It’s not you, it’s your skin
You can talk all you want about some people having worse hygiene, or worse diets, or even worse health than others and that being the cause(s) of their acne. But why do some people get away with eating crap and never break out while others break out even on a diet of pure alfalfa pellets?
Well, one of the reasons may lie in your skin itself and how it reacts to hormones. Is this “simple” genetic factor the reason you have acne?
If you’ve been keeping up with me, you know that androgen hormones are largely responsible for acne: they tell our skin to make more sebum, and to make it stickier. They also encourage the build up of dead skin cells by increasing new cell formation but inhibit the sloughing of dead cells. Finally, they increase inflammation, which is why our acne gets so painful, huge and red and takes so frickin’ long to heal.
How are these hormones doing this to our face? Well, our skin contains androgen receptors that can receive any type of androgen, such as the common one testosterone. Turns out testosterone can be metabolized by 5α-reductase (an enzyme) into a much more potent androgen, 5α-dihydrotestosterone (DHT). Both testosterone and DHT can bind to an androgen receptor (AR), but DHT has a ten-fold higher affinity to an AR compared to testosterone.
The minute an androgen binds to an AR is the minute we start experiencing the effects mentioned above. As if things weren’t bad enough, it turns out that having a lot of DHT activity and androgen-AR interaction also suppresses wound healing and increases inflammation.
examples of genetic differences
Well guess what?
There are a lot of genetic factors at play here. And there are a HUGE amout of variables for genetics to influence. For example, there are 3 (three!) different types of 5α-reductase and they all act a little differently. Genetics plays a role in determining how much of each enzyme type a person has and how sensitive to each one a person is.
Another example: androgens aren’t just talking to the ARs and vice versa. Both the hormones and their receptors have the ability to be influenced by any number of enzymes and other hormones, which will change their behavior slightly. For example, there is another hormone called insulin-like growth factor-1 (IGF-1) (which, incidentally, dairy is FULL of, and which is why dairy is contraindicated for acne) that can talk to androgens and affect the behavior of ARs. These secondary “cross talk” interactions are not well understood and can also be influenced to a huge degree by genetics. For example – do the androgens in your body speak IGF-1 fluently? Then you are more prone to acne than someone whose androgens get less “cross talk” from IGF-1.
Yet another example: some people have genetically more sensitive ARs, which receive androgens a lot more easily and eagerly, causing more acne.
Some people have more ARs in their skin period, increasing the activity of androgens on the skin.
A 5α-reductase II deficiency is also inherited. It causes lower DHT levels. These people have a much reduced chance of acne, because their receptors aren’t being bombarded with super androgens as frequently as us acne-prone people’s receptors (curse them!) are.
confused? just read this last bit
To put it simply, acne causing hormones behave differently in different people. Some people have a perfect storm where hormones, hormone receptors and enzymes in the skin all conspire to create the perfect conditions for acne. Some people have skin that, simply for reasons of chance and genetics, does not lend itself to encouraging and increasing the behavior of androgens.
Metaphorically speaking, we all have androgen/AR parties going on on our faces at all times. Some of us got stuck with the frat house rager, while others are having barely-there, civilized dinner
All of this androgen and AR activity and enzyme activity sucks and is super complex. But it has nothing to do with us, our food, our hygiene, our beauty inside or out, or our current state of health. It simply has to do with genetics.
Just FYI. Sometimes, it’s not your fault. 🙂
This does have interesting implications for healing acne though, although messing with hormones is usually, well, really messy and generally discouraged. Preliminary testing shows moderate success, especially with blocking/disabling androgen RECEPTORS, less so with blocking/disabling androgens. Greater success has occured with topical experimental trials than with internally “medicating.”
Well, that’s your daily Experimental Dermatology paper regurgitation!
Signing off for now and as always, sending you LOTS of bliss and beauty,