How Does
Acne Begin?
Acne affects about 80% of all adolescents. Acne begins with the
inflammation of tiny oil-producing glands in the skin. These glands are called
Sebaceous glands and produce an oil named "sebum". Sebum is responsible
for keeping the skin and skin hair supple and healthy. During puberty,
sebaceous glands grow and produce more sebum due to an increase in
Androgen hormones. This may also occur in early adulthood rather than in
your teens.
The sebaceous glands produce oil (sebum) which normally travels via
hair follicles to the skin surface. However, skin cells can plug the
follicles, blocking the oil coming from the sebaceous glands. When follicles
become plugged, skin bacteria (called Propionibacterium acnes, or P.
acnes) begin to grow inside the follicles, causing inflammation. Acne
progresses in the following manner:
Incomplete blockage of the hair follicle results in blackheads (a
semisolid, black plug). Complete blockage of the hair follicle results in whiteheads (a
semisolid, white plug). Infection and irritation cause whiteheads to form.
Eventually, the plugged follicle bursts, spilling oil, skin cells, and
the bacteria onto the skin surface. In turn, the skin becomes irritated
and pimples or lesions begin to develop. The basic acne lesion is
called a comedo. Acne can be superficial (pimples without abscesses) or deep (when the
inflamed pimples push down into the skin, causing pus-filled cysts that
rupture and result in larger abscesses).
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