Increased hormonal activity is the root cause of acne occurrence. This in turn causes excess oil production in the skin’s sebaceous glands. It is a sad fact that the areas most affected by acne are those that are almost constantly visible with today’s youthful fashion trends. Most acne prevention and control compounds contain specific compounds to address the problem. The packaging will indicate the presence of these compounds. One of these is benzoyl peroxide (sometimes in combination with the antibiotic erythromycin). The popular Clearasil contains this agent.

Most affected teenagers address acne prevention with manic scrubbing and dieting. They do this because of a mistaken assumption that the problem is related to poor hygiene or improper nutrition. Avoiding fat-laden junk foods like cheeseburgers is definitely a step in the right direction for other health-related reasons. However, it will do little by ways of acne prevention. Skin hygiene is important, and one can prevent acne to a certain extent by increased and regular cleansing. However, one tends to go overboard and resort to using extreme measures like a face wash of strong toothpaste and other harsh compounds. This will only aggravate the problem by encouraging increased compensatory oil production in the skin.

The belief that astringents discourage excess oil secretion is nothing but a myth. Astringents do take care of superficial oils. However, they are of no use in acne prevention because they cause the skin to contract. This clogs pores and causes long-term aggravation for short-term cosmetic benefits. The best course of action is using a mild cleansing agent to wash town the entire face (not just the fabled T zone or only acne-affected areas) and regular shampooing of hair.

Oily hair causes facial oiliness. This is especially true for those who sport chin/shoulder-length hair. Most importantly, picking at or rubbing of acne blemishes is strictly contraindicated. Doing this can lead to permanent scarring and skin discoloration that will require measures like laser treatment to correct later on. Excessive exposure to sunlight is also a definite no-no – especially if one is using a compound like trenitoin, which increases the skin’s photosensitivity. Tanning lamps can cause the same harmful effect. Females affected with acne must rigorously scan the contents of their cosmetics before using them – only those without an oily base and with the tag ‘noncomedogenic’ (non-obstructing to skin pores) on the label should be used. It is also important to avoid sports headgear such as headbands and cycling helmets. Many fashion accessories that cover part of the facial skin can cause constriction or irritation, too.

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Acne Prevention

Once your acne improves or clears, you may need to continue your acne medication or other treatment to prevent new acne breakouts. In some cases, you might need to use a topical medication on acne-prone areas, continue taking oral contraceptives or attend ongoing light therapy sessions to keep your skin clear. Talk to your doctor about how you can prevent new eruptions.

You can also prevent new acne breakouts with self-care measures, such as washing your skin with a gentle cleanser and avoiding touching or picking at the problem areas. Other acne prevention tips include:

* Wash acne-prone areas only twice a day. Washing removes excess oil and dead skin cells. But too much washing can irritate the skin. Wash areas daily with a gentle cleanser and use oil-free, water-based skin-care products.
* Use an over-the-counter acne cream or gel to help dry excess oil. Look for products containing benzoyl peroxide or salicylic acid as the active ingredient.
* Avoid heavy foundation makeup. Choose powder cosmetics over cream products because they’re less irritating.
* Remove makeup before going to bed. Going to sleep with cosmetics on your skin can clog tiny openings of the hair follicles (pores). Also, be sure to throw out old makeup and clean your cosmetic brushes and applicators regularly with soapy water.
* Wear loosefitting clothing. Tightfitting clothing traps heat and moisture and can irritate your skin. Also, whenever possible, avoid tightfitting straps, backpacks, helmets or sports equipment to prevent friction against your skin.
* Shower after exercising or doing strenuous work. Oil and sweat on your skin can trap dirt and bacteria.

Acne Prevention – Tip #1: Don’t over-wash. Since dirt is not causing your acne, excessive scrubbing and washing won’t make it go away. Try to limit yourself to two washings per day anything more than that can leave your healthy skin dry, and your acne-prone areas irritated. Habitual over-washing may also stimulate extra oil production, which could result in more breakouts.

Acne Prevention – Tip #2: Skip harsh scrubs. It’s okay to exfoliate, but be sure to use a gentle formula with small, smooth grains. Avoid products with almond or apricot shell fragments; they can irritate or even tear your skin and further aggravate your acne.

Acne Prevention – Tip #3: Say no to alcohol. If you use a toner, avoid products with high concentrations of isopropyl alcohol, or common rubbing alcohol. A strong astringent, alcohol strips the top layer of your skin, causing your sebaceous glands to produce more oil. The result? Dry, red skin and possibly more blemishes.

Acne Prevention – Tip #4: Don’t squeeze or pick. Squeezing or picking your blemishes with fingernails, pins or anything else can force bacteria deeper into the skin, causing greater inflammation and infection. You’ll also increase the damage to the surrounding skin, so the blemish is more likely to leave a permanent acne scar.

Acne Prevention – Tip #5: Hands off! Propionibacterium acnes (the bacteria that causes breakouts) is a normal resident of your skin; it doesn’t lead to acne until it gets trapped inside the hair follicle. Excessive touching of your face, including rubbing or even resting your chin in your hands, can drive bacteria into your pores  where it can begin its dirtywork.

Acne Prevention – Tip #6: Work out, wash off. When you exercise, your movement generates heat; clothing and equipment cause friction. Until you shower off, heat and moisture are trapped against your skin, creating an ideal breeding ground for the spread of bacteria. So whenever you can, shower off immediately after exercising.

Acne Prevention Treatment – Find a regimen and stick with it. Most cases of mild acne can be improved with “over-the-counter” products, or products that don’t require a prescription from your doctor. There is a wide range of treatments available, and theres a good chance one of them will work for you. If you start treatment before your acne gets severe, youll have a better chance of avoiding physical and emotional problems down the road. But if your acne gets worse or lasts more than a couple of weeks, see a dermatologist.

You may need other tests if your doctor suspects that acne is a symptom of another medical problem (such as higher-than-normal amounts of testosterone in a woman).

The Acne Test

Do you think you really understand acne? Do you have all the answers? Are you ready to take the acne test?

Below are several questions about acne. They are based on questions that everyone likes to ask and also answer. Several acne myths are also addressed in the acne test. Let’s get started!

True or False?

1. You will outgrow acne.

2. Acne is caused by dirt.

3. Acne is caused by chocolate.

4. Makeup makes acne worse.

5. Tanning beds reduce acne.

6. Good diet and exercise reduces acne.

7. Heavy washing and scrubbing reduces acne.

Answers

Will you outgrow acne? Maybe. According to the American Academy of Dermatology (AAD), 17 million people in the United States have acne right now. 85-95% of all people between 12 and 24 are hit by acne. The sad truth is that acne can strike at any age. As you get older, your body changes and you could be a victim. This is especially true for women due to hormone changes, particularly during pregnancy and menopause.

Is acne caused by dirt and grime? To a degree, yes, but not really. Poor hygiene is only a minor cause of acne. That’s because acne is caused a buildup of dead skin and naturally produced body oils. This in turn will clog your pores and bacteria become active. The outcome is acne. Note that there are many other factors, such as genetics and environment.

Does chocolate increase acne? There isn’t a lot of scientific evidence that there is a substantial connection between diet and acne. However, there does seem to be at least a minor connection. Based on what thousands of people have reported, it is very likely that good eating habits contribute to better skin which will reduce acne. The bottom line is that you don’t have to give up chocolate, but you should only have it in moderation.

Does makeup increase acne? No, the use of makeup will not generally cause or increase acne. There’s one catch. The makeup needs to be oil free and hypoallergenic. So, feel free to use the right kinds of makeup, especially since it’ll raise self-esteem.

Does tanning reduce acne? Unfortunately, tanning will not reduce acne. It might decrease redness but the acne itself won’t go away due to tanning. Further, tanning increases the likelihood of dry and irritated skin. It’ll also prematurely age your skin and increase your risk for developing skin cancer.

Does eating well and doing exercise help eliminate acne? It does seem that good health leads to healthier skin, which reduces acne. A balanced diet can’t hurt. If nothing else, it will improve your body image. In short, eat well and get some exercise to reduce acne.

Does scrubbing really hard eliminate acne? The short answer is no. Again, hygiene isn’t really related to acne. You’ll want to regularly wash you face to remove dead skin cells, surface dirt, and excess body oil. But, too much cleansing or washing will simply lead to dryness and irritation. That can make acne a lot worse. The recommendation is to gently wash your face 1-2 times per day and avoid harsh chemicals and cleaners

Acne Treatments

Treatments for acne include:

* Antibiotics taken by mouth or applied to the skin to control the growth of bacteria
* Synthetic forms of vitamin A (retinoids) taken by mouth or applied to the skin. The retinoid Accutane is a powerful oral drug used to treat very severe cases of acne. Pregnant women most avoid Accutane because it can cause birth defects
* Prescription formulas of chemicals such as benzoyl peroxide
* Sunlight. However, sun exposure must be limited as it can cause skin cancer

Your acne is caused when holes present in your skin in the form of pores and hair follicles get clogged by dead skin cells and excessive sebum content. Pores are little holes present on your skin. These pores are actually hair follicles containing very fine hair. Each hair follicle is connected to a sebaceous gland.

The sebaceous gland produces an oily substance called sebum. Sebum helps in keeping the skin soft. This sebum reaches the surface of the skin through the hair follicle. The hair follicle is lined with cells called Keratinocytes.

Now, during puberty, testosterone, a hormone present both in males and females, increases. This increase in testosterone encourages the sebaceous gland to produce more sebum. This sebum, hair, and keratinocytes fill and plug the hair follicle. Plugging of the follicle is the earliest sign of acne. Because the follicle is plugged, sebum cannot reach the surface of the skin. This means that the follicle is filled with oil (sebum) and cells (keratinocytes). A mixture of both these causes Propionibacterium acnes or P. acnes, which is present on the skin, to grow in the plugged follicle.

This bacteria in the plugged follicle, induces the white blood cells to attack it. When the white blood cells attack, they cause the skin to inflame. This inflammation is characterized by heat, swelling, redness and pain.

In due course of time, the wall of the hair follicle breaks down, spilling everything, that is, sebum, dead cells, and bacteria, on the nearby skin. This leads to lesions or pimples, which we commonly refer to as Acne. Acne can be either mild, moderate or severe.

Now that you know how acne develops, it is necessary to check out the factors that contribute to your acne. Following factors contribute to acne:

1. Hormones: At puberty, the body begins producing hormones called androgens (male hormones, but present in both males and females). These stimulate the sebaceous glands, which in turn, produce extra sebum. Androgen is also responsible for acne flare-ups during the menstrual cycle and at times, pregnancy.

2. Excess sebum: Excess sebum is responsible for plugging the hair follicle. It mixes with P. acnes and causes acne.

3. Dead cells: Generally, dead cells are thrown out gradually by the skin. But, when these dead cells mix with the excess sebum, they contribute to the plugging of the hair follicle, thereby pausing the skin’s natural process of throwing out dead cells.

4. Propionibacterium acnes or P. acnes: Though P. acnes is present on all skin types at all times, it starts multiplying rapidly once a follicle is plugged.

5. Inflammatory Response: In order to control unwanted bacteria, the body sends out white blood cells to fight against it. The skin reacts to these white blood cells by inflaming. This inflammation causes the pimples to become swollen, red and painful.

Remember that the functioning of these five factors is different for different people. That is, acne is a highly individualized problem. So, do not compare yourself with your friend.

How Acne Begins

Acne develops with your hair follicles, the lining of the skin duct surround hair follicles, and the sebaceous glands that produce oil. Your skin cells are in a continuous state of renewal. Usually, as the old cells die, they mix with your skin’s natural oil and are sloughed off. Some people don’t shed dead cells evenly and the cells become sticky. These sticky cells and oil form a plug, called a comedo, in the hair follicle—like a cork in a bottle.

This cork-like plug holds the oil and bacteria in the follicle, which begins to swell as your skin produces more oil. Your own white blood cells swarm around the follicle to kill the bacteria. The result is a pimple or red bump which appears within 2-3 weeks.

Your chances of getting acne are affected by many factors. The tendency to slough dead skin cells changes through life. The rate your skin produces oil is determined by your hormones. Because genetics play such a strong role in the development and persistence of acne, your family history is important. If one of your parents had severe acne, yours is more likely to be severe too. Early breakouts—before the age of 10—can indicate more severe acne later.

There are 2 types of acne: non-inflammatory and inflammatory acne.

Non-inflammatory Acne

Although all pimples start the same way, they may appear different on your skin. If the plug stays below the surface of the skin, it’s called a closed comedo or whitehead. If the plug enlarges and pops out of the duct, it’s called an open comedo or blackhead. This is not dirt and won’t wash away. The color is due to a buildup of melanin, the dark pigment in the skin.

Most people have non-inflammatory acne, a relatively mild form with just a few whiteheads and blackheads. Non-inflammatory acne can be treated with non-prescription medicines like Proactiv® Solution.

Inflammatory Acne

With inflammatory acne, the whiteheads become infected with bacteria and swell, producing pimples and pustules. Severe inflammatory acne can cause disfiguring cysts and deep scars, and is usually treated with prescription drugs like Accutane or oral antibiotics such as tetracycline, sulfa, or erythromycin.

Acne – What Happens

Acne develops most often in the teen and young adult years. During this time, both males and females usually produce more testosterone than at any other time in life. This hormone causes oil glands to produce more oil (sebum). The extra oil can clog pores and cause acne. Bacteria can grow in this mixture. And if the mixture leaks into nearby tissues, it causes swelling, redness, and pus (pimples).

Acne usually gets better in the adult years when your body produces less testosterone. Still, some women have premenstrual acne flare-ups well into adulthood.

In non-inflammatory acne, there are usually just a few whiteheads and blackheads on the face. A relatively mild type of acne, it can often be treated effectively with nonprescription medicines. The majority of people with acne have this type of acne.

With inflammatory acne, the whiteheads become inflamed, and red pimples and pustules develop. In its most severe form, inflammatory acne can cause disfiguring cysts and deep, pitting scars of the face, neck, back, chest and groin. Prescription drugs and sometimes surgery are needed to treat inflammatory acne.

Acne Symptoms

What are some common acne symptoms? Surprisingly, signs of acne can go way beyond that typical pimple.

Acne vulgaris, or common acne, is a disorder of the pilosebaceous unit, causing some form of lesions on the skin.

Non-Inflamed Acne
Acne can be divided into two categories: inflamed and non-inflamed. Non-inflamed acne breakouts consist of microcomedones, blackheads, and milia. These types of comedones are not red or painful. Symptoms of non-inflamed acne include bumps or bumpiness across the skin’s surface, or an uneven skin texture. Even if comedones are not readily visible, they will make the skin feel rough or “sandpapery.”

People with non-inflamed acne experience blackheads, milia, and closed comedones but rarely have reddened breakouts, such as papules or pustules. Left untreated, non-inflamed acne may progress to inflamed acne.

Inflamed Acne
Inflamed acne is characterized by redness and inflammation. Those with inflamed acne will have microcomedones, blackheads, and milia, as well as papules, pustules, and possibly nodules and cysts. Symptoms also include redness, swelling, and irritation of the skin, along with possible crusting, oozing, or scabbing of the lesions.

Inflamed acne ranges in acuity from very mild to extremely severe. Some inflamed acne sufferers will experience only the occasional pustule while others will battle angry-looking cysts. Cystic acne is the most serious form of inflamed acne. Inflamed acne sufferers are most at risk for skin damage and scarring.

Range of Acne
The areas of the body most typically affected by acne are:

* face
* neck
* chest
* shoulders
* upper arms
* back

Less commonly, acne appears on the torso, arms, and legs.

Pigmentation and Scarring
Most acne sufferers have to deal with at least some degree of pigmentation problems or scarring. Discolored, darkened, or reddened spots or blotches are common on acne prone skin. These problems can persist even after breakouts have fully healed.

Post-inflammatory hyperpigmentation (PIH) is the medical term used to describe discolored spots (macules) left behind after an acne lesion has healed. Those who have any type of inflamed breakouts are at risk for post-inflammatory hyperpigmentation. Luckily, PIH is not a true scar and will fade over time.

Acne Symptoms

Acne typically appears on your face, neck, chest, back and shoulders, which are the areas of your skin with the largest number of functional oil glands. Acne can take the following forms:

* Comedones (whiteheads and blackheads). Comedones (kom-uh-DO-neze) are created when the openings of hair follicles become clogged and blocked with oil secretions, dead skin cells and sometimes bacteria. When comedones are open at the skin surface they’re called blackheads because of the dark appearance of the plugs in the hair follicles. When comedones are closed, they’re called whiteheads — slightly raised, skin-colored bumps.
* Papules. These are small raised bumps that signal inflammation or infection in the hair follicles. Papules may be red and tender.
* Pustules. Similar to papules, pustules are red, tender bumps with white pus at their tips.
* Nodules. These are large, solid, painful lumps beneath the surface of the skin. They’re formed by the buildup of secretions deep within hair follicles.
* Cysts. These are painful, pus-filled lumps beneath the surface of the skin. These boil-like infections can cause scars.

If you noticed the acne you had when you were 15 has returned in your 30s, rest assured, you’re in good company. One in five women between the ages of 25 and 40 suffer from adult acne. Here are a few facts about adult acne and how to rid your skin of it:

Fact #1: Acne usually begins with blackheads Blackheads are not dirt, they’re actually the result of oil and dead cells getting trapped in a pore where they block the duct and mix with bacteria. They then turn black when exposed to air. Red pimples develop when blackheads become inflamed and they spread when touched with dirty hands. When the pimple becomes infected, it develops a whitehead or pustule. These can break and cause scars.

So how to banish blackheads? Gently, according to San Francisco dermatologist Seth Matarasso in InStyle Magazine. People tend to scrub too hard which causes inflammation, he says. Instead of a grainy scrub, Matarasso suggests trying an exfoliant with alpha-hydroxy acids. A good one is Lancome Pure Focus Deep Pore Refining Scrub. You can also use a salicylic acid cleanser like Bliss Clog Dissolving Cleansing Milk. These chemical products clean out pores better than scrubs. For a great quick fix, Biore Pore Perfect Strips will get rid of your blackheads.

Fact #2: There are several causes of adult acne These are: Stress, bad cosmetics, hormones and birth control pills. Stress causes your oil glands to overcompensate. Bad cosmetics lead to bacteria-laden pores. Hormones cause the sebacuous glands to overact and birth control pills with androgen in them can cause breakouts.

To keep breakouts at bay, look for oil-free, non-acnegenic products like Clinique Dramatically Different Moisturizing Gel and Neutrogena Oil-free Cleanser.

Fact #3: Cheese and chocolate have nothing to do with your acne Your skin, however, WILL benefit from a good facial. Why? Because acne is not a disease, rather it is a condition of the skin and a good facialist knows exactly what your skin needs: Sulfur, zinc and camphor masks, exfoliation, blackhead extractions and at-home follow-up.

Fact #4: Don’t treat adult acne like the teen kind The products you used as a teenager won’t work on adult skin. Here’s a 2-step program for cleansing and treating your blemished skin:

Step 1: Pick the right cleanser. Look for medicated cleansers with benzoyl peroxide or salicylic acid. A good choice is Biore Shine Control Cream Cleanser

Step 2: Exfoliate with a salicylic acid treatment, which will clean out pores. Just don’t exfoliate too much or scrub too hard (see the blackhead section above). Two to 3 times a week is perfect.

Fact #5: Treatment systems have completely cleared up skin on many people Proactiv Solution 3-step System is a classic kit that has worked wonders on many. Mario Badescu Drying Lotion is another program that is highly recommended and my friends with acne personally recommend MD Skincare All-Over Blemish Solution.

Fact #6: The dermatologist will clear your skin up fast Too many women wait to see a doctor for their skin problems. If you have basic acne, over-the-counter treatments with salicylic acid (there’s that magic word again) to unclog pores and benzoyl peroxide to reduce bacteria on skin should do you, but for serious acne, a dermatologist has an arsenal of products to clear up your skin.

Retinoids, antibiotics, azelaic acid and birth control pills are all options usually covered by insurance. You might consider laser treatments, but these are more costly (about $500-$2,400). Severe cases are best cleared up by Accutane, which is a 5-month course that is considered the most effective treatment available. It can, however, cause serious birth defects if taken during pregnancy.

Fact #7: Yes, those new machines that target acne do work We were surprised to hear this as well, but the reports are out on machines like Zeno Acne Clearing Device and they are good. They won’t help blackheads or deep cystic acne, but they do work for your general run-of-the-mill pimples, according to Glamour Magazine.

So how do they work? The Zeno, which is a handheld machine that looks like an iPod, works by driving heat through a pimple. The heat kills the bacteria and supposedly improves blood circulation to the affected area so it heals faster. Clinical trials show 90% of pimples treated with Zeno disappeared or were significantly reduced within 24 hours.

Cause

There are different types of acne. The most common acne is the type that develops during the teen years. Puberty causes hormone levels to rise, especially testosterone. High hormones cause signal skin glands to start making more oil (sebum). Oil releases from the pores to protect the skin and keep it moist. Acne begins when oil mixes with dead cells and clogs the skin’s pores. Bacteria can grow in this mixture. And if this mixture leaks into nearby tissues, it causes swelling, redness, and pus. A common name for these raised bumps is pimples.

See a picture of how pimples form Click here to see an illustration..

Certain medicines can cause acne to develop. This type of acne usually clears up when you stop taking the medicine.

It isn’t just teens who are affected by acne. Sometimes newborns have acne because their mothers pass hormones to them just before delivery. Acne can also appear when the stress of birth causes the baby’s body to release hormones on its own. Young children and older adults also may get acne.

A few conditions of the endocrine system, such as polycystic ovary syndrome and Cushing’s syndrome, can lead to outbreaks of acne.

Acne Cause

Acne Causes

Several factors contribute to the development of acne. The primary problem is that the abnormal flaking of cells inside the hair follicle leads to the formation of a plug. The plug can enlarge and even rupture the hair follicle. A ruptured hair follicle spills its contents of oil and debris into the skin where it leads to swelling and causes redness (inflammation).

* Bacteria that normally live on the skin also play a role in acne development. The bacteria known as Propionibacterium acnes are responsible for causing acne. These bacteria produce substances that cause redness and irritation (inflammation). They also make enzymes, which dissolve the sebum (oil from oil glands in the skin) into irritating substances. These substances also make the inflammation worse.

* Certain hormones called androgens are an additional factor in causing acne. Androgens are male hormones that are present in both men and women, but are higher in men. Androgens do two things: First, they enlarge the sebaceous glands in the skin. Second, they cause these glands to increase sebum (oil) production. The increased sebum leads to plug formation and serves as more “food” for the bacteria. Androgens surge at puberty, which is why teens develop armpit and pubic hair, and why boys develop facial hair and deeper voices. This hormonal surge also contributes to the development of acne in teens.

* Estrogens, which are the female hormones, actually can help to improve acne in girls. A woman’s monthly menstrual cycle is due to changes in the estrogen levels in her body. This is why acne in a female may get better and then get worse as she goes through her monthly cycle. A doctor may recommend acne treatment with birth control pills, which contain the helpful estrogens.

* We also now believe that acne can run in some families. This may be due to some genetic factor that has not yet been discovered.

* Anatomy of the hair follicle: Hair follicles exist on virtually all skin except for the palms of the hands and soles of the feet. Inside the follicle, the hair extends up from the deep layers of the skin and comes out of a pore. Near the surface, the oil gland (sebaceous gland) enters the hair follicle where it empties oil (sebum) at a relatively constant rate. The sebum lubricates the skin and provides a protective barrier to prevent drying. Skin on the face, chest, and back has an especially large number of sebaceous glands. These are the areas where acne occurs.

* Acne lesions: There are 2 major types of acne lesions: noninflammatory and inflammatory. Noninflammatory acne lesions include blackheads (open comedones) and whiteheads (closed comedones). Open and closed comedones along with papules and pustules are referred to as papulopustular acne-a form of inflammatory acne. Nodular acne is the most severe form of inflammatory acne.

o Noninflammatory acne: Open comedones result from the enlargement and dilation of a plug that forms from oil and flakes of skin inside the hair follicle.

+ The hair follicle pore remains open exposing a black plug (known as a blackhead). The dark color is not dirt inside the pore. Instead it is the oil inside the pore, which has become exposed from the outside air.

+ A closed comedo forms if the hair follicle pore remains closed. The plug in a closed comedo or whitehead is therefore not exposed to the outside air, and no black color develops. The closed comedo simply appears as a tiny, sometimes pink bump in the skin.

o Inflammatory acne: Inflammatory acne lesions consist of red blemishes, pimples also called zits (papules, pustules), and larger, deeper swollen tender lesions (nodules).

+ Papules are closed comedos, which have become red, swollen, and inflamed.

+ Pustules are closed comedos, which become inflamed and begin to rupture into the skin forming pustular heads of various sizes.

+ Nodules represent large, tender, swollen acne lesions, which have become intensely inflamed and rupture under the skin. If untreated, these can produce deep scarring.

Causes of acne

Acne is caused by overactivity of the sebaceous glands that secrete oily substances on to your skin.

The surface of your skin has lots of small sebaceous glands just below the surface. These glands make sebum (a natural oil) that keeps the skin smooth and supple.

Tiny pores (holes in the skin) allow the sebum to come to the surface of your skin. Hairs also grow through these pores.

The sebaceous glands of people with acne are especially sensitive to normal blood levels of a hormone called testosterone, found naturally in both men and women.

If you are prone to acne, testosterone triggers the sebaceous glands to produce excess sebum. At the same time, the dead skin cells lining the openings of the hair follicles (the tubes that hold the hair) aren’t shed properly and clog up the follicles.

The combination of these two effects causes a build-up of oil in your hair follicles. This causes blackheads and whiteheads to form.

For some people, their acne doesn’t progress beyond this stage.

However, in other people the build-up of oil in the hair follicles creates an ideal environment for a bacterium called Propionibacterium acnes to grow.

These bacteria usually live harmlessly on your skin but when the conditions are right, they grow. They feed off the sebum and produce substances that cause an immune response. This inflames the skin and creates the redness associated with spots.

In more severe inflammatory acne, cysts develop beneath the skin’s surface. If these cysts rupture, the infection can spread. This can result in scars.

Contrary to popular belief, acne isn’t caused by diet or hygiene. However, acne can be hereditary.

Acne isn’t infectious, so you can’t catch it.

Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent. However, the disease is not restricted to any age group; adults in their 20s – even into their 40s – can get acne. While not a life threatening condition, acne can be upsetting and disfiguring. When severe, acne can lead to serious and permanent scarring. Even less severe cases can lead to scarring.

Types of Acne
When you read about acne or other skin diseases, you encounter words or phrases that may be confusing. For example, the words used to describe the lesions of acne—comedo, papule, pustule, nodule and cyst—are understandable only if you know each word’s definition. It also is helpful to have a photo that is characteristic for each type of lesion.

Here is a brief summary of definitions of words used to describe acne, with accompanying photos. Let’s begin, though, with the definition of lesion, an
all-purpose word:

Acne

Lesion—a physical change in body tissue caused by disease or injury. A lesion may be external (e.g., acne, skin cancer, psoriatic plaque, knife cut), or internal (e.g., lung cancer, atherosclerosis in a blood vessel, cirrhosis of the liver).

Thus, when you read about acne lesions you understand what is meant—a physical change in the skin caused by a disease process in the sebaceous follicle.

Acne lesions range in severity from comedones (blackheads and whiteheads) to nodules and cysts. Here is a brief definition of acne lesions:

Comedo (plural comedones)—A comedo is a sebaceous follicle plugged with sebum, dead cells from inside the sebaceous follicle, tiny hairs, and sometimes bacteria. When a comedo is open, it is commonly called a blackhead because the surface of the plug in the follicle has a blackish appearance. A closed comedo is commonly called a whitehead; its appearance is that of a skin-colored or slightly inflamed “bump” in the skin. The whitehead differs in color from the blackhead because the opening of the plugged sebaceous follicle to the skin’s surface is closed or very narrow, in contrast to the distended follicular opening of the blackhead. Neither blackheads nor whiteheads should be squeezed or picked open, unless extracted by a dermatologist under sterile conditions. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci and other skin bacteria. The following photos are characteristic of acne with comedones:

Papule—A papule is defined as a small (5 millimeters or less), solid lesion slightly elevated above the surface of the skin. A group of very small papules and microcomedones may be almost invisible but have a “sandpaper” feel to the touch. A papule is caused by localized cellular reaction to the process of acne. This photo shows papules and comedones on the face of an acne patient:

Pustule—A dome-shaped, fragile lesion containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria. A pustule that forms over a sebaceous follicle usually has a hair in the center. Acne pustules that heal without progressing to cystic form usually leave no scars. This photo shows pustules, papules and comedones on the face of an acne patient

Macule—A macule is the temporary red spot left by a healed acne lesion. It is flat, usually red or red-pink, with a well defined border. A macule may persist for days to weeks before disappearing. When a number of macules are present at one time they can contribute to the “inflamed face” appearance of acne. This photo shows the “red face” appearance of acne with macules:

Nodule—Like a papule, a nodule is a solid, dome-shaped or irregularly-shaped lesion. Unlike a papule, a nodule is characterized by inflammation, extends into deeper layers of the skin and may cause tissue destruction that results in scarring. A nodule may be very painful. Nodular acne is a severe form of acne that may not respond to therapies other than isotretinoin (Click on Acne Treatments)

Cyst—A cyst is a sac-like lesion containing liquid or semi-liquid material consisting of white blood cells, dead cells, and bacteria. It is larger than a pustule, may be severely inflamed, extends into deeper layers of the skin, may be very painful, and can result in scarring. Cysts and nodules often occur together in a severe form of acne called nodulocystic. Systemic therapy with isotretinoin is sometimes the only effective treatment for nodulocystic acne. Some acne investigators believe that true cysts rarely occur in acne, and that (1) the lesions called cysts are usually severely inflamed nodules, and (2) the term nodulocystic should be abandoned. Regardless of terminology, this is a severe form of acne that is often resistant to treatment and likely to leave scars after healing. These photos show nodular, cystic acne:

Who gets acne?
Close to 100% of people between the ages of twelve and seventeen have at least an occasional whitehead, blackhead or pimple, regardless of race or ethnicity. Many of these young people are able to manage their acne with over-the-counter (nonprescription) treatments. For some, however, acne is more serious. In fact, by their mid-teens, more than 40% of adolescents have acne severe enough to require some treatment by a physician.

In most cases, acne starts between the ages of ten and thirteen and usually lasts for five to ten years. It normally goes away on its own sometime in the early twenties. However, acne can persist into the late twenties or thirties or even beyond. Some people get acne for the first time as adults.

Acne affects young men and young women about equally, but there are differences. Young men are more likely than young women to have more severe, longer lasting forms of acne. Despite this fact, young men are less likely than young women to visit a dermatologist for their acne. In contrast, young women are more likely to have intermittent acne due to hormonal changes associated with their menstrual cycle and acne caused by cosmetics. These kinds of acne may afflict young women well into adulthood.

Acne lesions are most common on the face, but they can also occur on the neck, chest, back, shoulders, scalp, and upper arms and legs.

Acne also has significant economic impact. Americans spend well over a hundred million dollars a year for nonprescription acne treatments, not even taking into account special soaps and cleansers. But there are also the costs of prescription therapies, visits to physicians and time lost from school or work.

What is Acne?

What is acne? How and why does acne develop? And, most importantly, what can be done to treat acne?
Answer:

Acne at its most basic is a disorder of the pilosebaceous unit, or what is commonly called the hair follicle or pore. According to the American Academy of Dermatology, it is the most common skin disorder in the United States. Acne vulgaris, as common acne is known, is classified as a chronic inflammatory disease of the skin.

Acne is characterized by the presence of pimples or “zits”, blackheads, and whiteheads. It chiefly affects the face, neck, chest, back, and/or upper arms of sufferers. Rarely you will find acne in other areas of the body. Acne varies in development from very mild to extremely severe.

Who suffers from acne?
Acne most frequently effects teens and preteens. Three out of four teens will experience acne. Acne strikes both sexes equally, but teen boys tend to have longer lasting and more severe acne than do girls.

But acne is not limited to teens. Many men and women suffer from adult onset acne breakouts. Acne can also occur in babies, toddlers, and children.

How does acne develop?
Acne occurs when oil and dead skin cells become trapped within the hair follicle, creating a plug within the pore. This plug of dead cells and oil is called a comedo. Blackheads and whiteheads are examples of non-inflamed comedones.

As the breakout progresses and bacteria invade, the follicle wall may rupture within the dermis, creating inflammation and redness. Inflamed blemishes vary in severity depending on the damage to the follicle wall and the amount of infection present. Severe cases of acne may lead to deeper lesions and cysts.

Most people with acne have a number of non-inflamed lesions, or comedones. However, not every acne sufferer necessarily suffers from inflamed breakouts.

What Is Acne?

Acne is a skin condition that occurs due to the overproduction of oil by the oil glands of the skin. The oil that normally lubricates the skin gets trapped in blocked oil ducts and results in what we know as pimples, blackheads, and whiteheads on the surface of skin. Sometimes it also includes deeper skin lesions that are called cysts.

Acne

* Pimples are small skin swellings that sometimes contain pus.

* Blackheads are dark formations on the skin due to an accumulated mixture of oil and cells in a blocked skin pore.

* Whiteheads are small flesh-or white-colored bumps due to skin pore blockage.

* Cysts are closed sacs beneath the skin or deeper that contain fluid or semisolid substances.

The areas of the skin that are most susceptible to acne are those areas that contain the largest number of oil glands. For example, it is estimated that there are 2,000 oil glands per square inch on the forehead alone. The face, chest, shoulders, and back are the areas with the highest population of oil glands.

Acne commonly occurs in people between their teenage years and their 20s. However, it is not restricted to this age. Older adults and children can also have acne.

Facts About Acne

* In most people, acne will last for about three to four years and in 15% of the cases, acne can continue for eight-12 years.

* In a smaller percentage (5%), acne will last beyond age 25 and can continue up to age 40.

* In women particularly, acne may not occur until age 25.

* In 70% of the cases, women will notice a flare-up in the acne condition prior their menstrual period the monthly discharge of menses or blood in women, perhaps due to an increase of androgens steroid hormones responsible for the development and maintenance of male physical characteristics. Androgens are steroid a naturally occurring fat-soluble organic compound present in bile acids, many hormones, some natural drugs, and precursor of certain vitamins hormones responsible for the development and maintenance of male physical characteristics.

* The more severe cases of acne tend to occur most often in men, because they produce more of the male hormones that stimulate acne formation.

* Women with a lot of body or facial hair, and those who have irregular periods, may be at increased risk of acne. These women may want to have their hormone levels evaluated by a physician.