A Primer on Acne — Causes, Treatments, and Future Research

A Primer on Acne: Causes, Treatments, and Future Research

There's still a lot to learn about acne — what causes it? What's the best treatment? See where research is headed to treat this condition.

Zits, pimples, blemishes, and all the other names for it — from those pre-pubescent days sometimes into adulthood, we’ve all likely experienced acne. But do you know where acne comes from? What exactly does your body go through to produce these inflamed marks?

How the Body Produces Acne
Our skin is covered with little dots — the openings of hair follicles, where hair emerges from the skin and where sweat is secreted — called pores. Each pore contains a sebaceous gland that produces sebum: an oily substance that covers much of our bodies in a thin protective layer. It helps to regulate body heat and to stop bacteria from setting up shop on the body’s surface. Of course, there can be too much of a good thing: Too much sebum (or oil), combined with naturally occurring dead skin cells and bacteria, can block our pores. What happens next? Sebum that becomes trapped causes the follicle to balloon, and thus a pimple is born.

Bacteria: Good vs. Bad
Now here’s a well-kept secret — our bodies are actually covered in bacteria. The good thing is that this bacteria helps rather than harms us. Recent research shows that an imbalance of good and bad (infectious) forms of the bacteria are associated with skin problems like acne. When there’s an overgrowth of the infectious type of bacteria, scientists believe this may lead to inflammation, blocked follicles, and, ultimately, acne.

Other Causes of Acne
Part of what makes acne so elusive to treat is the fact that it has different causes. For people in those awkward teenage years when zits have their coming out party, well, you can thank fluctuating hormones. While they do not directly create acne, these hormones do cause the sebaceous glands to enlarge, thereby producing more sebum. Remember that oily overload we mentioned before? The more sebum that’s produced, the greater the chances that some follicles will be blocked and become inflamed.

For those who are a bit older, i.e., young adults and adults, there are different factors. If you’re 30 and have full-blown adult acne or occasional breakouts, your acne may be caused by a combination of your genetics, diet, and overall health.

Acne Treatments and Research
Acne treatments currently fall into three main categories:

  • Topical Treatments: Topical retinoids, which are chemically derived from vitamin A, are often prescribed as the first line of defense against acne. They can help prevent dead skin cells from clogging pores when spread on the skin. Other topical acne treatments are geared to break apart the blocked follicles by including ingredients like benzoyl peroxide or salicylic acid. Many acne creams or treatments contain such high concentrations of benzoyl peroxide that you may even notice the ingredient’s bleaching effects on your favorite pillows, towels, and clothes. Unfortunately, these treatments often dry the skin.
  • Oral Antibiotics: An antibiotic acne treatment typically means taking a pill and trying to eliminate the acne by attacking the bacteria. But here’s the challenge — while antibiotics help to kill the infectious bacteria we mentioned earlier, they often do the same with good bacteria that we need to maintain beautiful, healthy skin. Recent developments have enabled researchers to counter this scenario with treatments that specifically target acne-causing bacteria. However, this approach is still under investigation and not yet on the market.
  • Other Treatments/Emerging Therapies: Another common approach is to fight acne with other oral medications — isotretinoin, for example, is a retinoid taken orally to stop sebum production. Other researchers are focusing on emerging treatments, such as an acne vaccine. They’ve identified an antibody to a toxic protein that drives the inflammation that leads to acne. The idea behind this approach, which is still being investigated, is to halt the acne-causing effects of bacteria rather than eliminate the bacteria altogether.

With 50 million people diagnosed with acne each year in the United States alone, it’s no surprise that researchers continue to explore different ways to combat this pervasive condition. Future studies may provide answers that will help us get rid of acne for good. If acne is causing trouble for you or a loved one, consider being part of the research to help find an answer. Take a look at Science 37’s open studies and see if one might be a fit.


Lawrence Lloyd has more than a decade of experience in health communication strategies, marketing, and content development in academic, Fortune 500, and start-up environments. Lawrence earned his MA in journalism from USC and his BA in communication from California State University, Los Angeles. He loves exploring the different ways that Science 37 can expand patient access to innovative therapies.

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