Updated: May 13, 2020
It is the common belief that acne is caused by dirty and oily skin. But the truth is much more complicated and I will try to simplify the real explanation.
The skin has sebaceous glands that makes sebum (a ‘skin oil’) which keeps the skin supple and, (combined with the skin’s microbiome) protects it from infection. This is your natural defense barrier. High testosterone levels stimulate the production of oil, hence acne often occurs during the teenage years when testosterone surges, or later on in life when women approach menopause and the ratio of estrogen to testosterone drops. The problem is not the amount of oil, but rather the quality of oil. Good oil is free owing, poor quality oil is gluggy, like cottage cheese, getting stuck in the pore causing a plug. This is the beginning of acne.
The skin has a ‘living layer’ called the microbiome which includes good and bad bacteria. A balanced microbiome with good, neutral and bad bacteria is crucial to skin health.
Most reading materials will suggest that p.acnes are the bacteria responsible for causing acne, hence they often suggest that skin be cleansed with an oil stripping agent and antiseptics such as benzoyle peroxide (active ingredient in most anti acne products). This would destroy all other bacteria putting the skin microbiome out of balance. The skin then tends to get dry, red and sensitive.
How acne develops
Two important things to note (1) p.acnes bacteria feed on our skin oil, and (2) you can never kill 100 per cent of bacteria. So when skin oil is stripped, the few p.acnes that are left will travel to the sebaceous glands in the pore (where their food is made) to feed and multiply causing in ammation in the pores and this is what we call acne.
We now understand that acne is mainly dictated by hormones, bacteria and oil. While we cannot do much about our hormones, we can control the quality of our oil production and the skincare we use. .Get your skin to make good quality oil and do not use products that can put your microbiome out of balance. Our skin is an amazing organ with its own mechanism to self cleanse, shed and renew. We just need to provide it the right environment to do its job. Talk to a skin therapist who can help you understand skin at a cellular level and the cosmetic ingredients you’re putting on your skin.