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Abolishing Acne: Part 2
What Causes Acne?
Disclaimer: I am not a doctor, just a cartoon deer on the internet with a background in chemistry and a hyperfixation on skin. This is not medical advice.
Alright team, we’re back at it again with the acne series. Last time, we talked about what acne is and isn’t - general stuff, I know! So today, let’s talk about a few components of acne: sebum, bacteria, androgens, diet, and lifestyle.
Sebum is the oil that your skin naturally produces. You know that greasy feeling you get after you’ve been running around all day and your face is kinda shiny? That’s sebum! It is an incredible substance that our bodies make. It is produced in sebaceous glands and gets funneled to the surface of our skin through pores.
It is the existence of sebaceous glands that predict where we are most likely to develop acne on our bodies. Have you ever wondered why you only get acne on your face, back, and shoulders, but not really anywhere else? That’s because we have the greatest density of sebaceous glands in those areas:
Theoretically, sebum production is a positive phenomenon! Sebum is protective - it helps keep our skin barrier healthy by acting as a natural moisturizer. As long as sebum flows freely through our pores, our skin looks great. However, when sebum gets trapped in a pore (perhaps due to dead skin cells), this may create an environment for bacteria to proliferate. If bacteria is present, the inflammation rises to the surface in the form of a whitehead, and you can pop it (although you shouldn’t!). If bacteria isn’t present en masse, you might get one those pesky red bumps that hurt but can’t be popped (the bane of my existence, rip).
Okay Fawn, now we understand what sebum is. But what impacts acne on a macro level?
Alright - let’s clarify that I am not a doctor, and I am not the person to come to for root cause analysis. While I am a holistic health maxi, I’m also on the “topicals, biochemistry, and biohacking” end of the spectrum rather than the esoteric end (but of course, you probably knew that by now). Regardless, let’s talk about diet and lifestyle!
Diet plays a role in skin health, but it is not the only cause of acne.
First, I don’t love the "clean diet" argument when it comes to teenagers. From a mental health standpoint, teenagers deal with enough insecurity about the way they look, and shaming them when they can’t even control their diets while living with their parents feels unnecessary to me. In fact, a major reason why we see so many teenagers dealing with acne is because of their increased androgen levels throughout puberty. Androgenic hormones like testosterone upregulate sebum production by binding to nuclear androgen receptors which are found in sebaceous glands.
Upregulated sebum production will inevitably lead to acne issues. Y’all want teenagers to somehow change millions of years of evolutionary biology? Spare me (insert Fawn-famous suspicious face, the guy with one eyebrow up, since Substack won’t let me include emojis)
Second, the connection between diet and skin is so much more complex than “seed oils and junk food” (glaring at you, esoteric Twitter). Yeah, controlling inflammation in the body through diet will always be a good move for your holistic health, but if you’re anything like me, it won’t solve all of your acne issues. Different people will have different triggers, and everyone has different opinions on their individual risk management. For example, can you tolerate whey isolate? I don’t tolerate it well, and my face proves it by breaking out when I consume it. Doesn’t matter though - if I’m cutting hard, I’m going to be leveraging protein powder. Thus, I’ll mitigate my breakouts with topical solutions as that is my preference for optimizing my life towards my aesthetic goals. Other people can’t tolerate maltodextrin, some can’t tolerate sugar, etc. Not even sugar breakouts could stop me from eating my mom’s Christmas cookies. It is what it is, that’s up to my own risk management!
Finally, let’s consider lifestyle.
Y’all know by now that I am an advocate for an active lifestyle, but damn if I don’t literally do myself dirty by sweating constantly. In fact, my acne issue didn’t present at its worst until I ramped up exercise a few years ago. Even beyond that, there will always be other random lifestyle factors. For example, do you sleep on your stomach? I do, and as much as I have tried to force myself to be a back sleeper, I can’t seem to make the transition. Burying my face in a pillow for eight hours a night is certainly not doing my face any favors whether in the form of acne or eventual wrinkles. Thankfully, the consequences are nothing a satin pillowcase and little retinol can’t fix.
In summary, there could be any number of contributing factors to your skin issues, and it’s okay if cleaning up your diet and drinking more water don’t give you perfect skin. I tried all “the right things” myself too. Hell, I even put myself in remission from an autoimmune disorder, and I still didn’t have perfect skin until I learned to leverage my chemistry background to demystify skincare.
In the final installment of this series, we will talk about all your options for treating acne. Trust that if I can go from being average five years ago to being a Stacy now, you can too. There’s a method to the madness. I’ll show you how - you just have to keep on reading.
That’s all for now! Happy skincare!
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