Acne: Genetic vs Environmental

What causes acne? We've got answers. Here's whether genetics or the environment are to blame for acne

Learn whether genetics or the environment are the cause of acne

If astringent face wash, concealer, and other acne skin care products continuously found their way to the top of the shopping list in your family home, and you and your siblings used to fight over the tube of Clearasil in your family bathroom, there is a good chance that both of your parents once struggled with pre-prom pimples and worried about their chocolate intake. In other words, if you’ve struggled with acne, it probably isn’t because you eat greasy foods, or don’t wash your face enough. Most likely you are dealing with breakouts because acne-prone skin runs in your family. However, the way you choose to care for yourself and your skin plays an important role as well.

Acne: Researchers Debate Nature vs. Nurture

According to research, acne has a clear genetic factor. Our genes have a critical role to play in determining the way our skin produces sebum, or natural, protective oil. It also plays a significant role in deciding how dead skin cells slough off, and the way skin reacts to hormonal changes.

It’s long been speculated that genetics plays a large role in acne-prone skin. However, because it’s also known that acne is caused by a specific bacteria type — the bacterium Propionibacterium — the link to genetics was disputed. The amounts of that particular bacterium inside the follicles determines whether or not a pimple will form. The specific strain of the bacterium causing the infection will determine how severe the breakout is, and whether or not there is scarring or hyperpigmentation left behind. However, this bacterium is present on the skin of all people, so something else has to be at play.

Four Factors That Cause an Acne Breakout

There has to be an increase in sebum production, often caused by hormonal changes.

The excess sebum triggers an increase in keratin, a hard protein that protects the skin from harmful substances inside the follicle.

The follicle becomes clogged or plugged.

Propionibacterium, which thrives best without oxygen, multiplies inside the plugged follicle and a small infection—a pimple—is formed. The pimple could be an open comedone, or a blackhead, or it may take the form of a closed comedone, a whitehead. Blackheads are much less likely to become inflamed and cause scarring than whiteheads which cause the clog to rupture beneath the skin and become inflamed, forming a cyst.

The Genetic Factor in Acne Breakouts

Thanks to a large study involving identical and fraternal twins, the link between acne and genetics has been established.

Researchers used information from nearly 4000 identical and fraternal twins, and over 600 siblings to determine definite correlations in acne breakout vulnerability between twins and twin/sibling relationships. According to the results of this study, heredity is responsible for 85 percent of acne issues, while environmental factors contributed to breakouts by 15 percent. Identical twins were found to produce the same amount of sebum on a daily basis, though some experienced more frequent breakouts due to lifestyle choices.

Researchers also analyzed variants in DNA sequences which might be contributing to acne breakouts. Interestingly, these codes are close to the genetic codes that control the metabolism of insulin in the body.

Acne and Environmental Factors

While the twin study firmly established a clear genetic link between heredity and a tendency to suffer acne breakouts, it also defined some specific environmental factors that contribute to the frequency and severity of the breakouts. Even in identical twins who produce equal amounts of sebum, acne may present in one twin as large, inflamed eruptions, and in the other as smaller breakouts of whiteheads and blackheads. Difference in lifestyle choices seems to make a difference in the severity of acne breakouts.

In the twin to twin comparisons it was found that increased intake of sugar and complex carbohydrates led to worsened breakouts. Twins with higher body mass index (BMI) suffered more severe acne breakouts than siblings with lower BMI. This is a clear indication that lifestyle choices play an important role in controlling acne breakout severity.

Thanks to the extensive twin research, it’s clear that both genetics and environmental factors play a role in acne breakouts. Genetics determine whether or not your skin is likely to breakout, but how you take care of yourself and your skin is critical in determining the severity of the breakouts.

Resources— Learnskin.com, Well and Good, PracticeUpdate, Owlcation

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