can shift growth hormones into overdrive, trigger insulin spikes just as powerfully as pure sugar does, trigger the skin follicle to make too much sebum and stimulates excess sebum, skin cell, and androgen production.
**Low-fat and non-fat dairy products actually contain a higher concentration of dairy proteins than high-fat dairy products, and therefore are even more effective at triggering breakouts in susceptible people.
Omega- 6 fatty acids like Soy bean could cause inflammation.
**Over-consumption of red meat can activate a protein complex in body which can affect sebum production and cause inflammation.
**Over-consumption of Caffeine leads to heightened stress hormones such as cortisol which could increase inflammation and production of sebum.