The science of acne
Acne is the 8th most common disease worldwide, affecting approximately 660 million people globally. Almost 1 in 10 of us will suffer from it in our life times.
In addition to its obvious physical impact, acne can have significant emotional and psychological effects on sufferers.
What is acne?
Acne is defined as a disorder of the pilosebaceous glands (hair follicles and its sebaceous glands) which are primarily found on the face, chest and back. It is characterised by the appearance of non-inflammatory lesions – comedones (blackheads and whiteheads) and inflammatory lesions – papules (small raised bumps), pustules (small raised bumps containing pus), nodules (solid, large raised bumps).
What causes acne?
Acne is a complex disease. Every case of acne is unique and the mix of factors that lead to acne varies between individuals. On the surface acne is simply the result of our body fighting infection. This infection occurs when our skin's ecosystem of bacteria is out of equilibrium. This happens when the certain bacteria are given the right conditions to thrive, such as in a blocked pore. Our pore's can become blocked when the production of sebum, skin cells and keratin within the pore becomes greater than the pore's ability to expel. The reason your body increases production of sebum, skin cells and keratin is linked to your body's hormones being out of balance. The reason your hormones might be out of balance is likely either your genetics or your lifestyle, or both. This is the acne forming chain.
How can we break the chain?
To stop acne you have to tackle each part of this complex process. Some parts, for example genetics, are out of reach with our current technologies. Others are tackled by various acne treatments. Almost all acne treatments available today tackle at best one or two parts of the whole process; normally the end symptoms. Treating acne symptoms will appear to work but acne will always return because the source of the acne is still there.
Treating one part of the chain in isolation to the rest can cause the chain to overcompensate when treatment is stopped - for example if we kill all the bacteria in a pore then as the bacterial population grow back some strains rebound and grow faster than others. This can make our acne worse than before.