Acne is a common skin condition that affects thousands of people. But if you’re one of those thousands, you might feel like you’re suffering alone, wondering what on earth is causing your acne.
Acne has many causes, and there are also plenty of myths surrounding other things that might cause acne, such as what you eat and how good your mental health is.
There are several main causes of acne that are scientifically accepted. For example, what is certain, is that the basis of acne development and severity is in our genes. Secondary contributors are hormones, bacteria, diet and stress.
For several other causes of acne, the evidence is inconclusive. The impact of smoking on acne severity is inconclusive. Exposure to sunlight may cause acne symptoms to flare up, but it isn’t a root cause.
There are a few causes that are common sense, such as using an oil based moisturiser on oily, acne prone skin, but these are not always confirmed by studies.
So in this article we aim to separate the fact from the fiction and discuss what can truly cause acne.
GENETIC CAUSES OF ACNE
If a family member has acne prone skin then you also have a higher chance of also having acne prone skin.
Studies in twins and first-degree relatives such as siblings and parents show that acne has a strong genetic link. This means that if your parents remember having teenage acne for example, there is a high probability that you may also develop it.
Being prone to acne does not depend on one gene, but multiple genes. Each of these genes have a small effect so it’s impossible to predict if you will have acne, and if you do, how severe it might be or how easy it will be to manage it.
HOW HORMONES CAUSE ACNE
Hormones play a critical role in acne development. Both female hormones called oestrogens that rise and fall during the menstrual cycle, and male hormones called androgens that surge during puberty can cause hormonal acne. Ultimately, they increase the production of the natural skin oil called sebum. Excessive levels of sebum, at any age, is a cause of acne.
ACNE DURING PUBERTY
During puberty, an increase in the androgen sex hormones causes the sebaceous glands deep within the skin to grow larger and make more oily sebum. It is important to remember that these ‘male’ androgen hormones are present not only in men but also in women, just in smaller quantities.
DIETARY SUPPLEMENTS CAN LEAD TO ACNE
An imbalance of male and female hormones can lead to acne. Over-the-counter bodybuilding and dietary supplements may contain added anabolic steroids which are synthetic androgens. They can cause or exacerbate hormonal acne.
Other hormones that can lead to severe acne formation are high levels of growth hormone and insulin-like growth factor 1 (IGF-1).
MEDICAL CONDITIONS THAT CAN LEAD TO ACNE
Medical conditions linked to hormone levels, such as polycystic ovary syndrome (PCOS), that affects one in five women in the UK, can also cause acne.
ACNE DURING PREGNANCY
An increase in androgen production during pregnancy leads to an increase in synthesis of oily sebum that can result in pregnancy acne. This however should be temporary and your skin should clear up during the weeks and months after giving birth.
While hormonal and genetic causes of acne are internal and impossible to control, there is also a major external cause of acne.
A bacterium called Propionibacterium acne is linked to acne and eye inflammation. An overgrowth of this bacterium contributes to the cycle of inflammation, excess sebum production and inadequate sloughing of dead skin cells from skin pores that cause acne spots and breakouts.
While there are subspecies (strains) of Propionibacterium that live on healthy skin, the acne causing strains are found colonising the skin of people with inflammatory acne. It’s not entirely clear if the ‘normal strain’ evolves into the pathogenic strain or those with acne become infected by the ‘bad’ strains.
Another natural skin inhabitant, a microscopic mite called demodex is also associated with acne development.
As with any disease associated with live organisms, developing and maintaining a correct skincare regime and using the right skin care products is very important in controlling and reducing bacterial acne.
WHAT FOODS CAUSE ACNE?
What we eat has a direct impact on the health of our entire body and also our mental wellbeing. Some foods also affect our skin, especially so if we have a genetic predisposition for acne prone skin or our hormones dictate that we produce excessive amounts of sebum.
Sugary foods can cause acne by increasing levels of inflammation. The glycaemic index of a food is a measure of how easily that food is converted into a simple sugar, or glucose.
Sugar rich foods with a high glycaemic index such as white bread, white pasta, white rice, sweets, cakes and pastries lead to an increase in acne severity. They increase the production of the hormone IGF-1 which is a cause of acne.
On the contrary, foods with a low glycaemic index such as vegetables, helps to support acne prone skin.
Excessive oil production by the skin leads to acne formation so eating foods high in fat such as fried foods, processed foods and takeaways can lead to acne spots and breakouts. This is especially true around the mouth area since eating oily foods leaves a layer of pore blocking grease around the mouth. Eating a diet high in fat can also negatively influence the hormonal causes of acne.
Dairy products are also associated with higher frequency and increased severity of acne. Dairy induced acne may be caused by many factors including the bovine growth hormones found in dairy milk, cheese and yoghurts.
These bovine hormones are androgen precursors very similar to human androgens. Having high levels of androgen hormones is a cause of acne. Milk and dairy products may therefore increase the production of androgen hormones and acne causing sebum, and promote the formation of comedones, raised bump like blocked pores.
Doctors can’t establish a link between eating chocolate and have acne breakouts but since chocolate is filled with sugar and usually dairy, it’s best to save for a treat.
In general, the typical Western diet is high in simple, sugary carbohydrates, milk and dairy products, trans fats and saturated fats, along with low omega-3 fatty acids intakes. This combined can lead to increased chances of acne.
To help control and manage your acne prone skin, aim to eat a diet low in fat and sugar, and high in fresh vegetables.
CAN STRESS CAUSE ACNE?
There’s little doubt that when you’re stressed, if you have acne prone skin, you’re more likely to develop acne breakouts.
As yet, researchers don’t know the exact cause of the link between stress and acne, but they do have strong theories.
When we’re stressed, our bodies create higher levels of the stress hormone cortisol along with other androgen hormones. Within the sebaceous glands, there are receptors for these hormones.
When these receptors detect the stress hormones, it triggers the release of more sebum. This in itself signals bad news for acne prone skin but these stress hormones also increase levels of inflammation which also leads to more acne spots.
DOES DEPRESSION CAUSE ACNE?
If you suffer with acne prone skin, then it could cause you to feel anxious or depressed. But could the reverse also happen, could depression cause acne? To date there is no conclusive evidence that being depressed causes acne. However, scientists do think that depression can lead to an increase in inflammation and an imbalance of hormones related to stress, which could then cause acne. Seeking help for anxiety, stress or depression could lead to an improvement in your skin.
DOES SMOKING CAUSE ACNE?
Smoking is an unhealthy habit and has detrimental effects on our all round health, including that of our skin.
Studies show that smokers are more likely to experience non inflammatory acne characterised by comedones, blocked pores and blackheads, rather than red, inflamed or cystic acne. That said, the study also found that smoking had a direct correlation with having acne in general and even coined a new phrase, “smokers acne face” where smoking causes acne to develop specifically around the cheeks.
Researchers put this down to smoking causing a decrease of the skin nourishing antioxidant vitamin, vitamin E. They also think that smoking causes an increase in inflammation, a major cause of both inflammatory and non inflammatory acne, and causes the skin healing mechanisms that help to fight acne, to break down.
So the message is clear – ditch the cigarettes if you want to improve your skin and your health!
DOES WORKING OUT CAUSE ACNE?
Performing vigorous, high intensity exercise can cause you to sweat. If this sweat is allowed to stay on the skin if you don’t shower after exercise, it can cause blocked pores which worsen acne symptoms.
However, it’s not a good idea to rule out exercise entirely. Exercise allows the blood to pump faster and more efficiently around the body. This delivers oxygen and nutrients to the skin, keeping it healthy and allows toxins to drain away more easily.
If you do exercise, try to shower immediately afterwards or stick to less vigorous exercise such as walking or yoga.
CAN SEX OR MASTURBATION CAUSE ACNE?
Having sex, not having sex, masturbating regularly or not masturbating all have no direct impact on whether you have acne or not.
DOES THE SUN CAUSE ACNE?
Laying out in the sun or using sunbeds is often touted as a way of ‘drying up’ acne but the sun itself isn’t a cause of acne.
Like energetic working out or sex may cause you to sweat and make your acne worse, sunbathing or being in the hot sun will also make you sweat.
If you know that sweating exacerbates your acne, then it’s best to avoid being in direct sunlight for too long.
Also, some sun creams may also cause you to sweat more. Make sure you use a sun cream that’s designed for the face not the body, and make sure it’s oil free or non-comedogenic.
CAN A LEAKY GUT CAUSE ACNE?
A leaky gut is one that doesn’t allow nutrients to be properly absorbed into the bloodstream, leading to potentially nutrient deficiencies.
It’s thought that a leaky gut is linked to high levels of inflammation which can also lead to acne spots and breakouts.
Taking probiotic supplements to help heal a damaged, leaky gut could help to fix your gut and manage your acne prone skin.
CAN HIGH CHOLESTEROL CAUSE ACNE?
Having high cholesterol indicates that you have higher amounts of lipids, or fats, in your blood. But this doesn’t mean that high cholesterol causes acne – to date there is no evidence to support any claims to the contrary.
BIRTH CONTROL PILLS AND ACNE
There are some types of birth control pills that can cause acne symptoms to become worse and other types that are actually used to help manage acne.
The ‘mini pill’ or the progesterone only pill should be avoided if you have acne prone skin as it can make your breakouts more frequent and more severe.
However, the combined oral contraceptive pill can help to balance your hormones and reduce your acne. This can be especially effective if you experience worse acne spots and breakouts around the time of your period or if you have PCOS.
DOES PREGNANCY CAUSE ACNE BREAKOUTS?
When you’re pregnant, your body experiences unusual surges and falls in hormones. These hormone imbalances can lead to pregnancy acne.
If you develop pregnancy acne, there are certain medications and topical ointments, creams and gels that you can’t use for safety reasons.
Using a water based skincare regime such as ours here at Sönd that has been specially developed to support acne prone skin will help to see you through your pregnancy. Once you’ve given birth, you should start to see an improvement in your skin.
VITAMIN SUPPLEMENTS AND ACNE
There are a variety of vitamin supplements that can help to support acne prone skin. These include vitamin C, vitamin E, zinc and omega 3 supplements.
But there are some vitamin supplements that can cause acne prone skin to become worse. Vitamin B12 has been proven to cause acne prone skin to become more problematic. It’s thought that this is due to its ability to support the survival of the bacteria that colonise the skin of acne sufferers.
Other supplements that can cause acne are biotin (vitamin B7) and iodine, which are often included in multivitamin supplements. Biotin is also often included in haircare products so avoid supplements, shampoos and conditioners including this vitamin.
SKINCARE PRODUCTS AND ACNE
Using oil based skincare products including skin moisturisers and makeup is a sure fire way of making oily, acne prone skin worse.
Using these products adds a film of oil over the skin that blocks the pores and allows the acne causing bacteria to take hold, leading to acne breakouts.
Instead, make sure you use water based products that help to flush out the pores rather than block them.
Wearing thick layers of makeup can cause acne also by blocking the pores. Opt for products that state they’re oil free or ‘non comedogenic’.
Over exfoliating can also cause acne breakouts. Whilst exfoliating is good for the skin as it helps to slough away the dead skin cells that can block the pores and lead to acne, overdoing things has a negative effect. Exfoliating too much can get rid of healthy skin cells that are there to act as a barrier against bacteria and harsh environmental toxins.
Try to avoid using harsh mechanical exfoliants and keep the use of fruit acids, AHAs and glycolic acid exfoliants to a minimum.
It isn’t just skincare products that can affect the oiliness of the skin. What you use on your hair will also have an effect, especially if you wear your hair down, over your face or have a fringe. It’s best to keep your hair clipped back if you’re experiencing acne breakouts around your forehead or neck.
OTHER CAUSES OF ACNE
Physically obstructing the pores or continuously rubbing the hair follicles, for example when wearing a facemask, hat or chinstrap for work can also provoke acne.
MANAGING THE ACNE CAUSES YOU CAN CONTROL
You can’t change your genes and it’s difficult to keep your hormones regulated. So if your acne is caused by genetic or hormonal reasons then managing it with the best skincare products available for acne prone skin is one of the best things you can do.
Second to that, your diet is another essential way of helping to prevent further hormonal imbalances and excess oil production.
Eating good fats from oily fish, nuts and eggs, vegetables and avoiding sugar, excessive animal products, fried food and unregulated dietary supplements will help to support your acne prone skin. As will avoiding stress and taking steps to improve your mental health. If you’re struggling with your mental health, make an appointment to speak to your GP.