Genetics, love it or hate it, much of what happens on our skin’s surface seem to be guided by an invisible code within our cells. This gets entangled with environmental factors in complicated ways to produce a pimple you’ll soon discover in the morning. Is there such a thing as the acne gene, and does it mean that you are powerless in controlling your acne?
Thanks for Your Acne Advice…
Some people have clear skin – even in their teen years. The rate of adult acne is increasing, and teenage acne has consistently remained at a high 90 percent in the West. It’s also true that some lucky people do have clear skin, and when they do get an odd pimple, it’s so minor that nobody can notice it except them. It’s also well known that genetic lottery winners of all types tend to be rather callous and cavalier about our lesser mortals’ concerns.
Lorde laughed up some of her experiences and struggled with acne last month. It can be summed up as:
“Susan, have you tried…washing your face?”
Oh my God, that’s *never* crossed my mind! (roll eyes)
It’s funny because it’s true. Those of us who have been blessed with a propensity to break out know what that feels like. Great intention; terrible delivery. This is true of acne, psoriasis, rosacea, and any other skin condition – people who don’t have it just don’t understand. You might say that it’s a part of the human condition – it’s tough not to project what you think and feel – and those with perfect skin can often be callous for this reason – they just don’t understand what it feels like to struggle with skin problems.
Her last line, we can all sympathize with, “Yes, I wash my face! I’m just genetically cursed!”
Genetics and Environment
The nature vs. nurture or genetics vs. environment debate is usually framed in an either/or manner, which is misleading – it’s both. Even so, it’s difficult to pin down exactly how to weigh these factors and to what proportion one side is responsible. Using acne as an example, some estimates have the ratio of genetic factors to environmental factors on acne formation at 80% genetics/20% environment. Others believe that acne is strongly environmental – one of the strongest voices for this is the Cordain study that we covered linking acne and diet, citing the lack of acne in two tribes living in a non-Western society. Both arguments are convincing – parents who struggled with acne, particularly severe acne that can affect the back – tend to have children who also struggle with acne. On the other hand, the evidence is mounting that environmental factors like diets affect acne and a substantial impact on a particular subset of acne patients. I think it’s clear that both genetic and environmental factors are at play in many skin conditions, and this is certainly the case with acne. The way that they interact may differ from condition to condition as well. In psoriasis, for example, it is thought that there are clear genetic factors predisposing people to psoriasis, but many patients can point at an environmental trigger that started their psoriasis as well.
There is no single acne gene – but genetic factors influence your skin physiology in a way that makes acne more or less likely to be a problem for you.
- Sebum production: Oily skin is generally accepted as a distinct skin type – and what it means is that your sebaceous glands work efficiently, lubricating the skin.
- Hormones: Testosterone levels have a strong influence on the inflammatory process that starts the acne process.
- Sensitivity: Sensitivity differences refer to how much testosterone and other hormones affect them. Various anti-inflammatory processes within the skin also vary from person to person.
- Other factors: There are almost certainly many layers that we have yet to unravel that play a role in influencing acne. A clear candidate is how we are likely to respond to stress – which is known to be pro-inflammatory.
Genetics plays an important role in how much problem acne will present both in our teens as well as our adult life, especially for women. At the most simple level, genetics and skincare can be thought of as: What problems did my parents have?
Your biological parents serve as the clearest blueprint for your skin type and the kinds of skin problems that you will likely encounter now and in the future. If one or more of your parents had acne, especially severe acne, in their teens, it’s much more likely that you, too, will have struggled with acne. Twin studies have shown that at least some aspects of acne formation have strong genetic links, such as sebum excretion. This is also true of many other skin conditions as well as skin type. If both your parents have oily skin, it’s very likely that you, too, will have an oily skin type. The way that your parents are aging is also a pretty good blueprint of how you will likely age. We find, usually to our dismay, the same flaws – wrinkles here, fine lines there – that we saw in our parents when we were children.
We can’t choose our biological parents – and therefore, we can’t just opt-out of having acne problems or choose never to have to worry about it. We can, however, choose, at least to a certain extent, how to interact with the environmental factors that affect us. Our genetics can give us an understanding of our skin – skin type, susceptibility to certain skin conditions, and how it will likely show signs of aging in the future. While it’s true that you can’t choose your genetics, you certainly do have control over how you manage your skin and influence how acne affects you.
What You Do Matters
Regardless of what proportion genetics and environment play in the generation of acne, what you do matters. Skincare matters, sun protection matters, and your lifestyle choices matter both in the short and long term.
Diet: The exact relationship between diet and acne is still unknown, but more evidence is showing that the two may be related and strongly related to some people. If you know that consumption of certain foods is correlated with acne breakouts for you, it’s likely not a coincidence. The evidence seems highest for high glycemic foods and dairy.
Stress Management: It’s well known that stress influences many skin conditions, as well as other non-skin conditions.3 Managing stress levels will be important for your skincare as well as your overall well-being. Sleep, diet, and exercise are the main pillars of lifestyle. Specific techniques like meditation or mindfulness can aid you in keeping your stress levels in control.
Avoid bad habits: First, do no harm. Popping your pimples or over-cleansing doesn’t do you any favors. Playing with your hair and face will also make acne more likely to be a problem. We’ve all done these things, and they matter.
Cleansing and Treatment: Acne is a chronic problem for a lot of us. To complicate things further, some people won’t respond to certain treatments. All treatments require patience – as a rule, most acne treatments can’t affect existing acne but only prevent new acne from forming. How you treat your skin does matter, though. Read the 4 step guide to keeping your acne under control.
Do genetics matter? Absolutely. If you have moderate to severe and chronic acne, most of this is likely due to genetic factors. Some people, regardless of how much effort they put into their skincare and lifestyle, will have more problems with acne compared to others who are less prone to acne. It’s important to remember that you can make your acne situation better if you treat it correctly and adjust your lifestyle and habits. Treating acne is never easy, but today the treatment options are vastly superior both in efficacy and safety. While a bit of trial and error can’t be avoided, you will find a treatment that works for you.
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1Some studies show that people who live a drastically different lifestyle may have much lower incidences of acne. https://dermletter.com/skin-care-science/non-western-acne.html
2The study with identical and non-identical twins points out that while there are important genetic elements, environmental factors do change how it manifests in acne severity – even identical twins have different acne severities. https://www.ncbi.nlm.nih.gov/pubmed/2965597