Retention Hyperkeratosis

It has everything to do with acne – and you might not even know what it is. When we strip acne down to its core, it’s all about retention hyperkeratosis.

Acne is not caused by being dirty, eating the “wrong” foods, or doing something wrong with your skincare. At its foundation, acne is driven by a genetic tendency toward retention hyperkeratosis, a process first clearly defined and taught by Vivant Skincare founder Dr. James Fulton.

Understanding retention hyperkeratosis won’t just make you sound smart – it helps shift the narrative around acne. It reminds people that acne isn’t a personal failure, and it makes the path to effective treatment much clearer.

So, what is retention hyperkeratosis?

Retention hyperkeratosis is the overcreation and retention of dead skin cells (keratin) within the pore. Instead of shedding efficiently, these cells accumulate and stick together, forming a plug.

If you’re born with this tendency, your skin produces dead cells faster than it can properly release them. Think of it like a traffic jam at the surface of the pore: everything behind it keeps coming, but nothing can move forward.

This process doesn’t happen because of something you did – it’s how your skin is wired.

Where oil comes into the picture

Hormones play many important roles in the body, and one of their jobs is signaling the skin to produce sebum, our natural oil. Sebum is essential for healthy, hydrated skin – but when retention hyperkeratosis is present, oil becomes part of the problem.

We have roughly 20,000 pores on the face, each acting as a pathway for oil to reach the surface. When those pores are partially blocked with retained keratin, oil gets trapped inside. Mix oil with dead skin cells, and you’ve created the perfect environment for congestion.

That congestion is the starting point of acne.

The role of bacteria

Everyone has a unique skin microbiome – a mix of bacteria that normally live on the skin. Many of them are harmless, some are helpful, and a few can become problematic under the right conditions.

Acne-related bacteria thrive in low-oxygen environments. When pores are clogged with retained dead skin and oil, oxygen levels drop, allowing these bacteria to multiply more easily. This is when inflammation enters the picture and acne lesions form.

In other words:
Retention hyperkeratosis + oil + bacteria = acne

How acne is treated

Once you understand acne as a disorder of retention, treatment becomes more logical. The foundation of acne care is helping the skin shed dead cells more effectively – in other words, correcting the retention hyperkeratosis.That said, no two cases are exactly alike. While exfoliation is a starting point, the type, strength, and frequency of exfoliation and how it’s combined with other treatments should be individualized. This is where professional guidance matters.

And finally, what acne isn’t

Acne is not a punishment.
It’s not because you’re unhygienic.
It’s not because you ate sugar, forgot to wash your face, or didn’t “try hard enough.”

Hormones, diet, cosmetics, and lifestyle can all influence acne, but they don’t create it from nothing. The underlying predisposition is genetic.

So the next time someone without acne tries to tell you how easy it is to “just clear it up,” feel free to politely move on. Or, if you want to impress them, let them know you have retention hyperkeratosis, and that acne isn’t as simple as using Dove soap or cutting out chocolate.

Retention hyperkeratosis doesn’t define you. But it is part of your DNA. It can go quiet, it can flare up, and with the right approach, it can be controlled – just not cured (at least not yet).