How
Acne formation is a complex interplay between genetics, hormones, excessive sebum production, blockage of pore openings, bacteria, and the body’s immune response.
Acne begins at the pilo-sebaceous unit, the oil-producing gland and associated hair follicle. Around puberty, the sebaceous glands grow in size and start producing more sebum under the influence of increased amounts of androgens (male sex hormones) circulating in the body. Androgens are present in both males and females, though males have higher levels of it.
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While the enlarged sebaceous glands increase sebum production, the increased and abnormal growth of the cells lining the opening of the pilo-sebaceous unit results in clogging of the opening, causing retention of the sebum and dead skin cells — sebaceous materials under the skin. The retained sebaceous materials result in the formation of whiteheads (closed comedones) and blackheads (open comedones).
The retained sebaceous materials provide a good environment for the Propionibacterium acnes (P. acnes) to grow and multiply. The body’s immune response to the bacteria and its products leads to inflammation, and the formation of red, sometimes painful, pimples. Deeper, more intense inflammation results in the formation of larger lesions (nodules) and even pus-filled cavities (cysts).
While the inflammation helps clear the bacteria from the skin, it unfortunately also destroys tissue around the pilo-sebaceous glands. This may cause permanent scarring as a final result of the healing process.
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Understanding the various steps in acne formation has allowed doctors and researchers to develop better medication to combat it at different levels, with better results. The trend is towards early treatment, and preventing or minimizing inflammation, thereby preventing scarring.
How Does Acne Form?
closed comedones
