In the US alone, nearly 4 million people suffer from acne, and we're not just talking teenagers here. Acne can affect almost any age group in any part of the world, but no one really knows why. So here's an attempt to find the causes of one of the world's commonest skin afflictions.
The thing about acne is that it is perhaps the most common skin affliction that the global population suffers from today. It is also one of the most ugly, and anyone with acne suffers intense emotional trauma as a result of often conspicuous scarring, which can mar an otherwise beautiful face, and a huge amount of information is available detailing the adverse social and mental impact of acne on a sufferer.
Of mysterious origins
So what's the point? The point is that despite its widespread nature and the obvious social impact that it has, acne remains something of a mystery for medical science. In plain English, we do not know exactly what causes acne. As dermatologist Dr Andrew Waite says, "Acne is somewhat like the common cold. Almost everyone gets it, but we don't know exactly what causes it, and therefore cannot formulate a pinpoint cure for it."
On a superficial level, however, we do know how acne occurs, so let's get that out of the way first. In very basic terms, acne develops when the pores of the skin are clogged. Beneath every pore of your skin lies a canal-like structure called a follicle, within which lie a hair and an oil gland. The oil gland is actually a sebaceous gland, which secretes an oily substance called sebum, which moisturizes the skin and helps remove dead skin cells. However, there are times when the sebaceous gland secretes excess oil, which is when your troubles begin.
When your skin receives excess supplies of oil, the pores are blocked, thus trapping grime and dirt underneath, which provides the perfect breeding ground for the acne-causing bacteria glorying in the name of propionibacterium acnes (understandably called P. Acnes for short).
Inevitably, the tip of the blocked pore will either turn white (and be called whitehead) or black (and be called blackhead), and since no one I know can resist picking at whiteheads and blackheads, these growths usually break open to spread the oil and bacteria to their immediate surroundings and infect them. And so you will sprout red pimples and go into a blue funk, and depending on the severity of the infection, you may even suffer from really excruciating cysts if the pimples are large enough.
What causes excessive sebum secretion?
For those who think I have just described the causes of acne, I have to point out an obvious loophole. My explanation begins at the point when sebaceous glands begin producing excess oil, but I am mum on the subject of why they act the way they do. The reason: no one knows what exactly triggers the excess sebum production.
The best that medical science has been able to do is to ascribe acne to heredity, which means if it runs in your family, you stand a high chance of getting it. Susannah Crewe, 25, an aspiring model from Tulsa whose career has suffered intensely owing to severe acne outbreaks, says she has a family history of acne, but the condition remained dormant until she began using certain cosmetics at around the age of 17, when she moved to New York with a promising career ahead of her. "I didn't realize it at the time, but the acne was triggered by these cosmetics," she says now.
The acne myths
Thus you will have people mistakenly attributing their acne to cosmetics, or food, or hormonal changes, or certain drugs, but the truth is that these are merely triggers and not the causes of acne. As Dr Waite says, "People experience hormonal changes at many stages, such as puberty, menstrual periods, pregnancy, or even in times of intense anxiety. Similarly, people who perspire excessively may attribute their acne to sweating, but these do not create acne, they just help bring it out."
So we are no closer to finding the exact cause of acne than we were at the start of the article. In subsequent articles, we will explore the aforementioned triggers in some detail, and that is our only hope of understanding, and perhaps preventing, this infernal malady.
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