Perhaps you’ve been plagued with it ever since you hit puberty. Maybe you only develop a few pimples here and there, or perhaps you’ve got a severe case that warrants the attention of a doctor. Acne is one of the most common skin disorders out there, but the impact—both physically and emotionally—is profound; after all, there’s a reason why Americans spend hundreds of millions of dollars a year on products that are touted as acne cure-alls. From teenagers plagued by raging hormones to middle-aged adults with stubborn spots, 60-70% of Americans experience acne at some time during their lives, which can lead to scarring in more severe cases.¹

However, while you may have spent hours in front of the mirror examining your acne, have you ever stopped to wonder what exactly acne is and how it’s formed?

Acne is frequently referred to as clogged skin pores or pimples, but it is much more complex than these common words would suggest. The affected skin pores are actually specialized pilosebaceous ducts, and acne is a chronic inflammatory follicular disorder of the skin that occurs in these pilosebaceous ducts. Comprised of a sebaceous gland and hair follicle, pilosebaceous ducts can be found everywhere in your body—although not normally on the palms and soles. Conversely, pilosebaceous ducts are more numerous on the face, chest, shoulders, and back. Sebaceous glands produce sebum, a mixture of lipids that form the natural oils in and on the skin that are believed to help keep it moisturized and protect it from infection.²

The causes of acne are still not completely understood, but research indicates that a variety of hormonal, stress, and genetic factors can all play a role.³ Diet, oxidative stress, and smoking may also contribute to acne development.²

Regardless of cause, there are four primary factors currently understood to be involved in acne development:²

• Increased production of sebum
• Formation of comedones
• Dysregulation of microbial bacteria—especially Propionibacterium acnes (P. acnes)
• Inflammation