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Causes of acnes

Acne is the most common skin condition worldwide. It mainly occurs in adolescents during puberty. There is no exact answer to the question “What is acne exactly?”, Since the disease occurs in various forms. Pustules, pimples and blackheads usually form on the face, mainly on the forehead and chin. Acne on the back and décolleté also occurs, but is less common. Slight forms of expression can usually be treated with washing and care series from the drugstore or the pharmacy itself. Severe acne must be treated by the dermatologist.

Almost every adolescent is more or less affected by acne. Acne in adults (acne tarda) is less common, according to recent studies it occurs in about four percent of all adults. Medical treatment is necessary for around a third of all those affected.

The classic view is that three factors contribute to the formation of acne:

Overproduction of tallow (sebum)

Clogging of the exits from the sebaceous glands and hair follicles Influence of skin bacteria.

Today we know that many factors play a role, especially the influence of (male) hormones on the sebaceous glands. There is also a genetic predisposition.

Acne occurs when the sebaceous glands of the skin become clogged with sebum and dead skin cells. Sebaceous glands secrete sebum, which protects the skin and hair and keeps it supple. It is usually transported outside through the skin along the hair root. If the body produces too much sebum and dead skin cells, these substances accumulate in the channels of the sebum glands and block them by forming a soft plug.

Such a plug can cause the wall of the gland to bulge outwards and form a bright blackhead. The graft can also be darker and form a black blackhead. If the clogged hair follicles become inflamed, pimples in the form of red spots with a white center appear at the affected area. Constipation and inflammation, which develop deep in the hair follicle, show a sensitive bulge on the skin surface. Other skin pores, such as sweat glands, are usually not affected by acne.

The reasons for the increased sebum production in acne are not known. However, a number of factors such as hormones, bacteria, certain medications, hereditary factors and stress can play a role.

The influence of diet on the development of acne

So far there is no clear answer. Several studies indicate that eating foods and sweets with carbohydrates that are quickly consumed leads to high blood sugar levels. The high blood sugar stimulates the release of insulin and an insulin-like growth factor (IGF-1). This has an immediate effect on the sebaceous glands and stimulates the outer skin layer to increase cell growth. Ultimately, this increases the risk of acne formation. It is also believed that sometimes dairy products can be unfavorable. Cow’s milk contains many substances that contribute to the growth (of the calf) and in this way influence the sebaceous glands. But you have to say that the influence of diet on acne has not yet been clearly proven and therefore no clear recommendations or bans can be made! However, everyone affected is free to change their diet for a while and wait for the effect.

Acne has nothing to do with poor hygiene. On the contrary, intensive cleaning of the skin is more likely to cause irritation and can make acne worse. Water and economical use of care products with normal skin pH are sufficient to clean the skin thoroughly.

Skin bacteria can colonize the blocked sebaceous glands, e.g.  the “acne bacterium” Propionibacterium acnes, and lead to inflammation, but they are not the only cause. Often there is even an inflammation without detection of the pathogen, i.e. the skin becomes inflamed and pus forms without any germ being involved. There are other germs that are sometimes detectable in acne patients, these are certain other bacteria, fungi and rarely a type of mite. However, a smear from the skin or pimples is rarely done because it usually does not affect the therapy decision. A look at the distribution and appearance of the pimples is often enough for the doctor to suspect what type of inflammation it is and then suggest a therapy accordingly close.

Predisposing factors

Hormonal changes in the body can trigger or worsen acne. Such changes are typical of:

Young boys and girls

Women and girls, all about ovulation and menstruation pregnant women stressed people

People who take certain medications such as B. Take cortisone.

Acne can arise from various causes. For most people, skin problems are triggered by hormonal changes – especially during puberty. In this phase of life, both boys and girls increasingly form androgens. These male sex hormones promote the development of acne.

The skin changes typical of the disease originate from the sebum glands, which are located all over the skin and mostly lead to hair follicles that surround the hair root. They produce a fatty secretion called sebum, which protects the skin and keeps it supple. The increased androgen production leads to an overfunction of the sebum glands. At the same time, the formation of horn material in the exit ducts of the glands is stimulated, which clogs them. Since the sebum can then no longer flow outwards, the blackheads filled with a sebum-horn mixture form first.

As a result, a germ called Propionibacterium acnes has improved growth conditions there and can therefore reproduce well. The bacteria, which are among the natural skin dwellers, then cause inflammation, which is manifested by pimples, pustules and papules.

Formation of a pimple: If horn scales block the outflow of the sebum, the secretion builds up.  Bacteria multiply and ignite the skin (blackheads).  Pus penetrates the surface and the surrounding tissue (pimples).

Formation of a pimple: If horn scales block the outflow of the sebum, the secretion builds up. Bacteria multiply and ignite the skin (blackheads). Pus penetrates the surface and the surrounding tissue (pimples).

However, not all adolescents get the disease. And adults 30 and older can also develop acne. This shows that in addition to hormonal changes in puberty, there must be other factors that cause or exacerbate the skin disease.

These include:

Certain medications such as cortisone preparations, psychotropic drugs, androgen-containing substances (anabolic steroids), vitamin B preparations or anti-epilepsy products.

Care and cosmetic products, especially with ingredients that promote constipation of the sebaceous glands

Stress and other mental stress


Obesity – is considered a risk factor especially for acne inversa Mechanical stimuli, for example from clothing that is too tight or the chin strap of bicycle and motorcycle helmets

Nutrition – especially high-glycemic foods that cause the blood sugar level to skyrocket (chocolate, chips, sweet baked goods, soft drinks, honey), but also a high consumption of milk and dairy products worsen the skin condition, according to some people. However, the connection between diet and acne has not been scientifically proven.

Genetic predisposition – if one or both parents have or had acne, the risk of illness in their children increases

Climatic influences – such as a hot and humid climate

Even during pregnancy, the woman’s skin may deteriorate, which is sometimes referred to as pregnancy acne. It is extremely rare that acne is triggered by the pill. In fact, many birth control pills even have a positive effect on blemished skin, blackheads or pimples and are therefore used to treat acne in patients who want to use the pill anyway.

The most common form, acne vulgaris , is mostly due to hormones. The cause is the male sex hormone, called androgens. These are produced not only in men, but also to a lesser extent in women, especially during puberty. However, since they occur in large quantities in men, men are also more affected by the skin disease.

The androgens stimulate the sebum glands of the skin to produce more sebum. This sebum is normally released through the pores. During the hormonal change in puberty, however, the production of horn material increases, which closes the execution ducts. The sebum accumulates under the skin surface and so-called closed blackheads develop. The whitishlooking sebum can pour into this.

At some point the skin tears open on the execution duct. The blackhead turns black due to contact with atmospheric oxygen. That means: blackheads are open blackheads.

The sebum in the blackheads “attracts” bacteria. They break down the sebum and produce fission products that promote inflammatory reactions (“flowering pimples”) and stimulate the formation of new blackheads.

Hormone fluctuations occur not only during puberty, but also during pregnancy, in the menopause (menopause) and when the contraceptive pill is discontinued. At these times, as well as during menstruation, when the skin is increasingly oily, women often experience an outbreak of acne again.

Other risk factors

In addition, fats in cosmetic products, medication ingredients and certain foods can stimulate sebum production or contribute to blockage of the ducts. Among the drugs that can cause acne include:

Corticosteroid (cortisone)

Anabolic steroids

Adrenocorticotropin (ACTH)

Psychotropic drugs




Vitamins B2, B6, B12

Cancer medicines (EGF receptor agonists)

For some people, diet can also promote acne. For example, very high-fat foods or chocolate have a bad reputation. However, this connection has not yet been proven in studies.

Skin care for acne

Squeezing pimples, caring for the face intensively and applying make-up – this is how many people try to cope with their acne. Some improvement is also hoped for from a certain diet or sunlight. But which of these is helpful, which is more harmful?

Countless soaps, facial tonic, lotions and creams for face care for acne are offered in shops and on the Internet. They sell well because many people with acne invest a lot of money and time in skin care. Here, less would often be more: If the skin is worked too hard and exposed to new “nourishing” substances, acne can intensify.

Which face care is suitable?

Normal soaps have a high pH (8 to 10) and can irritate the skin. So, soap-free cleaning agents that are adjusted to the pH of the skin (5.5) are more suitable for acne. Antibacterial washing lotions can improve the skin condition with mild acne, but also irritate sensitive skin. Excessive washing – for example, several times a day – can dry out the skin and increase irritation.

Light oil-in-water emulsions or moisture-storing gels (hydrogels) are recommended for skin care, since ointments containing grease, for example, can additionally clog the pores.

Everyone who has acne has ever expressed a pimple. It is understandable that you want to remove visible pus accumulations. Because squeezing pimples or pustules makes the skin look better at first. The pus can get deeper into the skin due to the pressure, which causes it to become more inflamed. Occasional expressions do not immediately lead to scars. However, if you overdo it with the expressions and don’t let go of deeper pimples, the complaints can intensify and later scars develop.

It is possible to have the pimples opened in medical cosmetic studios or in dermatological practices. There they can be removed by specialists under hygienic conditions. As a rule, the facial skin is first prepared with warm water or a steam bath to widen the pores. Then the pimples are opened and squeezed out, often with a special small instrument (comedone squeezer). In the case of severe acne, this treatment may be covered by the statutory health insurance.

How can pimples be covered?

Girls and women often use makeup to hide acne pimples. Many feel more comfortable when they leave the house. Inconspicuous make-up, powder and concealers are also used by young men. The following applies to cosmetics and care products in general: very fatty substances can clog the pores. Here, advice in a dermatologist’s office or in a medical cosmetic studio can help. However, it is not possible to predict exactly which product will act on the skin in acne. If you want to use make-up or concealer, you have to find out for yourself which agents are best tolerated by your skin.

Shave wet or dry?

Science is currently divided over whether an incorrect diet favors blemishes. For example, some people notice an improvement in their complexion if they do without dairy products.

You can’t do much against hormonal fluctuations, for example during the monthly cycle. Even an innate oily skin that tends to produce more sebum cannot be “healed”. Only careful care helps here.

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