It feels like breakouts always occur at the most inconvenient times. Take the other day for example, I was asked to do a presentation in front of the Taranaki Young Professionals group and the day before a large spot decided to make a show stopping appearance right on the side of my chin. At this point I was feeling stressed, a little over caffeinated, dehydrated and to put the cherry on the top I was hormonal! There is evidence to suggest that my spot’s appearance was no coincidence. Hormones, diet, lifestyle, stress and the environment all interact to influence bacterial growth, inflammation and how much oil our skin produces. When these factors combine with blocked pores you have the recipe for break out prone skin.
How do breakouts form?
Breakout formation begins with a blocked hair follicle/pore. This is caused by thickened dead skin cells building up due to the process called hyperkeritinization. Normally the oil produced by the sebaceous gland travels up the hair shaft helping to cleanse the skin’s pores of dead skin cells and then combines with sweat on the surface of the skin to protect it from environmental irritants. But because the pore is blocked, the oil and dead skin cells build up underneath the surface of the skin and inside of the skin’s pores.
Breakouts vs Blackheads
Oil trapped under the surface of the skin builds up and can result in either a black/white head or it can turn into an acne breakout. The reason an acne breakout can form rather than a black/whitehead is the presence of propionibacterium acnes (acne causing bacteria) and inflammation.
Bacterial growth and Inflammation
When acne causing bacteria are present they start to feed on the combination of oil and dead skin cells inside of the skin’s pores which can result in inflammation. As the sebaceous gland continues to produce oil, the bacteria continue to grow which causes an increase in inflammation and pressure on the skin’s blocked pore. Eventually enough pressure builds up causing the skin’s pore to rupture, spilling bacteria and oil underneath the skin. The body’s response is to send white blood cells to the rescue. The white blood cells protect the body from bacterial infection by forming a puss filled papule or a deep down cyst (depending on how deep down the pore rupture occurred). This means that if you attempt to pop a papule or acne cyst you run the risk of spreading the puss further under the surface of the skin often resulting in more breakouts occurring.
How do hormones diet, stress and the environment contribute?
There’s a receptor on the sebaceous gland of the skin called the androgenic receptor. This receptor is activated by androgen, a hormone released by the body. The activation of the receptor sends a message to the skin telling it to produce oil, meaning the more androgens in your system, the more oil the skin is likely to produce. Androgens are released in high amounts during puberty and around that time of the month. Giving us the link between breakouts and hormones.
What we eat can also increase the amount of oil our skin produces particularly dairy and refined sugars. Individuals with diets high in sugar and dairy products are likely to have increased levels of a protein called IGF-1. Increased levels of IGF-1 protein are associated with increased activation of the androgenic receptor and excess oil production by the skin, giving us a link between diet, oil production and breakouts. On the other hand caffeinated drinks like coffee and many “energy drinks” as well as alcohol are very dehydrating to your system and can often result in inflammation.
Stress also promotes inflammation by the release of pro-inflammatory cytokines. Inflammation combined with blocked pores, excess oil production and bacterial growth can lead to a follicle rupture and acne breakouts.
Lastly, environmental pollutants like cigarette smoke or car fumes produce free radicals which can promote inflammation and can cause the oil on your skin to oxidise. This oxidisation can create the perfect growing environment for acne causing bacteria.
So there you have it, diet, stress, hormones and the environment all play a role in the formation of breakouts.
What can you do to help reduce breakouts?
Watch my short three part video series for tips on how to achieve clear skin through diet, lifestyle and natural skincare.
Article supplied by Tailor Skincare.
For more information please contact:
Norman, R. A., Shenefelt, P. D., & Rupani, R. N. (2014) Integrative Dermatology, Oxford University Press.