Hormonal acne, also known as "acne" or "acne vulgaris," is one of the most common skin problems worldwide. This skin condition ranges from small comedones and pimples to severe inflammatory lesions. For most people, acne first appears during puberty. Eighty-five percent of people between the ages of 12 and 24 suffer from acne.1 It usually disappears spontaneously around the age of 25. However, the condition can be persistent, and some people continue to suffer from it into adulthood. In this blog post, we delve deeper into the causes of acne and the role of lifestyle factors.

Acne is a multifactorial condition and is influenced by 4 primary factors:

Sebum is an oily substance secreted by the sebaceous glands in our skin, protecting it from dryness and external factors. Increased production of this oily substance can clog pores, leading to the formation of microcomedones or small pimples. Hormones play a role in the development of acne because they regulate sebum production. Increased hormonal activity (primarily male hormones/androgens) can therefore lead to increased sebum production. Your hormone levels can change during certain phases of your life (e.g., menstrual cycle, puberty, pregnancy, illness), and as a result, you may experience more acne breakouts at certain times.

Hyperkeratinization is a second key element in the development of acne. Let's briefly explain this process of "hyperkeratinization": Our skin renews itself every 28 days. During this renewal process, new skin cells migrate from the bottom to the skin's surface. As they migrate to the skin's surface, the skin cells undergo a change in shape and composition. The top cells are called "corneocytes" and consist of old, dead skin cells that flake off the skin. This allows new cells to migrate to the surface. New cells are therefore constantly being produced, and old cells are constantly flaking off. With hyperkeratinization, there is insufficient flaking (desquamation) of dead skin cells. The corneocytes stick to the skin's surface, and a buildup of these old skin cells occurs. The combination of hyperkeratinization and increased sebum production leads to clogged pores and the development of primary acne lesions.

These primary acne lesions, rich in lipids, provide an ideal growth medium for the anaerobic bacteria Propionibacterium Acnes . This bacterium is always present on the skin, but can thrive under certain conditions (ideally, an oxygen-poor growth medium such as sebum).

The presence of large numbers of this type of bacteria triggers your immune system to react, and the production of inflammatory mediators initiates the development of inflammatory lesions. Inflammation thus results in pimples, papules, and painful lesions, which, if left untreated, can lead to acne scars.