Most people think that having acne means you just need to use harsher products. This is not true. In reality, acne has primary pathways that include the following?: Excess sebum production, dead skin cells stuck to the surface of the skin, too much acne-causing bacteria (propionibacterium acnes), and the inflammation of a follicle and surrounding skin. All of this leads to clogging, which is the first reason we'll cover.
To begin with, sebum is an oily substance that our skin makes. Hormones called “androgens” help to regulate it, and sebum protects the skin. But, when in excess, sebum can cause acne. This can lead to plugs in the skin because oil and skin get trapped beneath the surface. Likewise, the skin is not able to shed properly. On top of that, acne bacteria consume sebum and create waste products in the skin. This entire process leads to inflammation or irritation which can make the situation worse (Tobechi L. Ebede).
What else causes acne?
Even though it does not directly cause acne, a hormone called progesterone is associated with the production of sebum. After ovulation, progesterone levels go up for about 5 days before going back down.
Moreover, when estrogen levels are low compared to progesterone and testosterone, this is also associated with breakouts. At the proper levels, estrogen makes our skin more glowy, elastic, and soft. Estrogen has an impact on moisture retention and elasticity. However, estrogen levels begin to decrease in our 30s (Mohamed L Elsaie, 2016).
Remember how we mentioned androgens before? Androgens are essential hormones that help with reproductive function, emotional well-being, mental sharpness, muscle function and growth, bone strength, and hair growth (Verywell Health, 2022).
However, stress can increase androgens in women. “In adult women with acne, chronic stress increases the secretion of adrenal androgens and results in sebaceous hyperplasia.” Sebaceous hyperplasia is when there’s an overgrowth of oil-producing cells, and likewise, sebum becomes trapped inside the gland. The gland then swells and forms a bump underneath the skin. In addition, increased levels of cortisol are activated during stress (Dana Alrahmani. 2017).
And because all hormones work together, high cortisol, the stress hormone, can spike androgens even further. Also, not only can androgen dominance be exacerbated by stress, but it can also be made worse by our environment and an unhealthy diet. But, balancing blood sugar levels can potentially serve as a way to keep androgen levels down. During a response to stress, blood sugar levels may rise due to the release of certain hormones too (Mayur B Wanjari, 2022).
These are possible ways acne can form. But of course, this is not medical advice. Please speak with your physician and dermatologist. Everyone is different, and lifestyle changes such can serve to be an important part of skin health too.
- Hormonal treatment of Acne in women. The Journal of Clinical and Aesthetic Dermatology 2009. Tobechi L. Ebede, MD, Emily L. Arch, MD, and Diane Berson, MD
- Hormonal treatment of acne vulgaris: an update. Journal of Clinical Cosmetic and Investigational Dermatology. Mohamed L Elsaie. 2016.
- The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Journal of Clinical Cosmetic and Investigational Dermatology.Shadi Zari.Dana Alrahmani. 2017.