Acne Risk Factors
Why Do I Get Acne?
Why me? What could be the cause of my acne? Is it my diet?These are common questions encountered during consultation. While adolescent acne is often attributed to puberty, the reasons may seem obscure in adults. Patients are often perplexed as to why they get acne as an adult when they have had clear skin since their teens. On the other hand, they may suspect that certain factors in their lifestyle may be triggering off their acne and want further confirmation of their suspicion. Here, we will explore the factors that influence acne and its severity.
Age, gender and other trends in the population can influence acne severity. We know that acne is hormonally mediated, with more than 85% of adolescent experiencing some degree of acne. Sebum production increases during puberty. Reports indicate acne to be more severe in older teens compared to younger ones. In addition, adolescent acne is more common in men while post-adolescent acne is more common in women. Females 11-13 years of age tend to have more severe acne compared to males, this is likely due to earlier onset of puberty. Household incomes do not seem to correlate with acne severity.
Genetic and Hormonal Factors
A family history of acne in parents have been shown to increase the odds of developing acne by a factor of 2.9 times. There may be an additive effect on the odds if both parents have had a history of acne. Additionally, acne appears to be more severe if there is a positive family history of acne.
As sebum production is genetically determined, individuals with oily or mixed skin types have an increased risk of acne erupting.The risk appears lower in those with dry or neutral skin types.
Although the role of diet in relation to acne is debatable, studies show an association with certain food groups. These include:
- Dairy products
- Whey proteins
- High glycaemic index foods e.g. sugary and processed foods
- High chocolate intake
- High fat diet
Foods that may lower the risk of severe acne include:
- High intake of fruits and vegetables
- Higher consumption of fish
While there role of diet is controversial and more studies are needed, a healthy well balanced diet is always recommended.
Obese and overweight individuals have a higher prevalence of acne and acne severity. This could be due to increased in androgen and sebum levels, favouring acne formation. There is inconsistent evidence of whether smoking increases the risk for acne. However, some studies show an association with lack of sleep, mental stress and exam stress with acne presentation.
Certain conditions such as polycystic ovarian syndrome and congenital adrenal hyperplasia may increase androgen levels. This results in increased sebum production and a higher chance of acne.
Various medications can trigger off acne as a side effect, including corticosteroids, anabolic steroids, lithium and hormonal therapies.
Skin Care Products
Cosmetics, sunscreens and even moisturizers can trigger off an acne eruption. You should look for non-comedogenic products because it reduces the risk of forming open and closed comedomes and thereby active acne.
To Conclude... ...
It’s important to note that while these factors can contribute to acne, they may not necessarily cause it in every individual. Acne is a complex condition, and its severity and occurrence can vary widely among individuals. If you’re concerned about acne, it’s best to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.
- Heng AH, Chew FT. Systematic review of the epidemiology of acne vulgaris. Scientific reports. 2020 Apr 1;10(1):5754.
- Di Landro A, Cazzaniga S, Parazzini F, Ingordo V, Cusano F, Atzori L, Cutrì FT, Musumeci ML, Zinetti C, Pezzarossa E, Bettoli V. Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults. Journal of the American Academy of Dermatology. 2012 Dec 1;67(6):1129-35.
- Tan JK, Bhate K. A global perspective on the epidemiology of acne. British Journal of Dermatology. 2015 Jul 1;172(S1):3-12.