Acne is a disease of the hair follicles of the face, chest, and back that affects almost all teenagers during puberty – the only exception being members of a few primitive Neolithic tribes living in isolation. It is not caused by bacteria, although bacteria play a role in its development. It is not unusual for some women to develop acne in their mid- to late-20s.
Acne occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore.
Acne vulgaris is typical teenage acne which is characterized by three types of lesions:
What causes acne?
No one factor reason acne. Acne occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore. The plug can appear as a whitehead if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a “blackhead.” The plugged hair follicle gradually enlarges, producing a bump.
Food: Parents often tell teens to avoid pizza, greasy and fried foods, and junk food. While these foods may not be good for overall health, they don’t play an important causal role in acne. Although some recent studies have implicated a high-carbohydrate diet, milk, and pure chocolate in aggravating acne, these findings are far from established.
Dirt: Blackheads are oxidized oil, not dirt. Sweat does not reason acne and is produced by entirely separate glands in the skin. On the other hand, excessive washing can dry and irritate the skin.
Stress: Some people get so upset by their pimples that they pick at them and make them last longer. Stress, however, does not play much of a direct role in causing acne.
What other skin conditions can mimic acne symptoms and signs?
Rosacea: This situation is characterized by pimples but not comedones and occurs in the middle third of the face, along with redness, flushing, and superficial blood vessels. It usually affects people in their 30s and 40s and older.
Pseudofolliculitis: This is sometimes called “razor bumps” or “razor rash.” When cut too close to the skin, growing hairs twist into the skin and produce tender bumps. This is a mechanical problem, and treatment involves shaving less .Pseudofolliculitis can, of course, happen in patients who have acne, too.
Folliculitis: Pimples can happen on other parts of the body, such as the abdomen, buttocks, or legs. These represent not acne but inflamed follicles. If these don’t go away on their own, doctors can prescribe oral or external antibiotics, usually not the same ones used for acne.