What is Acne?

Question: What is 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.

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 causes acne?

There is no precise cause of acne; rather, it is a result of many factors coming together to create an acne situation. Those who are prone to acne often have skin that is oilier than average. Excess oil can easily become trapped within the pore, creating an impaction.

Acneic skin also produces more dead skin cells than is normal, and those skin cells are not being shed properly (a condition called retention hyperkeratosis). These dead cells stick to the surface of the skin and inside the follicles, mixing with excess oil and creating a comedo.

When the pore becomes blocked by cellular debris and oil, a bacterium that is normally present within the pore grows unchecked. Propionibacteria acnes (P. acnes) are found in great numbers on acneic skin, causing inflamed breakouts.

Why does acne occur?

Acne often first appears during puberty, when there is a surge of androgen hormones within the body. Androgens stimulate the sebaceous glands, creating an oilier complexion and one more prone to breakouts.

Most dermatologists agree androgen hormones significantly influence acne development. In addition to puberty, women may see considerable hormonal fluctuations are during menstruation, pregnancy, menopause and perimenopause. During these life phases, acne is most likely to develop or flare up.

Other factors that contribute to acne development include oily cosmetics, comedogenic skin care or hair care products, certain drugs such as steroids and estrogen medications. Acne tends to run in families. If your parents had acne at any point in their lives, your chance of developing acne is higher.