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What Is Acne and What Causes It?

Acne is a common skin condition that occurs when hair follicles beneath the skin become clogged with oil and dead skin cells creating outbreaks of pimples made up of a mix of whiteheads, blackheads accompanied by general redness. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. Cystic acne is characterised by hard raised bumps under the skin that often do not erupt above the surface and mainly occurs around the jawline as well as chest, neck and shoulders.

Acne is highly common among teenagers due to the hormonal changes that they are undergoing, however it can occur at any age and is prevalent among women aged 20 to 35 up to 50 years old. It is a frustrating issue to deal with whatever your age and can have a very damaging effect on your self-confidence. It is therefore important to take a fully personalised approach in remedying the underlying issue in order to restore healthy, clear skin and ultimately regain confidence.

Hormone Imbalances
In conventional medicine, hormonal imbalances are almost always identified as the key cause of acne, however very little attention is paid to understanding why the imbalance has occurred and how the imbalance can be restored naturally. Functional medicine focuses on acne as a chronic health condition with an underlying cause which begins by identifying which hormones are out of balance and why.

As an example, estrogen dominance is a common cause of acne which can be caused by a missing cofactor for an enzyme which creates excess estrogen; environmental toxins that disrupt the hormone balance and the contraceptive pill. Androgen is another hormone that is often responsible for acne as an excess of androgenic hormone testosterone increases sebum production which blocks pores. The imbalance can be due to stress and polycystic ovarian syndrome, among other causes which require a professional diagnosis in order to select the most appropriate treatment.

Your family background and individual genetic make-up can also be an underlying cause of acne if there is a predisposition in the family. A family history of hormonal imbalances such as polycystic ovarian syndrome, male pattern baldness, prostate cancer, and baldness in women may be signs of a genetic predisposition. This tends to be due to an increased level of activity of enzyme 5-alpha-reductase which accelerates the conversion of testosterone to dihydrotestosterone (DHT) – a more potent form of testosterone which may be responsible for the aforementioned conditions.

It is a commonly held belief that poor diet is the trigger behind acne as teenagers are often guilty of eating poorly and consuming a lot of junk food as well as sugar. A high carbohydrate diet can cause an increase in the conversion of testosterone to the more potent form (DHT) which does contribute to acne, however those who follow a healthy lifestyle and diet can also get acne. Some people have heightened sensitivity to changes in insulin-like growth factor-1 (IGF-1) which can be in high sugar diets, or in the consumption of dairy products that contain IGF-1. Receptors for IGF-1 are found in the sebaceous gland of the skin which is what produces sebum so when IGF-1 binds to these receptors, it stimulates sebum production triggering acne. For most people however, recent research has shown that an unhealthy diet comprised of processed industrial food and high levels of sugar serves to exacerbate existing cases of acne but is unlikely to be the main cause of it.

Imbalanced Microbiome
The microbiome extends from the digestive system to the microbes that live on the skin and is closely linked with the immune system. Exposure to toxins or a course of antibiotics can create an imbalance in the gut microbiome leading to a leaky gut whereby proteins from food enter the bloodstream and trigger an immune response which can present itself as acne. Small intestinal bacterial overgrowth (SIBO) is another disorder whereby the bacterium of the large intestine ends up on the small intestine and creates bloating, constipation, food sensitivities and skin conditions such as acne. Poor gut health is a very common cause of acne as 40% of acne sufferers have low stomach acid which makes it harder to break down proteins causing systemic inflammation in the body and the skin.

In the microbiome of the skin itself, the proprionum acnes bacterium which is deemed responsible for causing acne is just one of the many types of bacteria that live on the skin. A healthy balance of bacteria helps keep the skin healthy and fight off diseases as well as aid healing from wounds. However, a disruption in this delicate balance can play a role in skin conditions such as acne as well as atopic dermatitis and psoriasis.

At Seraphim Medical Center, we understand that acne is a sensitive issue that requires personalised attention and care. Our cutting-edge facilities undertake in depth blood testing, hormone testing, allergy testing and stool testing. Furthermore, Janus Skin Analysis and Acne Laser treatments are also available alongside expert nutritional advice to get to the root cause of your issue from a range of angles to find a sustainable solution that means you can be confident that your acne will not return.