Young and Healthy Skin: Study Could Explain Why Some People Get Acne and Others Don’t

They are lucky having no acne at all. Sadly, some suffer occasional acne or chronic cystic acne. It is not really fair. When I look at some people who have acne, I wonder how they achieve smooth acne-free skin. They are really lucky to have pimple-less skin, which is envied by someone who hassles with their skin and afford acne treatments and over-the-counter products like pill, scrub, and so on. Yet, they still are overwhelmed with unlikable acne.

Acne vulgaris (acne) is a common condition of the skin, particularly affecting the areas with the densest population of sebaceous (oil) follicles. This includes the face, upper chest, and back. Sebaceous secretions are intended to condition and maintain a hydration balance.

The bane of most adolescents, acne is characterized by areas of skin with seborrhea (scaly red skin), comedones (blackheads/whiteheads), pustules (pimples), nodules (large inflamed papules) – which can result in post-inflammatory hyperpigmentation (slow healing discoloration), giving the illusion of acne long since gone, and scarring (dimpling/pocking/permanent discoloration).

Acne affects 80 percent of Americans at some point in their lives and is most common among teenagers. Regardless of what some people say about “growing out of it,” the frustrating affliction can continue well into adulthood.

In adolescence, acne is usually caused by an increase in testosterone, which accrues during puberty, regardless of sex – yes, women have testosterone too.

In fact, higher levels of testosterone (or what is commonly referred to as androgens) are typically the cause of cystic acne – massive, inflamed red nodules along the chin line – in women. And ok, yes, for most people, once their hormones have balanced out, the acne does diminish or lessen over time. But there are people who suffer with it into their 40s and beyond.

It is difficult to accept and a wee bit unfair, but some people are just predisposed to have acne over others. Along with hormones, skin-surface bacteria play a role. Acne develops as a result of blockages in the follicles.

Dead cells are meant to desquamate (slough off). When they don’t properly shed they can accumulate within the pores and around hair follicles (hyperkeratinization), forming a commingled plug of keratin (natural protein), sebum (natural oil), and the dead cells. The cohesion of the protein, oil, and cells can block or cap the follicle or clog up the sebaceous duct.

In these conditions, the naturally occurring bacterium Propionibacterium acnes that thrive in the depths of our pores become inflamed. This leads to a variety of infected, inflammatory lesions in the dermis. When the bacteria provoke the immune system it results in swollen, red bumps.