Acne is an inflammatory skin condition that develops through four key steps.

  1. Dead skin, make up, or other skin products can trap oil inside the sebaceous glands (hair follicles), leading to breakouts.  
  2. The sebaceous glands continue to produce oil (sebum), which builds up in the clogged pore.  The hormone testosterone plays a significant role in increasing sebum production.  
  3. Naturally occurring skin bacteria - part of a healthy skin microbiome - become trapped in the pore.  The bacteria feed on the oil and produce pus as a byproduct.  
  4. The immune system responds to the bacteria and pus, resulting in redness, swelling, and inflammation.

There are many treatment options available for acne, each targeting a different part of this process.  

  1. Clogged pores (dead skin and debris): Most over the counter skincare products focus on reducing pore blockages by cleaning the skin and exfoliating dead skin cells and make up.
  2. Sebum (oil) production: Testosterone is a major driver of sebum production, which helps explain why acne is often linked to hormonal conditions (like PCOS) or hormonal changes (like puberty or the post-partum period).  Testing your testosterone levels and other hormones helps us determine if this is a driving factor in your skin.  
  3. Bacteria: topical or oral antibiotics may be used to help reduce acne-causing bacteria and prevent breakouts.  Options range from natural topical agents, over the counter topicals, as well as prescriptions.
  4. Inflammation: When the immune system is activated, it drives inflammatory pathways that cause the redness, pain, and swelling seen in acne and cystic acne.  Inflammation can often be reduced through lifestyle factors such as a healthy diet, exercise, and adequate hydration.   If the basics aren’t enough, certain natural supplements may also help calm inflammation in acne lesions.  

In many cases, the most effective acne treatment plan addresses all 4 pathways involved in acne development.  If you have been struggling with persistent acne, consider speaking to your doctor to about testing and treatment options that may be appropriate for you.

‍