It is the most disturbing problem at puberty when the young persons of both sexes, see pimples appearing on their face. If plucked/broken, blood/pus out from pimply eruptions which leave back black scars on the face. Skin's sebaceous glands get activated due to hormonal activity. If skin is too much oily more lubricant is released due to hyperactivity of glands, which, in turn, infects and blocks hair follicles. The young person’s arc advised not to break/squeeze the erupted spots; otherwise the infection will spread to the surrounding areas (of tissues). If acne persists even beyond puberty, professional help will be needed. Persons with oily skin are more likely to suffer from severe infection.
Acne typically affects the skin of the face, back, neck, chest and arms and the severity of the condition can vary.
Acne affects people of all skin colours. The processes that cause acne are exactly the same in people with black or brown skin but the impact is altered by the skin pigmentation.
Acne is very common and affects about 80 in 100 people aged 11-30 at some time.
The skin
The surface of the skin has lots of small sebaceous glands just below the surface. These glands make an oily substance called sebum that keeps the skin smooth and supple.
Tiny pores (holes in the skin) allow the sebum to come to the skin surface. Hairs also grow through these pores.
Causes
Acne is caused by the over activity of the sebaceous glands that secrete oily substances onto the skin.
The sebaceous glands of people with acne are especially sensitive to normal blood levels of a hormone called testosterone, found naturally in both men and women.
Testosterone in people prone to acne triggers the sebaceous glands to produce an excess of sebum. At the same time, the dead skin cells lining the openings of the hair follicles (the tubes that hold the hair) are not shed properly and clog up the follicles.
These two effects combined cause a build-up of oil in the hair follicles. This causes blackheads and whiteheads to form.
For some people, their acne does not progress beyond this stage.
However in other people, the build-up of oil in the hair follicles creates an ideal environment for a bacterium called Propionibacterium acnes to grow.
These bacteria normally live harmlessly on your skin but when this ideal environment is created, they grow. They feed off the sebum and produce substances that cause a response from your body's immune system. This inflames the skin and creates the redness associated with spots.
In more severe 'inflammatory acne', cysts develop beneath the skin's surface. These acne cysts can rupture, spreading the infection into nearby skin tissue. This can result in scarring.
Acne myths
Contrary to popular belief acne is not caused by:
eating fatty food or chocolate
dirt - blackheads get their dark colour through excess skin pigment - not dirt so washing more does not help, although if you do not wash your skin at all, bacteria will be able to multiply
What makes acne worse?
There are a number of things that can make your acne worse. These include the following:
Picking and squeezing the spots may cause further inflammation and scarring
stress can make acne worse in some people, although it is not clear why
in women, outbreaks may be affected by the hormonal changes that occur during the menstrual cycle
Excessive production of male hormones such as testosterone from conditions such as polycystic ovary syndrome may be another cause.
Some contraceptive pills may make acne worse. This is due to the type of progestogen hormone in some pills whereas some other types of contraceptive pills can improve acne.Your GP will advise you which contraceptive pill to take some medicines can make acne worse. For example, some medicines taken for epilepsy, and steroid creams and ointments that are used for eczema. Do not stop a prescribed medicine if you suspect it is making your acne worse, but tell your GP. An alternative may be an option steroids can cause acne as a side-effect
Diagnosing acne
Acne is easily recognized by the appearance of the spots and by their distribution on the body.
There are several varieties of acne and your doctor will be able to tell you which type you have after examining your skin.
