Evolution of Acne

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Isn’t it strange that only humans are affected by acne? I’ve been reading “Acne Rx” by James E. Fulton, MD. He describes how we came to be the only species prone to acne and discusses the skin’s modern uses of sebum:

“When we had course hair all over our bodies, the follicles with their sebaceous glands had plenty to do busily oiling and waterproofing these hairs. In the evolutionary process over millions of years, our skin, becoming more and more complex, took over various protective functions once served by scales, feathers and fur. Loss of dense hair and the skin’s resulting greater diversity was an important step in our metamorphosis into the complex animal we are today. However, the oil glands still producing have not yet caught up with our altered state. As humans grew less hair, the stage was set for the uniquely human disease of acne.”

Is sebum useful for the skin?

“Scientists suspect at this point in human history, sebum has no function at all. Like the appendix, sebum appears to be biologically useless in humans. That said, for a trait (or organ) to be retained over time, ie. oily skin, it doesn’t need to be beneficial. As long as it’s not disadvantageous, the trait will stay. Some speculate that oil moisturizes the skin. “Moisture” is in fact the water content of the skin, and an oil film on the surface could slow down evaporation of water.”

Since our body hasn’t quite caught up with our modern day selves, we need to be ahead of our skin instead. As an acne specialist, I notice similar traits among my clients who have moderate – severe acne. About 95% of them are very oily. How I gauge that is I ask how long they begin feeling oily after washing their face in the morning. This is always a good indication of excess oil production. Anything within 1 – 3 hours is too much in my opinion. The goal with treatment is to use an oil stripping cleanser and wash whenever their skin feels greasy. As long as the skin is producing oil, people who are genetically predisposed to acne will likely breakout. I always recommend if you’re struggling with acne to keep your skin as much on the ‘dry’ side as you can, and this in turn keeps you one step ahead of future breakouts!

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