
What Causes Acne?
Dermatologist provides tips for healthier, clearer skin
Acne is the most common skin problem on the planet and across genders, ethnicity and skin color.- It is an inflammatory disease of the pilosebaceous unit (translated, the pore), meaning that the complex balance of inflammation is not controlled, and the problem is centered around pores.
- A person's complexion can have laboratory evidence of unbalanced inflammation but without acne lesions visible to the eye. This means that acne is more of an inflammatory imbalance than simply a problem with pores.
- In an article in The Journal of Drugs in Dermatology, Dr. Leon Kircik described the revelation stating, “We have accepted the presence of subclinical inflammation and therefore consider (acne vulgaris) as a primary inflammatory process rather than a secondary inflammation to P. acnes.”
- Also, even once an acne lesion is healed, the inflammation may continue in the skin leading to hyperpigmentation and scarring.
This means acne is bigger than just the zit on your chin or the blackheads on your nose. Acne is an inflammatory condition!
We’ve thrown out the old thinking about acne:- Debunked is the belief that acne is caused from “hyperkeratinization and comedogenesis,” meaning the formation of a blackhead!Acne is not caused because a blackhead is present or forming in a pore.
- Debunked is the belief that P. acnes, the bacteria with a name that sounds like acne, is the cause of acne.Only some types of P. acnes play a role, depending on if they further trigger the problem with inflammation in the skin.Add to that, P. acnes is becoming more and more antibiotic-resistant, and you can expect to see changes in how we treat acne.
What causes acne?
- “Multiple inflammatory cascades (are) involved in the pathogenesis of (acne vulgaris).”
- P. acnes, if it plays a role, does so by triggering the cascades.
- Scarring and hyperpigmentation happen after a lesion heals because inflammation is silently still out of balance where the lesion once was.
With this in mind, what do you do differently if you have acne?
Get your lifestyle and diet choices set to fight acne! We know that diet and lifestyle make a difference. Get those in order as best you can to fight acne. Click here to learn more about diet and acne. Too busy to jump to another page?Here is the Rx Summary for Acne:
- Foods that worsen acne: cow dairy products, bad fats, high carbs, and sugar diets
- Foods that help your skin fight acne: Whole foods including real fruits and veggies, beans and whole grain breads and grain-based foods
- Get rest and exercise, try to create a balanced schedule for stress and rest.
- Set your skin care to fight acne.
Skin care options proven to help acne include:
- Benzoyl peroxide Best in 2.5% which works as well as higher concentrations with less risk of irritation.
- Salicylic acid Penetrates into oily pores to loosen blackheads
- Glycolic acid Loosens pore clogging debris
- Retinoids Options include prescriptions such as Tretinoin or non-prescription Retinol
- Pyrithione Zinc If you have yeast type of acne too called Pityrosporum folliculitis, wash with pyrithione zinc, a time-honored remedy for this yeast.
Do you also suffer from back and chest acne?

References: Kircik Leon H, Advances in the Understanding of the Pathogenesis of Inflammatory Acne, J Drugs Dermatol. 2016: 15(1 Suppl 1):s7-s10