Will Teen Acne Go Away on its Own?

Dr. Gilligan, Chief Scientific Officer at AcnEase, collaborated with me today to clarify the facts about teen acne.     

The Truth About Teen Acne

Most teenagers will experience acne at some point during their adolescent years. A number of factors contribute to teenagers having the highest incidence of acne. Many parents attribute acne to poor diet or lack of attention to proper skin cleansing and moisturizing. However, the real cause of acne is a hormonal imbalance related to adolescence that over stimulates the sebaceous glands.  

A hallmark of teenage skin aside from the pimples is "greasy or oily skin". 

The appearance of oily skin goes hand in hand with the increased appearance of acne. The oily skin is due to an over secretion of sebum (skin oil) by the sebaceous glands. This over production of sebum not only manifests itself as oily skin but can also lead to clogged pores that are seen as "white heads" and "black heads." Once the pores of the skin are clogged with sebum, they accumulate dead skin cells and provide a perfect breading ground for the growth of bacteria. This combination of clogged pores and growth of bacteria is responsible for acne. 

A proper skin cleansing routine with the use of non irritating and non over drying toners and hypo allergenic moisturizers can help but cannot really treat acne. Topical bacteria killing agents such as benzoyl peroxide are also a staple for treating teenage acne, however, neither of these approaches addresses the real problem; that being over secretion of the sebaceous glands.

Why Acne Won't Just Go Away

The answer to this question is based upon understanding the genesis of teen acne. Treating teen acne is indeed necessary for at least three reasons: first - about 35% of teen acne will not go away on its own and will become chronic acne; second - even if teen acne does eventually go away, during the time it's left untreated, potential permanent damage to the skin can occur. This damage manifests itself in the form of acne marks and scars as well as psychological and social issues.

A number of factors can cause an increase in sebaceous gland secretions, but the primary culprit is the androgen hormones. In particular the analogs of testosterone, dihydrotestotsterone (DHT) and dehydroepiandrosterone (DHEAS) which are thought to have the most dramatic impact on sebaceous gland secretions. Understanding that androgen related hormones can influence sebaceous gland secretions is only part of the story. What most people do not know is that both females and males produce testosterone, estrogen and progesterone (just in different amounts), and that only 1-2% of these hormones circulate freely in the blood. The remaining 98% are bound to a protein called Sex Hormone Binding Globulin (SHBG). If the androgen hormones are bound to SHBG in the blood, they will not cause acne - it is only the "free form" of DHT and DHEAS that can cause the sebaceous glands to make more sebum.

Teenagers (male and female), as they transition through puberty, have significant fluctuations in their respective hormone levels. A rapid increase in either estrogen or testosterone will lead to an increase in "free" hormone levels which will result in over production of sebum by the sebaceous glands. 

During the teenage years, there is also a noticeable growth spurt caused by increased levels of growth hormone. Growth hormone is the key hormone responsible for teenagers to reach their optimal adult height. Aside from stimulating growth of the skeleton and muscles, growth hormone decreases the production of SHBG leading again to increased levels of "free" hormones in the blood further stimulating the sebaceous glands and increasing the likelihood of acne.