…we still have no clue.

After scouring the research from the last several years regarding sebum (skin oil), acne bacteria, gene transcription, and a bunch of other super techie stuff, the answer to what causes acne is…um…we still have absolutely no idea. Most diseases are tricky things, and acne is no exception. Scientists are really only still scratching the surface when it comes to nailing down what actually happens that starts the acne ball rolling.

Let’s take acne bacteria for instance. Over the past few years, scientists have located more strains of P. Acnes, the bacteria present in human skin. We don’t know which strains might be harmful and which might actually be helpful. Furthermore, we don’t know which of the secretions of which of the bacteria strains cause problems and why. Additionally, we don’t know if it’s the secretions that cause a problem or if certain strains of bacteria interact with cells in some other way, such as interacting with cell RNA, toll-like receptors, or inflammation. And, um…if these bacteria do interact with skin cells in some way, we don’t know whether it’s dermal cells, oil cells, or immune/inflammatory cells.

The story is equally muddled when you look at the immune response of the skin, the inflammatory cascade, cell signaling, et cetera, et cetera.

Regardless, it’s not all bad news. Some directions of inquiry are starting to look more interesting than others. For instance, scientists are starting to frame acne as an inflammatory disease and are focusing in on how to mediate the body’s inflammatory response in the skin.

With time, we may be able to better specify what causes acne, which could theoretically lead to a cure. Rest assured that I’ll keep on top of the latest research. In the meantime, The Regimen should work well to keep acne under complete control, and in more severe cases, Accutane is an option as well.


Leave a Reply

  • Erick

    Dan is a hardworker 🙂 Thank you Dan for your research

  • baysh

    you’re suggesting Accutane as an option?!

  • Anonymous

    Huh? We know what causes acne, Testosterone. Which convert to DHT and stimulates sebum production. Bacteria is nothing to do with causing acne. Bacteria only come into play when feeding off the sebum…

  • Anonymous

    You can’t get accutane in America so how can you suggest that with you yourself being American……..or do you know how I can get some legally and safely here???

  • Andres

    If it is testosterone then why don’t more men have acne then women?

  • pensive

    For everyone who posted above (with the exception of Erick): do a little reading once in a while before saying idiotic things

  • Shane

    having suffered from acne for years, i know how complicated it truly is and it doesn’t come off as a surprise that it still remains a mystery, maybe its because the fact that it is not threatening to physical health made it less of a priority than say cancer. the most frustrating thing about acne is that different people have difference experience with acne, some people may break out from lack of sleep, but dairy product doesn’t affect them, and somebody else may break out from dairy product but will not get new break out for not sleeping…

  • Anonymous

    Just Google ‘Testosterone DHT (Dihydro Testosterone) and Acne’. It’s not even a discussion, it’s mainstream, widely accepted scientific fact that this is root cause of acne.

    If you’re genuinely interested a poster called Sweetjade has posted many incredibly detailed posts on this subject.

  • Andrew

    Hi Dan,

    Is it possible to obtain a copy of that research?

    Can you put it on your site or wiki it?

    I’d be interested in analyzing more, as I assume others, to work together to see if we can figure it out.


  • Dr Hulda Clark

    Herbal treatment is good for the Acne, creams, lotions or any type odf beauty products are good for present but after an year it will show the dis-advantages of beauty products!!

  • KG

    I am 36 and still suffer acne. After years of studying my own face, I am absolutely convinced that acne is an inflammatory disease. My body’s immune system overreacts to something in my pores (bacteria? dead cells?) and blammo! I break out. I break out really fast and often with large welts. I also tend to suffer from other inflammation related stuff: allergies, bug bites, etc. I think there is a connect—I don’t know what yet!—to sugar. Like sugar somehow triggers the overreaction. I hope this all doesn’t sound too crazy . .. .

  • Elly Bexley

    As a fellow sufferer i have tried the lot and no solution has really helped long term. I found some interesting research at : *paula’s choice website* i appreciate the sell Acne products but there seems to be some science behind it.

    The info is more focused on the contents of various product but i have to say the product has worked reasonably well for me.


  • Melissa

    Thank you for posting this. I’ve struggled with acne for most of my life and nothing drives me crazier in regards to my skin than when people go all know-it-all on me and act like they know everything about acne and they know how to cure my skin (when in reality they’re just trying to sell me something). There could be a dozen different causes for acne and each person suffering from it has their unique combination of causes to treat. For me, it was full-body inflammation. When I began to treat that (primarily through diet and nutrition), my acne got drastically better. No topical product I ever tried produced such great results. Just goes to show – there is not just one cause of acne.

  • D

    I don’t understand why Dan is playing “scientist” for years now? If and when dermatology community finds the cause and cure for acne, your local dermatologist will know about it and will lead you to the proper miracle cure.

    What’s the point repeating what has been known for years and then still saying your only option is “the regimen” or “accutane.” BP for acne use has been known to science forever, just like accutane it does not work well for everyone, otherwise it would be the miracle solution by now.

  • RW

    Maybe thinking about acne as an inflammatory disease will get scientists more interested in studying it, as there are many difficult to treat diseases that involve inflammatory reactions and/or auto-immune reactions. What could be more useful than studying how the immune system works and malfunctions? It has implications for treating infectious diseases, auto-immune disorders, allergies, and cancer. I don’t mean to discount the role of hormones or diet, but the immune system is affected by hormones and diet, so that could be how the connection works.

    Zinc is helpful in treating inflammatory responses, and I have had excellent results reducing the redness and swelling of acne with zinc oxide cream (diaper cream). Other people use oral zinc supplements to reduce acne and cold symptoms, which are immune/inflammatory responses of the nasal mucous membranes.

  • Andy

    My comment on this is that … even if the scientists found a way to completely cure acne, they would still likely be stopped by all other parties (i.e. dermatologists, pharmaceutical companies) to release the medication. below is just completely my speculation.

    the acne market is just too lucrative for the entire skin care industry. think about all the dermatologists, all the miscellaneous Rx acne medication, all the scar removal procedures, all the aesthetician offices, all the skin care products (luxury ones and OTC ones), and the list goes on…. the chain effect is HUGE! even the medicine can make so much $ for one Rx company, it’s still relatively short-term as the generic comes out very soon after patent protection.

    i really hope this is not true… bc i’ve been suffering from Acne for the past 10+ years… now i’m still suffering… but i just can’t help imagining that … with the current advanced pharmaceutical tech and researches, we still cant cure that little red bumps for the world?? maybe the scientists are just slacking off….i hope.

  • A M

    Discovering chemicals that cause a reaction is science, and science is applied in creating formulas that offer moderate results with ongoing use, patented by big businesses for profit. The scientists are employed by major pharmaceutical companies, or their universities receive grants from them (which supposedly academe is above being corruptly influenced by — shhyyaa! Right!). Announcements to the public won’t be made before the research is divulged in academic journals and in corporate-sponsored, private research projects. We the public would be the last to know. Because most of us aren’t chemists. Trial-and-errorers at best. 😛

    And you know what I think? What profit is there in a cure? Especially when treatment can be made ongoing. But when it comes to skin care, there probably isn’t a lot of clear data. Our diets have radically changed throughout the last century, antibiotics are being chronically overused, hygiene is up, exercise is down, increasing numbers of women take hormonal birth control pills (for better or worse), and stress is probably at an all time historical high in these modern times. I imagine lots of factors do complicate the quest for a miracle cure-all (if such a universal product is even possible).

    We play guinea pigs for an endless array of profitable products. It’s not as if we’ll stop using everything in protest of too many mediocre choices, right? Gonna try to manufacture/extract our own? So, there’s always money to be made. Wish more companies could place citizen well-being and consumer satisfaction higher up their values totem pole.