What Causes Acne?

Understanding Acne is important in helping to treat acne successfully

Acne is caused by clogged pores or follicles (small openings in the skin) that contain a hair and sebaceous (oil) gland. It can show up anywhere on the body but it is usually found on the face, back, shoulders, and chest. Follicles become clogged with dead skin cells and oil (called sebum) made in the pore.

Humans have hundreds of hair follicles, or pores, on the surface of the skin through which hair grows. Deep inside each follicle is a hair shaft attached to small glands called sebaceous glands. These glands make an oily substance called sebum to moisten our hair and skin. Sometimes when too much sebum is made, it can mix with dead skin cells (that we are constantly shedding) to create a sticky plug. Trapped bacteria called P. acnes grow very fast in these plugged follicles and make chemicals that can cause swelling, redness, and pain. Eventually, the plugged follicle can burst and spill everything – oil, dead skin cells, and bacteria – onto the skin surrounding other follicles.

When a person becomes a teenager and goes through puberty, their body makes more hormones (especially androgen hormones). This can make sebaceous glands enlarge and too much oil or sebum can be made. Sebum is supposed to carry dead skin cells up to the surface of the skin, but when there is too much of it, it clogs the pores leading to whiteheads, blackheads, pimples, and cystic acne.

What are the types of Acne

Acne Vulgaris is the most common form of acne which includes several types of pimples. These acne lesions include blackheads, whiteheads, papules, pustules, nodules and cysts.

Mild to moderate acne vulgaris consists of the following types of acne spots:

• Whiteheads appear as small skin bumps. They are blocked swollen pores that are filled with dead skin cells and sebum(oil);
• Blackheads happen when a clogged pore is open and a chemical reaction causes the surface to darken. The blackhead is caused by a build-up of melanin-a skin pigment and its reaction with oxygen in the air.
• Papules and pustules both occur when a clogged pore becomes infected by bacteria (p.acne). Papules appear as a small red, raised lump. Pimples/pustule appear as fragile small white pus-filled domes, which is the body’s way of reacting to a bacterial infection. Pimples, also called “zits,” can be tender to touch.

Severe acne vulgaris is characterized by nodules and cysts:

• Cysts and nodules occur when clogged up pores break under the skin causing bigger and often very painful bumps. If left untreated, these cysts can cause scarring.
• Nodules are large, hard bumps under the skin’s surface.
• An acne cyst can appear similar to a nodule, but is pus-filled, and has been described as having a diameter of 5mm or more across.

Acne Rosacea can look similar to the aforementioned acne vulgaris, and the two types of acne are sometimes confused for one another. It appears as a red rash which is normally confined to the cheeks, nose, forehead and chin. The redness is often accompanied by bumps, pimples, and skin blemishes.

How can I treat acne?

Photodynamic Acne Treatment (PDT) is one of the options available for treating resistant and cystic acne. Roaccutane, another treatment option, has been used in the past but may have potential side effects, including dryness and changes in night vision, among others. It’s important for patients to discuss with their healthcare provider to understand the best treatment option for their specific condition, as individual responses to treatments can vary.