We all know that acne causes unsightly pimples and lesions on your skin, but what causes acne? In fact the causes of acne are not fully understood, although much has been learned of the various factors that lead to the condition. However, before discussing what is known about acne causes, let us first dispel some untruths.

Acne is not caused by eating fatty foods or chocolate. In fact one of the principal treatments for acne is best taken with fatty foods. Acne is not diet related, irrespective of what you might have heard or read on even fairly authoritative websites. Nor is it related to genetics and it cannot be passed from one person to another. It is not a disease but a skin condition, though bacterial activity is a significant factor.

We know enough about acne causes to break it down into three specific areas. These can be better understood if you first understand what acne is. Irrespective of the type of acne, or how deep into your skin it goes, it is basically caused by a sticky plug of oily sebum and dead skin cells blocking up your follicles and skin pores, and becoming infected by bacteria.

The bacteria triggers your immune response that not only releases macrophages to kill the bacteria and form what you know as pus, but also sets off the inflammatory response that causes the inflammation, swelling and pain of the pustules. All of these reactions are intended to kill off the bacteria, but they also cause you pain and distress as a result.

Let's take each of these three components (sebum, dead skin cells and bacteria) in turn, and consider how they are themselves caused.

Sebum

Sebum is a natural skin oil, which is generated by the sebaceous glands, and it both protects and waterproofs your skin and hair. Its production is accelerated by hormonal activity after puberty. The hormones responsible are believed to be the androgens, or male hormones, present in both men and women, but much higher in men.

The effect of androgens is to enlarge the sebaceous glands and also to increase the production of sebum. The sebum can mix with dead skin cells inside a hair follicle and forms a plug in the follicle (pore). The increase in sebum accelerates the formation of plugs in the pores, and also speeds up the multiplication of the bacteria on your skin. The plug can also rupture the follicle, and release its contents into the body of the skin itself.

Female hormones can help to ease the symptoms of acne, which is why the severity of an acne attack in a girl or woman can change during her menstrual cycle in accordance with the relative amounts of androgen and estrogen in her body.

Skin Cells

Skin is a living organ of your body, composed of individual skin cells. These have a short life, and your skin surface renews itself every two or three weeks. The dead skin cells generally get washed off, but they can also form in the pores of your skin and mix with the sebum to form a gooey mass. You can help to avoid this through regular use of an exfoliating body scrub, using a mild version for your face. You can also use Vitamin A treatments to flake your dead skin off, again helping to prevent it from mixing with the sebum.

Bacteria

Bacteria grows naturally on your skin, and normally do no harm as long as they are not of a dangerous kind. The bacterium responsible for acne is known as Propionibacterium acnes, and produce substances that initiate your immune system. They can infect the sebum and skin cell plug in a pore or follicle, cause inflammation and the formation of pus through the action of your immune response.

A good antibacterial soap will help to prevent this from happening, and an antibiotic can often relieve the more painful symptoms of acne and the inflammation.

Finally, what causes the different types of acne? Non-inflammatory acne cause blackheads (known as open comedomes) and whiteheads (closed comedomes), while inflammatory acne forms pustules and papules. Blackheads are caused by a plug enlarging inside an open follicle, and the black color is due to the infected sebum reacting with air and the skin pigment melanin (not dirt!).

A whitehead is formed in the same way, but the pore remains closed. The white pus is caused by dead white blood cells that have been fighting the bacteria as a result of the immune response to the chemicals they have emitted. It is not so much the bacteria themselves that cause the problem as the toxins that they produce.

The more inflammatory papules and pustules are formed in a similar way, but deeper within the skin, with the pores being plugged much deeper down. These can cause scarring if left untreated, the most severe scarring occurring from nodules that have ruptured beneath the surface of the skin.

Although the actual reasons for the onset of acne are unknown, the reason why acne causes the symptoms that you experience are well known and the treatment you receive basically depends on those symptoms or form of acne that you develop. With proper care and treatment, there is a good chance that your acne condition can be managed successfully.