Acne

Please note: Your Personal DNA Reports show genetic 'susceptibility' to traits, but not a direct relationship. As the majority of traits are influenced by environmental and lifestyle factors as well as your genes, you may find that not every result reflects your lived experience.

What is acne?

Acne, clinically known as acne vulgaris, is a common skin condition that primarily causes pimples on the face. For many of us acne is a rite of passage in teenage years, but severe forms of acne can leave permanent scars, which may affect us throughout our lives.

Recent studies indicate that more than 85% of teenagers suffer acne globally, with approximately 8% reporting severe cases [1] Jump to reference section: [1] . Due to improved biological understanding of acne over the years, we now know that acne is not a teenage rite of passage but a condition that is caused by both genetic and environmental factors. 

Acne develops when skin pores or hair follicles are clogged by dead cells, skin oil and bacteria. The skin on the pore openings then becomes inflamed, swollen, painful, and red. In normally functioning pores, skin cells (keratinocytes) that form the lining of the skin pores are shed to the skin’s surface. The skin oil (sebum) is also produced on the skin’s surface to help nourish it. Where these processes are ineffective, such as in individuals with genes associated with risk of acne, the skin cells and oil are stuck inside the pores leading to the development of acne [2] Jump to reference section: [2] .

Which genes increase the risk of acne? 

TGF B-2 gene  

One gene, called Transforming growth factor-beta 2 (TGF B-2) is involved in how skin cells are formed and specialised to perform their functions. Scientists have discovered this gene plays a role in some of the processes that lead to the formation and progress of acne. Rapid production of skin cells may lead to normal hair growth being blocked and the formation of comedones, which are skin pores that are clogged with oil, bacteria (Cutibacterium acnes) and dead skin cells.

This gene also regulates production of oil by the sebaceous gland - an oil-producing gland in the skin. An ineffective TGF B-2 gene can result in increased production of skin oils as seen in acne patients. Additionally the gene also controls the body’s immune response to acne. Without the fully functioning gene, the body’s immune response to acne is reduced or ineffective, leading to increased acne growth [3] Jump to reference section: [3] . Overall, studies found that individuals with acne had lower expression of the functional TGF B-2 gene compared to those with unaffected skin [9] Jump to reference section: [9] . 

rs1256580

While the risk allele for acne, C, is common among European populations, it is most common in African populations.

rs1159268

The rs1159268 variant of this gene is more frequent among European and African populations. The A allele is associated with increased susceptibility to acne among those with this genetic variant.

WNT10A gene

This gene is involved in the formation of tissues in skin, hair, nails, teeth, and sweat glands from the embryonic stage of growth. It influences the formation of the ectoderm, an outer layer of cells formed in an embryo, that later develops into surface layers such as the skin and sweat glands [5] Jump to reference section: [5] .

Studies have associated this gene with abnormal and increased cell growth that is experienced in acne [9] Jump to reference section: [9] . This is because the gene is involved in mechanisms that determine cell growth rate during the embryonic stage of life, which may later restrict normal function of skin cells leading to conditions such as acne [1] Jump to reference section: [1] .

rs121908120

This variant, including the risk allele, T,  is very common among African and European populations. 

OVOL1 Gene

This gene is involved in the pathways that make skin cells specialise in their functions [4] Jump to reference section: [4] . Ineffective functioning of this gene may prevent proper growth of these cells, affecting how skin cells carry out their functions including production of sebum and healthy functioning of skin pores. The T allele of the variant rs478304 has been associated with increased risk of acne [3] Jump to reference section: [3] .

rs478304

This variant is common among European, African and Asian populations, including the risk allele for acne, T.

What else can increase risk of acne?

Other than genetics, diet, the environment, and hormones (among other factors) may increase your risk of developing acne. The development of acne is centred around how skin oil is produced and released through the skin pores, so any factors that affect this process may contribute to causing acne. 

While the food you eat may not directly cause acne, certain foods play an important role in increasing your acne susceptibility and severity. Dairy products and food with high refined sugar content have been most closely associated with acne susceptibility and severity. These products initiate the production of an insulin-like growth factor-1 (IGF-1) in the body that triggers the mechanism involved in developing acne [10] Jump to reference section: [10] . 

Hormonal changes, especially during puberty and stress, may increase the production of skin oil (sebum) and lead to an acne breakout. Similarly, the use of skincare products and intake of certain medications may cause acne - as these products may enhance oil production or block skin pores. Hormonal changes caused by medications such as antidepressants may also affect the production of sebum [6] Jump to reference section: [6] . 

Environmental factors such as temperature, humidity, air pollution and exposure to the sun may also increase the risk of acne. Temperature, exposure to the sun and low humidity can trigger increased sebum production, while air pollution causes blockage of pores [7] Jump to reference section: [7] .

Note: There are lots of myths about what causes acne. It is important to note that acne is primarily linked to sebum production and the function of skin pores. Despite the involvement of a bacteria, acne is not contagious, nor is it caused by factors such as not washing your face enough, touching the face, or eating chocolates and fried foods [10]. 

What can I do about it?

While you cannot control your genetic susceptibility to acne, you can do things to help prevent yourself from suffering severe forms of the condition.

Washing your face regularly (twice daily), helps unblock pores and allows free movement of sebum to the skin’s surface. Choosing non-oily skincare products or those that do not clog your skin pores can also help reduce the severity of acne. Keeping a food diary and identifying foods that increase your acne so that you can then avoid them can also be a helpful strategy.

It can also be useful to avoid drugs that increase acne risk in instances where the benefits of taking the medication does not outweigh your acne risk. If possible, discuss with your physician whether they could recommend alternative medications with less acne risks.

Finally, you may want to reduce stress by taking part in activities such as exercising and finding time to relax [8] Jump to reference section: [8] .