Updated: November 2, 2023

Acne is a complex skin condition that affects millions of people through adolescence and into their adult years. 

Up until recently, it was widely believed by leading dermatologists and skin researchers that bacteria is the root cause of acne. This philosophy has led to the widespread use of antibacterial acne treatments such as prescription antibiotics and skincare routines that focus primarily on killing bacteria. Learn more with Flawless by Melissa Fox. 

However, recent emerging research is changing the way we approach the treatment of acne. Evidence now suggests that inflammation, not bacteria, may be the true root cause of acne. In this article, we’ll explain how inflammation plays a role at every step in the acne formation process, and how to effectively reduce inflammation through lifestyle and skincare practices to stop acne before it forms.

A red, swollen pimple that is painful to the touch - this is what we all recognize as the signs of inflammation. This type of inflammation happens in response to acne bacteria, or after the bacteria has infected the pore. However, research has now identified the presence of inflammation at a microscopic, cellular level that is present even before the acne bacteria invades the pore. 

Systemic inflammation, or inflammation at a cellular level, is largely caused by oxidative stress. Oxidative stress is a fancy term for an imbalance of toxins and antioxidants in the body - too many toxins, not enough antioxidants. This imbalance impacts our overall health, including our cardiovascular health, mental health and the appearance of our skin. 

Excess oxidative stress triggers our body’s immune response, causing a cascade of inflammation with both visible and invisible side effects, including the formation of acne. 

Symptoms of chronic inflammation include fatigue, anxiety, depression, weight gain, bloating, joint pain- the list goes on.

Research shows that the entire acne process starts when this type of inflammation at a cellular level causes the oil in our pores to oxidize, or become damaged. As inflammation damages the oil in our skin, it creates the ideal environment for acne bacteria. This damaged sebum, or oil, also produces more dead skin cells, which clogs the pore. Once the bacteria invades the pore, infection develops and triggers a secondary inflammatory response leading to those red, round, inflamed pimples that we all know and love.

Inflammation is caused by lifestyle factors, environmental factors, stress, infection, auto-immune conditions and toxins.  Inflammatory foods such as sugar, refined carbohydrates, alcohol, processed meats and trans fats are often listed as foods to avoid in “anti-acne” and “anti-inflammatory” diets.  These foods trigger our body’s inflammatory response, creating the perfect environment for acne bacteria to flourish. 

Stress and environmental pollutants have a similar effect on the body. If you are prone to acne during stressful periods, know that this is because of an overall inflammatory response that affects the entire body in ways you can’t even see!