Testosterone, the male hormone coursing through adolescent veins, triggers new and more abundant hair growth within teens, as well as increases in the skin's natural oil production. In the meanwhile, enzymes produced in this process tell pores to get bigger in order to accommodate the new hair and the greater oil flow.
The idea behind this skin madness is that those hair follicles that are more developed and dilated don't break out as easily, because there is more room for proper flow and the excretion of oil and dead skin cells, along with more room for bacteria-killing oxygen to get in and air out the pores. In other words, the skin is better able to clean itself out!
In females, pores that are not quite developed yet, and/or contain more sensitive male hormone receptors, get backed up with oil and dead skin cell over-production, which means they don't receive enough oxygen from air flow to kill bacteria. The result is acne that is impacted and inflamed.
To make matters worse, there can be a genetic propensity for oil to be a little more sticky, and with faster cell turnover creating a greater number of dead skin cells than otherwise would, a mass of dead skin cells all stuck together collects inside pores creating impactions. This is a condition called Retention Hyperkeratosis. Normally, dead skin cells come to the surface of the skin to be sloughed off throughout the day and oil flows through and out of pores onto the surface of the skin to be washed away. The cause of Retention Hyperkeratosis and why oil in people with genetic acne has a stickier fatty acid makeup in some people and not in others, is still being studied.
With Retention Hyperkeratosis leading to more extreme pore congestion, once a pore becomes swollen or impacted, bacteria inside pores, which are anaerobic, meaning they live and thrive without air, can grow and thrive. The issue of whether teens with acne have more bacteria inside pores as compared to others is still unsolved.
"I'm not a teenager anymore. Now what?"
The important thing for those who suffer from Adult Acne to remember is that the genetic tendency to easily accumulate oil and dead skin cells (which create the mix that blackheads are made of!) inside pores becomes less severe as the person ages, but it pretty much stays around until pre-menopause (or in some people, until after menopause). It doesn't mean all is hopeless, but it does mean you need to be ever vigilant in guarding your skin from pore cloggers, dehydrators and irritants. Retention Hyperkeratosis, and the acne that accompanies it, can be controlled.
Now, a sizable percentage of people with adult acne who come to me for help clearing their skin never had acne as teens. As with Retention Hyperkeratosis, pore impactions and inflammation can lead to swelling, blackheads and infection. In this case, various circumstances cause oil rushes in the skin but pores are usually not large enough to accommodate. Special help is needed in these cases, which is one of the primary reasons I specialize in adult acne.
In all cases, every single thing that goes on the skin, body products, hand products, haircare products, makeup, and of course, skincare, need to be monitored by a skincare professional who is expert in Adult Acne issues (like me!). Additionally, your diet must be taken into account, as foods rich in iodine, sugar, and for some people, dairy, can aggravate acne conditions. Cleansers must be thorough without stripping the skin of oils, hydration must be maintained using the right non-clogging moisturizers and/or serums, and the right exfoliation for your particular acne condition is a constant requirement.
Know of anyone else who has been plagued by teen and acne but still are breaking out in their 30s, 40s or 50s? Please share this post!
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