What is the description of acne?

Technically called acne vulgaris, this skin disease affects millions of Americans annually. It can vary from quite mild to extremely severe.

Acne usually develops when the sebaceous glands and the lining of the hair follicle begin to work overtime, as they do in adolescence. Normally, the lining of the hair follicle sheds cells that are carried to the surface of the skin by the sebum. When the follicle is overworked and clogged, cells and sebum accumulate, forming a plug (comedo).

If the plug stays below the surface of the skin, it is called a "closed" comedo or whitehead. If the plug enlarges and pops out of the duct, it is called an "open" comedo or blackhead because the top is dark. This is not dirt and will not wash away. The discoloration is due to the way light is absorbed by the skin cells within the opening.

What Causes Acne?

Acne is a systemic inflammatory disease affecting the skin. More than 90% of adolescents, almost 50% of all adult women, and 25% of all adults are affected by this disease, either chronically, or at some point during their lives. Acne is the most common skin affliction in the world, yet is still among the most difficult to treat. Although there is no cure for acne, the treatment options available in today’s world make it a far more manageable condition than ever before.

Even with all of our knowledge today, it is still widespread belief that acne is caused by specific things that we do, and while there are definitely parts of our everyday life that we can change to help treat and prevent acne, the truth is that a combination of factors at work beneath our skin are most to blame.

A blemish begins far before we see it on the surface of our skin. In fact, what we see when a pimple finally becomes visible to the naked eye, is actually the last stage of the pimples cycle. 2-3 weeks before we realize that we have a pimple, the sebaceous hair follicle (pore) becomes clogged. The pore is a far more complex part of our bodies than we often give it credit for. Deep within each pore, our sebaceous glands are producing sebum, which is more simply put, the oil that keeps our skin moist and flexible. As our skin renews itself, the old cells die, mix with the sebum, and are shed naturally through the pore openings.

Normally, dead cells are shed at an even rate as fresh new skin replaces them. However, when cells shed unevenly they become sticky with sebum and stick together to form a plug (comedo). This mass of sticky dead cells plugs the opening of the pore. With the pore clogged, excess oil and bacteria have no way to escape. As our body continues with its natural production of oil, the pore begins to swell. Our body’s natural defense against bacteria is to send out a rush of white blood cells to attack it.

Finally, sometimes weeks later, after this battle has been being fought beneath the surface, a pimple appears. If a plugged follicle stays beneath the surface of the skin it is called a closed comedone (whitehead), and generally appears as a small white bump. If the plug becomes so large that it pushes up through the surface of the skin, it is called a blackhead (open comedone). Oxidization and an abundance of melanin give the blackhead its dark appearance.
Papules are small red bumps resulting from the inflammatory response. Pustules are white or yellow pus filled pimples, and nodules (more commonly known as cysts), are inflamed pus filled lesions that form and stay deep beneath the surface of the skin when some of the material from the comedo spills into the surrounding skin and the body reacts by producing pus to fight the infection causing agents.

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