How to Get Rid of Acne For Good—According to Science

Summary

This SciShow episode delves into acne, the most common skin condition affecting up to 80% of people. It explains how acne forms due to clogged pores from excess sebum and dead skin cells, exacerbated by factors like genetics and hormones. The video covers various acne types, from blackheads to cystic acne, and discusses treatments ranging from topical medications to laser resurfacing, emphasizing the normalcy and treatability of acne.

Takeaways

• 🌟 Acne vulgaris is the most common skin disease, affecting about 80% of people at some point in their lives.
• 🔍 It predominantly occurs between the ages of 11 and 30, but can affect older individuals as well.
• 🧬 Acne forms when hair follicles and pores become clogged with dead skin cells and sebum, an oily substance produced by sebaceous glands.
• 💧 Sebum is essential for waterproofing and moisturizing the skin, but overproduction can lead to acne by clogging pores.
• 🌱 Keratin, a protein produced by hair follicles, when overproduced, can bind with dead skin cells and cause blockages.
• 🦠 Propionibacterium acnes, a commensal bacteria, lives on the skin and can cause acne when it penetrates deep into clogged pores.
• 🚨 Inflammation and infection are common results of clogged pores and can lead to various types of acne, including blackheads, whiteheads, pimples, and cystic acne.
• 🧬 Genetics and hormones, particularly androgens like testosterone, play a significant role in the development of acne.
• 🍽 The link between diet and acne is not conclusively proven, although some studies suggest possible connections.
• 🧴 Topical treatments for mild acne include benzoyl peroxide and salicylic acid, which help unclog pores and kill bacteria.
• 💊 For more severe acne, treatments may include antibiotics, retinoids, and hormonal therapies to regulate sebum production and reduce inflammation.
• 🛠 Procedures like dermabrasion, laser resurfacing, and chemical peels can help reduce acne scars, but do not treat the acne itself.

Q & A

What is the most common skin disease in humans?

Acne, or acne vulgaris, is the most common skin disease in humans.

What percentage of people does acne affect at some point in their lives?

Acne affects about 80% of people at some point in their lives.

What are the main causes of acne?

Acne happens when follicles and pores become clogged with dead skin cells and oils.

What is the role of sebum in the skin?

Sebum is an oily, waxy substance produced by sebaceous glands that helps keep the skin waterproof and moisturized.

Why is keratin production a factor in the development of acne?

Increased keratin production can cause the extra protein to bind with dead skin cells, preventing them from shedding and leading to pore blockages.

What type of bacteria is commonly associated with acne?

Propionibacterium acnes, a commensal bacteria that naturally lives on the skin, is associated with acne when it infects clogged pores.

What is the scientific term for a clogged pore?

The scientific term for a clogged pore is a comedo.

How do blackheads and whiteheads differ?

Blackheads are open comedones where the trapped sebum and dead skin cells become oxidized, turning dark. Whiteheads are closed comedones where the clogged material appears whitish due to the lack of oxidation.

What is the most severe form of acne?

The most severe form of acne is cystic acne, which involves deep skin infections that can cause solid bumps called nodules or pus-filled bumps called cysts.

What are some factors that may contribute to the development of acne?

Factors that contribute to acne development include genetics, hormones like androgens, stress, and exposure to topical oils from cosmetics or moisturizers.

What is the general advice against doing when you have a zit?

The general advice is not to pop a zit, as it can push the infection deeper into the skin, cause more inflammation, and spread bacteria to unaffected pores.

What are some common treatments for mild acne?

Common treatments for mild acne include topical over-the-counter medications such as benzoyl peroxide and salicylic acid.

How do antibiotics help in treating acne?

Antibiotics can be used to treat acne by stopping bacterial growth and reducing inflammation.

What is the role of retinoids in treating acne?

Retinoids, related to vitamin A, work by binding to skin cell receptors to remove dead skin cells, encourage healthy skin cell growth, unclog pores, and reduce inflammation.

How can birth control or corticosteroids help with acne?

Birth control or corticosteroids can regulate female hormones and reduce the amount of androgen hormones being produced, leading to less sebum production and thus less acne.

What are some procedures that can reduce acne scars?

Procedures to reduce acne scars include dermabrasion, laser resurfacing, and chemical peels, which remove layers of skin or perform a controlled injury to reveal healthy skin cells underneath.

Outlines

00:00

😖 The Common Woes of Acne

Acne, or acne vulgaris, is a prevalent skin condition affecting approximately 80% of individuals at some stage in their lives, predominantly between the ages of 11 and 30. It arises when hair follicles and pores become obstructed by a combination of dead skin cells and sebum, an oily substance secreted by sebaceous glands. This blockage can lead to various forms of acne, such as blackheads, whiteheads, pimples, and more severe manifestations like pustules and cystic acne. The script delves into the skin's structure, the role of sebum and keratin in acne development, and the bacterial involvement, particularly Propionibacterium acnes, which can cause inflammation and infection when trapped within pores. It also touches on the different types of acne and their scientific names, providing a comprehensive overview of this widespread skin issue.

05:02

🧪 Acne Treatments and Misconceptions

This paragraph explores various treatments for acne, emphasizing the importance of not popping pimples to avoid spreading bacteria and causing further inflammation. It outlines the use of over-the-counter medications like benzoyl peroxide and salicylic acid for milder forms of acne, which work by killing bacteria and unclogging pores. For more severe cases, prescription treatments such as antibiotics, retinoids, and hormonal therapies are discussed. The paragraph also addresses common misconceptions about acne, including the role of diet, the impact of stress on hormone production, and the use of non-comedogenic products to prevent pore blockage. It concludes by discussing procedures to reduce acne scarring, such as dermabrasion, laser resurfacing, and chemical peels, and reassures viewers that acne is a normal, treatable condition that most people outgrow over time.

Keywords

💡Acne

Acne, also known as acne vulgaris, is the most common skin disease affecting approximately 80% of people at some point in their lives. It is characterized by clogged pores and is most prevalent during adolescence but can affect individuals well into adulthood. In the video, acne is the central theme, with its causes, effects, and treatments being discussed in detail.

💡Sebaceous glands

Sebaceous glands are special glands in the skin that produce sebum, an oily substance that helps keep the skin moisturized and waterproof. In the video, it is mentioned that when these glands produce too much sebum, it can lead to clogged pores and the development of acne.

💡Sebum

Sebum is an oily, waxy substance secreted by sebaceous glands. It plays a crucial role in maintaining skin health by preventing water loss and keeping the skin moisturized. However, as highlighted in the video, overproduction of sebum can lead to acne by clogging pores.

💡Keratin

Keratin is a protein produced by hair follicles that provides structure to hair and the top layer of the skin. The video explains that excessive keratin production can cause the protein to bind with dead skin cells, leading to pore blockages and acne formation.

💡Propionibacterium acnes

Propionibacterium acnes is a type of commensal bacteria that naturally lives on the skin and is generally not harmful. The video describes how this bacteria can cause acne when it penetrates deep into the pores, leading to infection and inflammation.

💡Inflammation

Inflammation is the body's response to infection or injury, characterized by increased blood flow and immune cell activity. In the context of the video, inflammation is a result of the immune system's reaction to bacterial infections in clogged pores, which is a common symptom of acne.

💡Comedo

A comedo is a scientific term for a clogged pore, which can be either open (blackhead) or closed (whitehead). The video uses this term to describe the initial stage of acne development, where sebum and dead skin cells form a plug within the pore.

💡Cystic acne

Cystic acne is a severe form of acne that involves deep skin infections, often resulting in solid bumps called nodules or pus-filled bumps called cysts. The video mentions cystic acne as one of the most severe types, which may require aggressive treatments and can lead to scarring.

💡Benzoyl peroxide

Benzoyl peroxide is a common over-the-counter medication used to treat mild acne. As described in the video, it is effective at killing bacteria by releasing reactive forms of oxygen that destroy bacterial molecules, helping to clear acne.

💡Retinoids

Retinoids are compounds related to vitamin A that are used in acne treatments. The video explains that retinoids work by binding to skin cell receptors to remove dead skin cells and promote healthy skin cell growth, effectively unclogging pores and reducing inflammation.

💡Non-comedogenic

Non-comedogenic refers to cosmetic or skincare products that are formulated not to clog pores. The video suggests looking for this label on products to avoid contributing to acne by introducing additional oils that can block pores.

Highlights

Acne, or acne vulgaris, is the most common skin disease affecting about 80% of people at some point in their lives.

Acne typically occurs between the ages of 11 and 30, but can persist in older individuals.

Acne forms when follicles and pores become clogged with dead skin cells and oils.

Sebum production imbalance can lead to skin issues, including acne.

Increased sebum and keratin production are major factors in acne development.

Propionibacterium acnes, a commensal bacteria, can cause acne when it infects clogged pores.

Inflammation from acne is a result of the immune system's response to infection.

Different acne types, such as blackheads, whiteheads, pimples, and pustules, have distinct characteristics.

Cystic acne is the most severe form, affecting deeper skin layers and causing nodules or cysts.

Genetics and hormones, particularly androgens, play a significant role in acne prevalence.

Stress may increase hormone production, potentially exacerbating acne.

The relationship between diet and acne is not conclusively proven, but some studies suggest a possible link.

Non-comedogenic products are designed not to clog pores and may help prevent acne.

Frequent face washing is not recommended as it can irritate the skin and worsen acne.

Topical over-the-counter medications like benzoyl peroxide and salicylic acid are effective for mild acne.

For more severe acne, prescription treatments including antibiotics, retinoids, and hormonal regulators may be necessary.

Dermabrasion, laser resurfacing, and chemical peels are procedures that can reduce acne scars.

Most people outgrow acne as they age, but some may continue to experience it into their later years.

Transcripts

Imagine waking up the morning of prom, or your wedding day, or a big job interview…

and sure enough, you look in the mirror to find your forehead is covered in zits!

It’s happened to lots of us.

Acne, or acne vulgaris, is the most common skin disease in humans.

It affects about 80% of people at some point in their lives.

Most people get acne between the ages of 11 and 30, but sometimes older people continue

to struggle with it, too.

Acne happens when follicles and pores become clogged with dead skin cells and oils.

And … it sucks.

But by studying how acne forms, doctors have developed ways to prevent and treat it.

It all starts with your skin: a complex organ made up of two layers and lots of nerves,

blood vessels, and glands.

Your skin cells regenerate about once a month, so you constantly have dead skin cells sloughing

off, and new skin cells rising to the surface.

This whole skin-replacement thing isn’t much of a problem, on its own.

But lots of these dead skin cells come out through your pores.

And pores make things more complicated.

Skin pores are essentially just openings for tiny hairs.

Hair follicles, the root ends of the hairs, are embedded in your skin and surrounded by

clusters of sebaceous glands, special glands that produce sebum.

Sebum is that oily, waxy stuff that comes out of your pores.

It helps keep your skin waterproof and moisturized: it keeps excess water out of your body, and

it keeps water already inside you from getting out through your skin.

So, sebum is important.

But things can go very wrong if your sebum production gets out of whack.

When your body doesn’t produce enough sebum, your skin can dry out, making you more susceptible

to bacterial or fungal infections.

But if your body produces too much sebum, it can build up inside your pores, trap dead

skin cells, and cause a blockage.

Increased sebum production is one of the major factors involved in the development of acne.

Increased keratin production is another one.

Keratin is a protein produced by your hair follicles.

It gives structure to each strand of hair, as well as the top layer of your skin.

But when the hair follicles produce too much keratin, the extra protein binds together

dead skin cells, so they can’t just shed out of the pore like they normally would.

You end up with a blockage that then traps more dead skin cells, plus sebum.

Once the pore is officially clogged, it becomes a breeding ground for colonies of bacteria

— especially Propionibacterium acnes.

That’s a species of commensal bacteria, which basically means it’s friendly.

It naturally lives on your skin, and it’s not harmful … most of the time.

The commensal bacteria that make up your microbiome probably even help prevent other, more harmful

bacteria from colonizing on your skin.

So having colonies of Propionibacterium acnes living on you isn’t a bad thing.

You want them there — as long as they stay on the surface of your skin.

When the bacteria find their way deep into skin pores where they don’t belong, that’s

when they can cause an infection.

And infections often cause inflammation.

When you get an infection, your immune system responds by increasing blood flow to the area

and sending extra immune cells and enzymes to fight off the infection.

Different combinations of symptoms cause different kinds of acne, with names you’ve probably

heard before:Blackheads, whiteheads, pimples, pustules … technically, they all mean different

things.

The scientific term for a clogged pore is a comedo, which actually used to mean a parasitic

worm.

People started using the term to refer to a clogged pore because the stuff that comes

out when you squeeze it looks kind of like a worm.

When the main symptom is just that the pore is clogged, without much inflammation, that’s

either a blackhead or a whitehead.

Blackheads are what it’s called when the comedo is open.

The trapped sebum and dead skin cells become oxidized, which turns the surface of the clogged

material into a dark color, kind of like how silver tarnishes.

When the comedo closes, skin cells grow over the top of the plug and stop this oxidation

from happening, so the whitish color of the sebum shows through.

That’s called a whitehead.

When there’s a comedo plus an infection that causes inflammation, that’s a different

kind of acne: pimples!

The typical reddish bumpy kind are more specifically called papules.

If the inflammation gets really bad, sometimes the bumps start leaking fluid or bacteria-filled

pus.

Those kind are categorized as pustules, and they’re usually a much brighter red, or

sometimes white from the oozing fluid.

The most severe kind of acne is generally called cystic acne.

That’s when the infection takes root in the deepest layers of the skin.

Sometimes the infection causes more solid bumps to form, called nodules.

And sometimes the infection causes pus-filled bumps, called cysts.

So that’s how acne happens.

But what causes it in the first place?

What makes healthy pores become clogged, infected, and sometimes ooze-y?

Again, there are a few different factors involved.

Genetics seem to be important, for one thing.

So if your parents had acne, you’re more likely to have it too.

Hormones also have a huge influence on acne — specifically, androgen hormones, like

testosterone, which influence the development of both the male and female reproductive systems.

Which explains why acne is so much more of a problem during puberty.

Androgen hormones are linked to sebum production.

So during puberty, when the hormones are highly active, there’s an increase in sebum production.

Increased stress has been thought to increase hormone production, as well.

So if you find yourself breaking out the day before a big test, that’s probably why.

When you’re stressed, you produce more hormones, which then increases your sebum production.

Since sebum is an oil, a lot of people say that greasy foods will cause acne.

Sometimes you’ll also hear that dairy makes it worse, or even more specific foods, like

chocolate.

But the truth is, scientists aren’t really sure how or whether diet and acne are connected.

There have been lots of studies investigating this, and some do suggest a possible link.

But others don’t.

We need more comprehensive, controlled trials with plenty of subjects before we can come

to any real conclusions.

Doctors do acknowledge that there’s anecdotal evidence, and they say that if changing your

diet has helped with your acne, then it makes sense for you to stick with it.

There just isn’t enough evidence to support the idea that diet has a role in acne in general.

But we do know that exposure to other topical oils, like some cosmetics or moisturizers,

can cause acne by blocking your pores with extra oils and trapping sebum.

It’s easy to avoid the problem, though — just look for products that say they’re non-comedogenic,

which means that they shouldn’t clog your pores.

But the natural oil on your face isn’t really a problem.

You’ll often hear that you should wash your face a lot to help prevent acne, but acne

isn’t caused by dirt or by the natural oil that’s already on the surface of your skin.

And washing your face too much can actually irritate your skin, making acne worse.

To treat acne, the goal is to reduce the factors that come together to cause breakouts.

The one thing you shouldn’t do is pop a zit.

The big risk is that you’ll push the infection out of the hair follicle and into the surrounding

skin, instead of out to the surface.

Plus, you’ll irritate the area, causing more inflammation and making the acne take

longer to heal.

You might also spread bacteria to non-affected pores.

Instead, treatments try to lower sebum production, stop dead cells from clumping together in

the pore as much, prevent bacterial growth, and lower inflammation.

Treatments can range from mild to aggressive, depending on how severe the symptoms are.

For mild acne like blackheads and whiteheads, you can usually use topical over-the-counter

medications.

One of the most effective is benzoyl peroxide, a chemical compound that’s really good at

killing bacteria.

It decomposes into super reactive forms of oxygen, which bind to and destroy the molecules

the bacteria need to survive.

Another common treatment is salicylic acid, which doesn’t kill the bacteria, but stops

them from replicating.

It can also break down skin cells and keratin to help unclog the pores

Inflammatory acne, like papular pimples or cystic acne, sometimes needs stronger treatment

to reduce the inflammation.

That usually means prescription meds.

###Antibiotics — the kind that are also used to treat other bacterial infections,

from strep throat to urinary tract infections — can be used to treat acne.

They stop bacterial growth and reduce inflammation.

Another kind of treatment involves retinoids, which are compounds related to vitamin A.

Retinoids work by binding to skin cell receptors to remove dead skin cells and encourage healthy

skin cell growth.

So retinoids work really well to unclog pores full of dead skin cells.

They’re anti-inflammatory, too.

In severe cystic acne cases, stronger retinoids actually work at the deeper layers of skin

to reduce the size of the oil glands so they produce less sebum.

And since hormones are a big factor in sebum production, using birth control or corticosteroids

can regulate female hormones and reduce the amount of androgen hormones being produced.

Fewer androgen receptors at work means less sebum production, which means less acne.

Sometimes, severe, cystic acne will leave scarring, but there are ways to reduce it.

These procedures don’t necessarily treat or prevent the acne itself, but they can reduce

the bumps and scars left over from bad breakouts.

Dermabrasion uses a gentle sanding tool to wear down layers of the skin that have scarred

over from cystic acne, but it only works for people with lighter skin.

This procedure has mostly been replaced by laser resurfacing, which uses laser pulses

to remove skin layer by layer until the scar has smoothed out.

Then there are chemical peels, which use compounds like salicylic acid or retinoic acid to perform

what’s basically a controlled injury to the top layer of skin, killing the top layer

of cells.

The dead skin cells peel off, revealing healthy skin cells underneath.

Luckily, most people grow out of the acne-ridden years of puberty, though some people will

continue to have acne well into their 40s and 50s.

But even though a bad breakout might make you self-conscious, it’s normal, it’s

treatable, and it’s not life-threatening.

So take care of your skin, talk to your doctor about prescription treatments if you want

them, and trust that your acne will probably get better with age.

And then you get to look forward to wrinkles!

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