It’s not your fault. Contrary to popular belief, acne is not caused by anything you’re doing — what you eat, how often you wash your face or work out — but by a combination of factors at work far beneath the surface of your skin.
A healthy follicle
A blemish begins approximately 2–3 weeks before it appears on your skin’s surface. It starts in your sebaceous hair follicles — the tiny holes commonly called pores. Deep within each follicle, your sebaceous glands are working to produce sebum, the oil that keeps your skin moist and pliable. As your skin renews itself, the old cells die, mix with your skin’s natural oils, and are sloughed off. Under normal circumstances, these cells are shed gradually, making room for fresh new skin.
But sloughing is different for everyone. Some people shed cells evenly; some don’t. Uneven shedding causes dead cells to become sticky, clumping together to form a plug — much like a cork in a bottle. This plug, or comedo, traps oil and bacteria inside the follicle.
A plugged follicle
The plug traps oil and bacteria within the follicle, which begins to swell as your skin continues its normal oil production. Your body then attacks the bacteria with a busy swarm of white blood cells. The whole process takes 2–3 weeks, culminating in a pimple.
An inflamed acne lesion
Why me? There is no one simple “cause” of acne — the condition is influenced by many factors, many which are out of your control. The regularity with which you shed skin cells can change throughout your life. The rate at which you produce sebum is affected by your hormone balance, which is often in flux — especially for women. Research has also shown that genetics play a big part in the development and persistence of acne, so your family history is a valuable prediction tool as well when considering the various causes of acne.
