Breakouts occur due to a complex interplay of four primary biological events: follicular hyperkeratosis, increased sebum production, microbial colonisation, and inflammation. When your skin cells do not shed correctly (hyperkeratosis), they block the pilosebaceous unit, creating a plug known as a comedone. Under the influence of androgenic hormones, sebaceous glands increase oil production, providing a lipid-rich environment that allows the anaerobic bacterium Cutibacterium acnes to proliferate rapidly [1].
In the Australian climate, external factors like high humidity and UV radiation can further exacerbate these biological processes. Localised inflammation is often the final step, where the immune system responds to bacterial activity and follicular rupture, resulting in visible papules, pustules, or cysts. Understanding whether your breakouts are driven by hormonal fluctuations, lifestyle factors, or improper product use is essential for selecting an effective targeted treatment [2].
From a biomedical perspective, acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Emerging research suggests that subclinical inflammation may actually precede the formation of the comedone, challenging the traditional view that inflammation is merely a secondary response to bacterial colonisation [3]. This 'inflammation-first' model highlights the importance of using anti-inflammatory agents alongside traditional antimicrobial treatments.
Furthermore, the skin's microbiome diversity plays a critical role in maintaining barrier integrity. An imbalance (dysbiosis) between specific phylotypes of C. acnes, rather than the mere presence of the bacteria itself, is now recognised as a primary driver of lesion development. Modern dermatological science focuses on re-equilibrating this microbiome and stabilising the acid mantle to prevent the cycle of recurrent breakouts [4].
For those looking to address the underlying causes of congestion, our Surface Purify was formulated with Salicylic Acid to gently clear follicular blockages and Bakuchiol to support a clarified complexion without compromising the skin's defence. To further encourage a harmonious environment for the skin's microbiome, many of our customers find that pairing this with Balance Biome Crème helps to restore a sense of calm and resilience through the inclusion of Bifida Ferment Lysate and Niacinamide.
FAQ
How does diet influence skin clarity?
Clinical evidence suggests that high-glycaemic load diets and certain dairy products can stimulate insulin-like growth factor 1 (IGF-1). This hormone promotes sebocyte proliferation and lipogenesis, leading to increased oiliness and potential blockages [5]. Favouring low-glycaemic whole foods may help stabilise these hormonal signals.
Can stress actually cause spots to form?
Yes, psychological stress triggers the hypothalamic-pituitary-adrenal (HPA) axis, leading to the release of corticotropin-releasing hormone (CRH). CRH has been shown to stimulate sebaceous gland activity directly, increasing sebum output and worsening inflammatory responses in the skin [2][6].
Is my sunscreen causing my breakouts?
Some sunscreens contain comedogenic lipids or heavy silicones that may physically occlude pores, a condition known as acne aestivalis. However, in Australia, it is vital not to skip sun protection; instead, look for 'non-comedogenic' or 'oil-free' formulations that utilise lightweight chemical filters or micronised minerals [7].
References:
[1] Zaenglein AL, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. 2016;74(5):945-973. doi:10.1016/j.jaad.2015.12.037
[2] Chen H, et al. Brain-Skin Connection: Stress, Inflammation and Skin Diseases. Inflammation & Allergy - Drug Targets. 2014;13(3):177-190. doi:10.2174/1871528113666140522104422
[3] Tanghetti EA. The Role of Inflammation in the Pathology of Acne. The Journal of Clinical and Aesthetic Dermatology. 2013;6(9):27-35.
[4] Dréno B, et al. Microbiome in healthy skin, update for dermatologists. Journal of the European Academy of Dermatology and Venereology. 2016;30(12):2038-2047. doi:10.1111/jdv.13965
[5] Adebamowo CA, et al. High school dietary dairy intake and teenage acne. Journal of the American Academy of Dermatology. 2005;52(2):207-214. doi:10.1016/j.jaad.2004.08.001
[6] Zouboulis CC, et al. Corticotropin-releasing hormone: An autocrine hormone that promotes lipogenesis in human sebocytes. Proceedings of the National Academy of Sciences. 2002;99(10):7148-7153. doi:10.1073/pnas.102180999
[7] Mills OH, et al. Assessing Comedogenicity. Journal of Applied Cosmetology. 2006;24(2):67-72.
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any new skincare regimen. Content reviewed by a biomedical scientist.
