What causes acne. You remember what your derm told you?
Probably something about excessive sebum, blocked pores and bacteria.
That's the standard textbook explanation. But did you ever stop and wonder why those things happen? Why does your skin make too much sebum? Why do your skin pored get blocked?
Ever asked those questions?
Most acne victims haven't. Let's venture under your skin and see if we can answer those questions.
Let's start with the big picture of what causes acne.
Click for a bigger picture.
As you can see acne is a result of two 'evils'
Blood sugar problems (because of insulin resistance)
Chronic, low-intensity inflammation
I dubbed those as 'Acne Engine' because they 'drive' the pump that pushes hormones into your bloodstream that lead to:
Excessive sebum production
Increased proliferation of skin cells; meaning faster shedding of old skin cells and growth of new skin cells (it sounds good, but it's not because it leads to premature aging of the skin)
Dead skin cells sticking together instead of separating to individual cells
Overgrowth of p. acnes bacteria because of weakened immune system
Inflammation of blocked skin pores
Insulin resistance and inflammation goes hand in hand. They create a vicious cycle as they feed each other. Insulin resistance increases inflammation that lead to more insulin resistance and so on (hence the cycle in the what causes acne picture).
If you want to get clear you need to stop this cycle. Fortunately that's simple. Insulin resistance and inflammation are lifestyle related conditions and respond well to lifestyle adjustments.
First let me show how these buggers lead to acne. They trigger your body to release certain hormones that are linked with acne.
This picture shows the hormonal reactions that cause acne.
The red line shows what happens to your blood sugar levels when you are insulin resistant (or eat high GI foods). The green line shows a healthier blood sugar response. I explain insulin resistance a bit later.
When your blood sugar levels rise too high the pancreas releases insulin to bring them down. With insulin resistance the insulin doesn't work so well and the pancreas has to release more insulin to compensate. Eventually the insulin gets through and blood sugar levels crash. Often they go too low.
Low blood sugar levels trigger another emergency response. The adrenalin glands release cortisol and adrenalins that signal the liver to release glycogen (blood sugar). This increases the blood sugar levels. You also get cravings for foods that increase your blood sugar levels.
Insulin levels also affect other hormones. Here we are interested of two: insulin like growth factor 1 (IGF-1) and insulin like growth factor binding protein 3 (IGFBP-3). When insulin goes up IGF-1 follows but IGFBP-3 levels go down.
Here's how those hormones cause acne:
Insulin, IGF-1 and adrenalin increase sebum production
Insulin and IGF-1 are powerful growth hormones and increase the growth rate of your skin cells (they also make cancer cells grow faster)
IGFBP-3 triggers the skin cells to separate when they die
So now we have:
More sebum
More dead skin cells that have to be pushed through the skin pores
Bigger lumps of dead skin cells (instead of individual cells)
Take sticky sebum and a bunch of dead skin cells in big lumps. Insert into narrow skin pores and mix well. Does that sound like a recipe for blocked pores and acne?
Insulin resistance and acne
Since insulin resistance is a big reason behind your acne let's see how it happens.
You weren't born with insulin resistance - just like you weren't born with acne either. They are conditions that developed over time and are a result of a certain diet and lifestyle.
Here's how to cause insulin resistance and acne.
I mentioned that this insulin resistance - inflammation cycle feeds itself. Most likely you are at that state. But it wasn't like that always. Your body doesn't like these conditions and fights them at every opportunity. It often takes years and decades to reach this point.
This is how you do that:
Eat too much fat; as in typical Western diet Eat too many calories; excess calories are turned into fat which does to the bloodstream and we are back at point one.Inflammation and oxidative stress; toxins, chemicals, bacteria and anything else that creates free radicals
When you eat too much fat that goes into your bloodstream. Fat makes it more difficult for insulin to do its job (i.e. insulin resistance). It also slows down oxygen and nutrient delivery to cells. Strike one.
When you eat more calories than your cells can use at the moment those excess calories are turned into fat (also called triglycerides). That fat goes into your bloodstream and causes insulin resistance. Constantly eating excess calories on their own also lead to insulin resistance. The body doesn't want to put on excess weight and fights it with insulin resistance. Strike two.
Anything that creates free radicals leads to oxidative stress and insulin resistance. It has now been proven that inflammation is the biggest reason behind diabetes, metabolic syndrome and other diseases related to insulin resistance.
Chemicals and additives in processed food; basically all foods that come from a factory have chemicals and additives. Only foods in their natural state don't. Some common examples: fast foods, TV-dinners, packaged and canned foods.
Did any of those as a kid? Perhaps even more than once? That's strike three.
As you strike out often enough this cycle starts to feed itself. Your cells develop insulin resistance, inflammatory hormones levels go up and your body is full of toxins and chemicals.
That's insulin resistance and acne.
Let's look at the other side of the coin: inflammation.
How inflammation causes acne
First I need to say inflammation is a good thing. It starts the healing process and without inflammation you would die quickly. Acute inflammation starts after an injury and fades out quickly as the body heals the injury.
Things turn ugly when you develop chronic inflammation. With our modern diets and lifestyle we keep injuring ourselves all the time. It happens below our pain threshold so we don't notice it. We do this by eating wrong foods, stress, exposing ourselves to pollution and not sleeping enough. Just to mention few examples. All those create free radicals that cause oxidative stress.
They cause damage at cellular level. Free radicals damage cells and those cells need to be replaced or healed after the damage. Healing means inflammation.
As this happens over and over (for most people after every meal) free radicals 'attack' cells all over your body. Which of course means you have inflammation all over the place. Slowly but surely inflammation turns chronic.
Inflammation reduces insulin sensitivity of cells that are near the inflamed area. What happens when you have inflamed cells all over the body? Most cells become insulin resistant.
This also taxes the immune system. Inflammation is an immune system response. When you engage the immune system all the time it has less energy and resources to tackle the bad guys (bacteria and virus). As a result acne-causing bacteria get a chance to take over your skin cells.
As a final insult inflammatory hormone levels are high all the time. This means that when the immune system goes after the bacteria in your skin pores the inflammatory response is too strong. This turns otherwise harmless blackheads and small pimples into nasty, red, painful and pus-filled cysts.
Putting it all together
There; in simple English how insulin resistance and inflammation cause acne.
Now, please listen carefully because this is important. Better hold on to your hat also.
Though the explanation of how insulin resistance and inflammation cause acne is simple there's no simple solution to the problem. There's no single reason that causes insulin resistance and inflammation that you could remove and cure your acne.
It's a bit more complicated.
Controlling blood sugar and inflammation are critical processes. They are among the most vital processes the body has. When they get out of hands you can say hello to some serious health problems (such as diabetes, cardiovascular problems, heart attack and cancer).
These processes affect and are affected by almost every other process and function in the body. Because of this you cannot pinpoint a single cause and neither can you find a single solution.
They are lifestyle related conditions; and you can only fix them with diet and lifestyle.
That's probably not what you wanted to hear. And for many that may be a bitter pill to swallow. But you need to hear that if you want permanently clear skin.
Hopefully you can also hear a message of hope here. Because this puts the power back into your hands. It shows that you are in control of your skin. And you can get clear if you choose to.
I want to finish with the difference between cause and trigger. Because many acne victims confuse these ideas.
Here's what I call 'acne equation'.
It just says that to get acne you need both a cause and a trigger.
Most people think sugar or stress cause acne. They confuse cause and trigger. They see that they get more pimples after eating sugar (or whatever their trigger may be). So they assume that sugar must cause acne.
From this follows that to get clear they have to avoid sugar. While avoiding triggers is a good thing it's often not enough to permanently cure acne. Because nearly anything can trigger acne. The ones listed in the picture are just few common examples. Avoiding triggers can lead you to an endless hunt. You cut out one food after other and soon you are left with nothing to eat. I wrote an article about dangers of anti-acne diets. It clearly highlights this point.
While they run after triggers many acne victims never realize the real solution to permanently clear skin is to take the cause out of the equation. To do that you have to address all the lifestyle causes, many of which have nothing to do with acne triggers.
My free minicourse Acne 101 gets you started on the right path.
"Acne suddenly made so much sense"
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"Good work! Finally, I got a healthy skin now... Thank you very much Mr. Seppo Puusa!! God bless."
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Related articles:
Candida and acne. Candida doesn't cause acne. Find out why trying to get rid of Candida can prevent you from curing acne. And a simple way to take care of both.
Why Anti Acne Diets Don't Work?.Thinking diet can cure acne is a dangerous idea. It can lead to frustration, wasted effort and even keep you from getting clear.
Nothing Causes Acne If you are looking for a specific cause to your acne you can never get clear. Find out the real reason you have acne.
It just says that to get acne you need both a cause and a trigger. 
