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Acne 101: What is acne, and why does it form?

Acne is the most common skin condition in the United States. About 85% of people will have experienced some degree of acne in their lifetime – eighty-five percent!! So, if you’re frustrated by your breakouts, know that you are not alone.

Even though acne is so common, what causes acne and why it develops is less known. But don’t fret, we are here to help you understand what acne is, how the microbiome is involved with acne, and what treatments are available to treat it.

What is acne?

Acne starts when the body produces excess sebum (a.k.a. oil) on the skin. This excess oil combines with a buildup of dead skin cells to plug hair follicles and form comedones or what is also known as clogged pores. Clogged pores are a form of non-inflammatory acne and are classified as either whiteheads or blackheads. Both whiteheads and blackheads show up as tiny bumps on the skin, but blackheads are open to the environment, which allows oxidation to occur, giving it a black color. Whiteheads, on the other hand, are closed to the environment and are white or skin tone in color.

Inflammatory acne happens when bacteria infect the clogged pores, causing inflammation. These types of acne are called pustules and papules and are larger, redder, and sensitive to the touch when compared to whiteheads and blackheads.

How is the microbiome involved with acne?

The microbiome is your skin’s natural community of microbes (bacteria, fungi, viruses) consisting of mostly bacteria, which live in our bodies and on our skin. Most of these bacteria are necessary and beneficial for our skin health since they protect our skin from harmful bacteria, provide essential nutrients and lipids, and help train our immune systems.

The microbiome becomes unbalanced when harmful bacteria grow in place of good bacteria. With acne, the unbalance in the microbiome involves the overgrowth of the skin bacterium, C. acnes. At less abundant levels, C. acnes is harmless, but when it overgrows, it can cause acne. Clogged pores have lots of sebum and low levels of oxygen, which make them the perfect environment for C. acnes to thrive and grow. This overgrowth of C. acnes triggers your body’s immune system, which results in inflammation and the red, tender, bumps you commonly see with acne.

How to treat acne?

Since the overproduction of sebum, the improper shedding of dead skin cells, and the overgrowth of bacteria cause acne, ingredients to treat acne target at least one of these causes.

Ingredients to exfoliate the skin

Some acne treatments work by exfoliating the skin to prevent the buildup of dead skin cells and clogged pores. Salicylic acid is the most common exfoliant to treat acne and unclogs pores by breaking apart the glue that holds your dead skin cells together. Sulfur is another exfoliant used to treat acne and works by drying out the skin. Retinoids can also act as an exfoliant by increasing cell turnover to both breakup clogged pores and prevent new clogs from forming.

Ingredients to kill bacteria

Benzoyl peroxide is the most common OTC acne medication that works by killing bacteria. It also has some exfoliation and sebum-reducing properties. Antibiotics are another commonly used treatment to treat acne by targeting bacteria.

Ingredients to reduce sebum production

Isotretinoin, also known as Accutane, treats acne by decreasing sebum production and is often used as a last resort when other acne treatments do not work. Due to high side effects, Accutane is prescribed for only those who experience severe and cystic acne. Birth control pills are another way to alter sebum levels for women who have hormonal acne.

Dermala developed the #FOBO Kit to address these different causes of acne. The products balance your microbiome on both the inside and outside to kill acne-causing bacteria, unclog pores, and keep your skin glowing from the inside out.


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