Why acne keeps coming back, starting with the causes

Acne & Pores

Acne that returns just when it seemed under control. Behind that pattern there is usually not one cause but several overlapping factors.

Acne does not arise from a single cause

Acne is a chronic inflammatory condition that develops in the pores and sebaceous glands. It is often described simply as a problem of oily skin, but in practice four processes are interlocked: sebum production increases, dead cells thicken at the pore opening and block the passage, bacteria multiply inside it, and finally an inflammatory reaction occurs.

Which of these four weighs most heavily differs from person to person. Even under the single name of acne, skin that mainly shows raised white closed comedones and skin in which red, swollen inflammatory lesions keep recurring call for different approaches.

There are reasons why it recurs

A pattern of improving and then worsening again is not unusual with acne. Hormonal cycles, season and humidity, sleep and stress, how rich the cosmetics you use are, and friction from things that touch the skin such as masks or helmets all act as variables.

Another point that is often missed is the moment you feel it has got better. Visible lesions settling down does not mean the condition inside the pore has been resolved along with them. Continuing care for a while even after the surface has quietened can help widen the interval between flare-ups.

What the habit of squeezing leaves behind

The most common and most regrettable habit is squeezing lesions by hand. Pressing an inflamed lesion on your own can spread the inflammation into deeper layers, and acne scars or post-inflammatory hyperpigmentation are then likely to remain in that spot.

Unlike pigmented marks, scars often do not disappear on their own over time. Red marks tend to fade over several months, but depressed scars do not. It is worth weighing looking a little better today against the state of your skin several years from now.

The basics you can keep to at home

• Cleanse twice a day, briefly, with lukewarm water. Scrubbing hard or washing more often can instead stimulate sebum production.
• Adjust the frequency of exfoliation according to your skin condition. When inflammation is severe, it is better to pause for a while.
• Do not skip moisturising. When the skin barrier weakens, the skin becomes more sensitive to irritation.
• Sun protection can help reduce the darkening of pigmented marks.

When a consultation is needed

If lesions are deep and painful, if they recur in the same place, or if marks and scars have already begun to remain, it is better to have the condition assessed rather than judging on your own. The care required differs with how far things have progressed, and missing the right moment can change how much trace is left behind.

This column is general medical information provided to aid understanding. It does not guarantee the results of any specific treatment and does not replace a medical consultation. Treatment results and the course of recovery vary from person to person. Please confirm what is appropriate for your own condition through a consultation.