Overview of Acne
Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum—oil that helps keep skin from drying out—and dead skin cells plug the poreswhich leads to outbreaks of lesionscommonly called pimples or zits. Most oftenthe outbreaks occur on the face but can also appear on the backchestand shoulders.
Acne is an inflammatory disorder of the skinwhich has sebaceous (oil) glands that connects to the hair folliclewhich contains a fine hair. In healthy skinthe sebaceous glands make sebum that empties onto the skin surface through the porewhich is an opening in the follicle. Keratinocytesa type of skin cellline the follicle. Normally as the body sheds skin cellsthe keratinocytes rise to the surface of the skin. When someone has acnethe hairsebumand keratinocytes stick together inside the pore. This prevents the keratinocytes from shedding and keeps the sebum from reaching the surface of the skin. The mixture of oil and cells allows bacteria that normally live on the skin to grow in the plugged follicles and cause inflammation—swellingrednessheatand pain. When the wall of the plugged follicle breaks downit spills the bacteriaskin cellsand sebum into nearby skincreating lesions or pimples.
For most peopleacne tends to go away by the time they reach their thirtiesbut some people in their forties and fifties continue to have this skin problem.
Who Gets Acne?
People of all races and ages get acnebut it is most common in teens and young adults. When acne appears during the teenage yearsit is more common in males. Acne can continue into adulthoodand when it doesit is more common in women.
Types of Acne
Acne causes several types of lesionsor pimples. Doctors refer to enlarged or plugged hair follicles as comedones. Types of acne include:
- Whiteheads: Plugged hair follicles that stay beneath the skin and produce a white bump.
- Blackheads: Plugged follicles that reach the surface of the skin and open up. They look black on the skin surface because the air discolors the sebumnot because they are dirty.
- Papules: Inflamed lesions that usually appear as smallpink bumps on the skin and can be tender to the touch.
- Pustules or pimples: Papules topped by white or yellow pus-filled lesions that may be red at the base.
- Nodules: Largepainful solid lesions that are lodged deep within the skin.
- Severe nodular acne (sometimes called cystic acne): Deeppainfulpus-filled lesions.
Causes of Acne
Doctors and researchers believe that one or more of the following can lead to the development of acne:
- Excess or high production of oil in the pore.
- Buildup of dead skin cells in the pore.
- Growth of bacteria in the pore.
The following factors may increase your risk for developing acne:
- Hormones. An increase in androgenswhich are male sex hormonesmay lead to acne. These increase in both boys and girls normally during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy can also cause acne.
- Family history. Researchers believe that you may be more likely to get acne if your parents had acne.
- Medications. Certain medicationssuch as medications that contain hormonescorticosteroidsand lithiumcan cause acne.
- Age. People of all ages can get acnebut it is more common in teens.
The following do not cause acnebut may make it worse.
- Diet. Some studies show that eating certain foods may make acne worse. Researchers are continuing to study the role of diet as a cause of acne.
- Stress.
- Pressure from sports helmetstight clothesor backpacks.
- Environmental irritantssuch as pollution and high humidity.
- Squeezing or picking at blemishes.
- Scrubbing your skin too hard.