What Causes Acne?
by Adam Friedman, M.D., FAAD
New Discoveries in Acne Formation
Acne may be an exceedingly common condition, but the factors that contribute to its formation remain a bit of a mystery. Despite all we know about acne, scientists are still uncovering new evidence that identifies major factors in the formation of the dreaded acne lesion. This gives dermatologists and skincare specialists more insight into the clinical course, and helps identify new avenues for treatment.
The most recent discovery is the role of the inflammasome, a multi-protein complex found inside cells which, together, help set inflammation into motion (keep in mind that acne, at its simplest description, is extra, inappropriate inflammation).
For almost 20 years, dermatologists have known that inflammation in the skin can precede the whitehead or blackhead, and likely plays a major role in their ultimate formation. Certain receptors on the skin surface (named toll-like receptors) recognize the bacterium P. acnes and in turn, bring on the inflammation, but there was something missing. This is where the discovery of a particular inflammasome comes into play: While toll-like receptors sit on the surface of the cell, this complex is inside the cell, and has now been linked specifically to acne and all the inflammation that goes along with it.
So, what does this mean for the people who struggle daily with acne-prone skin? Scientists and dermatologists hope that new, more advanced medications can help target this pathway in addition to acne’s other triggers including increased skin turnover, oil production, and bacteria. In the meantime, those who struggle with acne already have inflammation throughout their skin long before acne is visible on the surface. This is why good skincare practices are of the utmost importance. Simple acts such as keeping the skin hydrated by applying an oil-free moisturizer to damp skin, protecting skin by using sunscreen daily, and even making conscious food choices can help control inflammation that contributes to acne, and subsequently contributes to the development of other skin issues such as dark marks and scars.