Causes of Acne
Exactly why some people get acne and some do not is not fully known. It is
known to be partly hereditary. Several factors are known to be linked to acne:
Hormonal activity, such as menstrual cycles
Stress, through increased output of hormones from the adrenal (stress) glands
Hyperactive sebaceous glands, secondary to the three hormone sources above
Accumulation of dead skin cells
Bacteria in the pores, to which the body becomes 'allergic'
Skin irritation or scratching of any sort will activate inflammation
Use of anabolic steroids
Any medication containing halogens (iodides, chlorides, bromides), lithium,
barbiturates, or androgens
Exposure to high levels of chlorine compounds, particularly chlorinated
dioxins, can cause severe, long-lasting acne, known as Chloracne
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Traditionally, attention has focused mostly on hormone-driven over-production
of sebum as the main contributing factor of acne. More recently, more attention
has been given to narrowing of the follicle channel as a second main
contributing factor. Abnormal shedding of the cells lining the follicle,
abnormal cell binding ("hyperkeratinization") within the follicle, and water
retention in the skin (swelling the skin and so pressing the follicles shut)
have all been put forward as mechanisms involved.
Several hormones have been linked to acne: the male hormones testosterone,
dihydrotestosterone (DHT) and dehydroepiandrosterone sulfate (DHEAS), as well
as insulin-like growth factor 1 (IGF-I). In addition, acne-prone skin has been
shown to be insulin resistant.
Development of acne vulgaris in latter years is uncommon, although this is the
age group for Rosacea which may have similar appearances. True acne vulgaris in
older adults may be a feature of an underlying condition such as pregnancy and
disorders such as polycystic ovary syndrome or the rare Cushing's syndrome.
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