Causes of Cystic Acne

Reviewed by:  Andrea G. Di Stefano, MD Dr Andrea G. Di Stefano is an European Board-Certified Dermatologist with a particular interest in Acne, skin cancer, infectious and Sexual Transmitted Diseases and autoimmune skin disorders....more

Acne is not caused by a single factor. Cystic acne is not caused by dirt on the skin. Blackheads are not dirt but oxidized oil, therefore excessive cleaning in not needed to prevent acne. Psychological factor such as stress might increase cystic acne severity, but does not directly causing it. Stress is associated with the production of a hormone called cortisol, which triggers the expansion of the skin's oil glands, and the over-production of sebum. It is the male hormone, testosterone, which stimulates the production of the sebaceous glands in times of stress. This is why people often develop acne when under stress. Cosmetics, especially oily or heavy make up can contribute and even aggravate the acne if the skin is already an oily type. Most cosmetic products available today are water-based and oil-free and do not clog the skin pores, therefore are less likely to cause severe acne too.

Despite the popular myth that certain foods such as chocolate, nuts, oily fried foods, junk foods and other foods might cause acne, recent studies do not support this. However, a high glycemic diet and dairy products might worsen the acne but this finding is yet to be established. Diet has a direct effect on our body's insulin levels. Insulin is our master hormone and affects all of our other hormones, including our androgens (male hormones). Scientists heavily suspect that hormonal fluctuations, particularly in our androgen levels, can result in acne flare ups. It is hypothesized, yet unproven, that a diet which causes insulin spikes may affect the pathogenesis (development) of acne.

Researchers believe high glycemic index carbohydrates, that will cause glucose and insulin levels to rise quickly, may have influence on the development and severity of acne. On the other hand, a high protein diet and low glycemic index carbohydrates are seems to improve acne breakouts.

Meat (including poultry) contains hormones and hormone-like substances which can affect the hormonal balance in the body. Beauticians have reported that women who regularly eat meat are more likely to suffer from acne and hirsuitism which they put down to the steroids and hormone levels in the meat.

The right diet may also be related to acne in positive ways. Eating a low glycemic diet rich in veggies, fruit, seafood, and grass-fed meat can help stabilize insulin levels, which theoretically may have an impact. Also, ingesting Omega-3 fats, such as fish oil, for instance, has been shown to be a powerful anti-inflammatory agent in our body. Since a big part of acne is inflammation, it makes theoretical sense that eating an anti-inflammatory diet would help.

Researchers have theorized that the hormones in cow's milk could also stimulate the same mechanisms. Studies found that milk, cream cheese, and cottage cheese were all associated with acne (Adebamowo, 2005). Skim milk had a higher association with acne than whole milk, suggesting that the fat content of milk was not the contributing factor. Whole milk contains more estrogen, and estrogens tend to reduce acne. Reducing or stopping milk intake may be an important part of an acne regimen. A popular acne treatment program does recommend a dairy-free diet (Perricone, 2003). It is essential that teenagers maintain adequate bone mineral health. This is a complicated subject, but it is clear that exercise is key to the maintenance of healthy bones during the teenage years. Intake of calcium, magnesium, boron, and other minerals may also be important factors in maintaining bone health. And remember, do not drink soy milk because of the negative consequences on thyroid hormone production and mineral metabolism.

Lacking of nutrients such as zinc, Omega 3-fatty acids, selenium, Vitamins (A,E,C,B5 being most popular) is also one of the cause. Research published in the Journal of American Academy of Dermatology has shown that Essential Fatty Acids (EFA) can help hormonal imbalances that lead to acne. In fact, people with hormonal related acne have been shown to have deficiencies of EFA's. Foods rich in EFA's include sunflower, soybean, corn or safflower oils, sunflower seeds and linseeds (otherwise known as flax seeds).

Zinc is known to help acne sufferers. Whilst the mechanism by which it works is still not fully understood, a lack of zinc has been shown to increase the production of male hormones. Zinc is found naturally in generous amounts in brewers yeast, whole grains, brazil nuts and pumpkin seeds.

Researchers have found that people with unstable blood sugar levels have a high incidence of severe acne and that when these patients are given 400 micrograms of chromium in the form of yeast, their skin rapidly improved.

Research has shown that selenium coupled with vitamins A & E can within 12 weeks reduce the severity of persistent acne and help alleviate resultant scarring.

 

Other Factors That Might Cause Cystic Acne

As we know, cystic acnes are due to extra production of sebum by overactive oil glands. There are other factors that might play a role in causing this, including hormonal activities, bacteria, certain drugs and also genetic factor.

Hormonal activities during menstrual cycles, puberty and sometimes during pregnancy, may contribute to acne outbreaks. Increase in male sex hormones called androgens cause the sebaceous glands to enlarge during the normal growth process. In the case of cystic acne sufferer, the oil glands are over-stimulated and lead to overproduction of sebum. Overactive glands will also cause irregular shedding of dead skin cells than normal. When extra sebum mixes with extra dead skin cells, plugs are formed in the follicle. These plugs will clog the skin pores and increase the chance of bacteria infection and thus the outbreaks of acne. Men can be affected during puberty or by an increase in androgens, the male hormone, associated in steroids or found in other drugs. Stress is another reason hormone levels fluctuate for both men and women.

Bacteria infection is another cause of acne. The bacterium P. acnes (Propionibacterium acnes) are common bacteria that present in the sebaceous glands of our skin and are generally harmless. However, when skin pores are clogged, an anaerobic condition makes these bacteria multiply rapidly and trigger inflammation within the pores and the surrounding skin. If this condition is not treated promptly by reducing the P. acnes population, it will later lead to the outbreak of cystic acne.

Some drugs may also cause acne or make the condition worse. The examples are drugs which contain iodides, bromides, oral or injected steroids, anticonvulsant medications and lithium. However, many cases of severe acne are not drug-related.

Genes are also an important acne cause. Acne is often inherited in families whose members suffer from acne. The most common inherited acne is cystic acne. Though acne is not a hereditary disease that can be transmitted, there is a chance for children to have acne at any part of life, if their parents had acne once. This is because of the fact that parents determine the skin type of the children.

 

Video: Acne 101: Acne Causes by DermTV.com

 

References:

1. About.com Guide, Angela Palmer,  Cystic Acne-Understanding Cystic Acne and Nodulocystic Acne, updated July 30, 2009. http://acne.about.com/od/acnesymptoms/a/cystic.htm
2. Acne.com, What Causes Acne? http://www.acne.com/#/types-of-acne/what-causes-acne/
3. Mayo Foundation for Medical Education and Research (MFMER), Acne: Symptoms, Causes, Risk Factors, November 3 2009. http://www.mayoclinic.com/health/acne/DS00169
4. Robyn N Smith, Neil J Mann, Anna Braue, Henna Mäkeläinen and George A. Varigos , A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial, American Journal of Clinical Nutrition, Vol. 86, No. 1, 107-115, July 2007. http://www.ajcn.org/content/86/1/107.full
5. MedicineNet, Alan Rockoff, MD, Acne (Pimples), http://www.medicinenet.com/acne/article.htm#1whatis
6. MedlinePlus, U.S. National Library of Medicine, Acne, December 11 2009. http://www.nlm.nih.gov/medlineplus/ency/article/000873.htm
7. DermTV.com, Dr. Neal Schultz, Video: Acne 101: Acne Causes, Episode #121, November 11, 2009. http://www.dermtv.com/acne-101-acne-causes
8. About.com Guide, Laura Dolson, What is the Glycemic Index?, Updated October 01, 2007. http://lowcarbdiets.about.com/od/faq/f/faqgi.htm
9. About.com Guide, Laura Dolson, Carbohydrates, Updated November 12, 2006. http://lowcarbdiets.about.com/od/glossary/g/glosstermcarb.htm
10. Adebamowo CA, et al. High school dietary dairy intake and teenage acne. Journal of the American Academy of Dermatology. Feb. 2005; 52(2): 207-214.

 

Advertisement

 

 

What Next?

This site complies with the HONcode standard for trustworthy health information:
verify here.

This page was last modified on: December 02, 2011