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There are several factors that determine the appearance of acne and it is important to remember that they can intertwine or exist simultaneously in the same person:

  • genetics

Everyone’s DNA controls and determines the amount of keratin and sebum and the size of the sebaceous glands. The hormonal level of testosterone and DHT (dihydrotestosterone) that act on these glands is also genetically regulated.

  • the bacteria

The bacterium Cutibacterium acnes (previously called Propionibacterium acnes), normally present on the skin, contributes to acne by multiplying excessively in conditions of increased sebum, and the substances released by it to process its food attract able cells from the blood, leading to inflammation follicles and the accumulation of pus. It is important to mention that the presence of bacteria on the skin is normal, and acne is not an indicator of poor hygiene.

  • menstruation and pregnancy – starting with the day of ovulation, the level of testosterone increases and acts on the sebaceous glands. The same happens with progesterone during pregnancy.
  • cosmetics – oilier care products can cause clogging of pores, so people prone to acne should opt for those marked as non-comedogenic and choose more watery products that do not burden the skin
  • stress – causes an increase in the synthesis of testosterone and DHT, with direct action on the sebaceous glands
  • diet – although there are no studies that prove a direct link between diet and acne, some people have an aggravation of lesions or an eruptive pustule after consuming certain products, especially if the foods are pro-inflammatory.
  • Friction – tight clothes, sweat and heat lead to the blocking of hair follicles, affect the integrity of the skin barrier through
  • friction and create a warm, inflamed, moist environment in which bacteria thrive.
  • pre-existing medical conditions – for example hormonal imbalances (polycystic ovary syndrome)
  • drugs – steroids, lithium, hormone therapy, etc

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