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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.

  • 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, perhaps due to an increase of androgens. Androgens are steroid 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.

 

 

Who Gets Acne?

 

Adolescents are the most commonly affected. Because of the high hormonal activity during puberty, acne affects many teenagers. Those individuals whose oil glands produce more oil tend to be affected by acne more often than those whose glands don't produce excess oil.

Heredity Can Play A Role

Statistics suggest that heredity is a strong contributing factor for acne. A family history of acne means that there probably is a genetic basis for the condition.

Nice To Know:

Does stress cause acne?

Stress can be partially responsible for acne. Hormonal changes are associated with stress, and hormones stimulate the oil glands. People who are anxious may also change their behavior towards their appearance, leading to inappropriate treatment of the acne that can worsen the condition.

Consult your family physician on methods to reduce stress. These may include:

  • Exercise
  • Recreational breaks
  • Good sleeping habits
  • Meditation
  • Laughter
  • Social support network
  • Reduced consumption of stimulants (such as caffeine)

Does a greasy diet make acne worse?

It was long thought that fatty foods, chocolate and sugar aggravated acne. But dietary causes for acne have never been proven scientifically. So although a well-balanced healthy diet that includes plenty of water is recommended for overall good health, no special restrictions on food are imposed for preventing acne.

 

 

What Causes Acne?

 

There are four major factors responsible for causing acne. They act together to cause the characteristic pimples, whiteheads and blackheads associated with acne. They are:

  • Overactive oil glands
  • Blockage of the skin pores
  • Activity of normal skin bacteria
  • Inflammation

Overactive Oil Glands

Oil glands are located deep in the skin. They are also known as sebaceous glands.

Each oil gland is connected to a tiny canal that contains a hair. The canal with its contained hair is called a follicle.

  • The glands produce oil (also known as sebum) that flows to the surface of the skin through these canals to lubricate the hair follicles and the surrounding skin.
  • The opening of the canal with the attached hair (follicle) onto the skin is the skin pore.

The oil glands vary in size, and the larger ones are associated with visible skin pores.

The oil glands are stimulated to produce oil by hormones, specifically the male hormones called androgens (women also have these hormones, but much less of them). These hormones are produced by the testes in men and by the ovaries in women. In both sexes, androgens are also produced by the adrenal glands.

During times of stress, the adrenal glands produce increased levels of these hormones, causing even greater enlargement of the oil glands.

During puberty, the oil glands become overactive in response to hormonal changes.

Blockage Of The Skin Pores

Oily skin occurs when an overactive oil gland enlarges and overproduces oil. Acne develops when some of the pores (through which oil normally flows from the oil gland to reach the skin surface) become blocked, resulting in trapping of oil within the skin pores.

The pores are blocked by skin cells that have been shed from the lining of the skin pore and have bunched together. The cause for this clogging is not known, but it is not due to poor hygiene. A blackhead or whitehead will develop from this skin pore blockage

Activity Of Normal Skin Bacteria

Although acne is not caused by a bacterial infection, bacteria do play a role in making the situation worse. The bacterium Propionibacterium acnes ( P. acnes ), is a normal part of the skin surface. It keeps the skin from being invaded by harmful bacteria.

When oil is trapped in the hair follicles, the normal skin bacteria P. acnes will grow in the blocked pore. The bacteria produce chemicals that alter the composition of the oil, which makes it more irritating to the skin and causes inflammation.

Inflammation

Inflamed skin is characterized by redness, swelling, warmth and discomfort. Inflammation of the skin occurs because the body's immune system is acting to rid itself of a foreign substance. In the case of acne, this substance is either bacteria or the irritating compounds they have produced.

These four factors contribute to blocked skin pores, which bulge outward to form:

  • Blackheads. These form when the pores are clogged close to the surface of the skin. Because they are exposed to the skin surface, blackheads don't usually become inflamed. Blackheads are dark due to the presence of a dark pigment. This color is not the result of dirt in the pores.
  • Whiteheads. These develop from a blockage deeper in a pore. Lacking a drainage path, the oil accumulates in the skin, causing small flesh-colored or white-colored bumps. Unlike blackheads, whiteheads are more likely to lead to the red inflammations known as pimples or zits.
  • Pustules (also known as pimples or zits) occur when the walls of the blocked follicle ruptures. Oil, dead skin cells, and bacteria normally found on the skin surface get into the skin and irritate it, forming small areas of inflammation.
  • Cysts are larger, red, inflamed areas deep in the skin that indicate a more extensive infection.

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