08/19/2020
ACNE
One of the most common skin conditions I see in practice is acne. Worldwide, this inflammatory skin condition affects 85% of young adults from ages 12-25, however, in clinical practice we see acne affecting men and women into later stages of their life into their 50s.
Development of acne is tightly linked to something called your sebaceous glands and the inflammation within these glands. At the level of your skin, acne can develop because of:
1. Excess Sebum Production: sebum is a naturally occurring moisturizing substance produced by your sebaceous glands. For a variety of reasons (hormones, dietary factors, medications, etc) we can have excess sebum, or altered composition of that sebum leading to a thicker substance that struggles to get to the surface of the skin. This sebum can get stuck leading to the development of a zit or papule.
2. Changes in Keratinization: keratinization involves the process of dead skin cells being shed from inside the skin pore, to eventually be deposited on the surface of the skin. If these dead skin cells get stuck they can block the pores/follicles.
3. Dysbiosis on the skin: there are a variety of bacteria found on the skin, one of the most abundant being P. acnes. This bacteria is anaerobic, meaning it thrives in an environment with no oxygen (i.e. a plugged pore/follicle with thick sebum and dead skin cells). So you can see how the above two factors allow this inflammatory bacteria to thrive!
Most interesting, research and cohort studies have started to see acne as a Western skin concern, as we don’t see high prevalences in the developing world. This is where questions around dietary factors, hormones, medications, pollution and other Western influences are looked at as driving factors for acne.
PMID: 29633388
