Acne Causes and Symptoms

Acne is a disorder that involves the oil glands of the skin.  The skin has tiny holes called pores which lead to oil glands below the surface of the skin. Acne is a disease caused by hormones and other substances in the sebaceous glands (oil glands) and hair follicles. These oil glands secrete sebum which is an oily substance. The pores are connected directly to the oil glands by a tiny canal known as a follicle. Within these follicles, the secreted oil carries dead skin cells to the skin’s surface. There is a thin hair growing through the follicle and protruding above the surface of the skin. When these pores become blocked and outbreak of lesions occurs commonly called zits or pimples. When a follicle becomes clogged, a pimple is the result. This is nature’s way of unblocking the follicle. Acne pimples normally occur on the shoulders, chest, back, neck and face. While acne is not usually a threatening condition, it can be the cause of considerable emotional stress. Severe acne can result in permanent scars.

How Does Acne Occur?

The sebum (oil), hair and keratinocytes (cells lining the follicle) form a plug which blocks the narrow follicle.  The plug stops the sebum (oil) from pouring out onto the skin’s surface.  The mixture of dead cells and oil provides a medium for bacteria to grow (Propionibacterium acnes or P. acnes) which normally found growing on the skin.  These bacteria make enzymes and chemicals the invite white blood cells and this produces inflammation (characterized by redness, pain, swelling and heat). When the follicle wall breaks down, sebum, dead skin cells and bacteria spill into the surrounding skin which causes lesions also known as pimples or zits.

Individuals afflicted by acne often have different types of lesions.  The most common acne lesion is called the comedo (kom’-e-do).  This is a blocked and enlarged hair follicle. Should the blocked follicle (comedo) remain below the skin, it is referred to as a closed comedo and makes a white raised area referred to as a whitehead. A comedo that makes it to the skin’s surface is referred to as an open comedo also know as a blackhead.  It is called this because it’s appearance is black on the surface of the skin.  This black color is caused by alterations to the oil (sebum) when it is exposed to air.  Dirt is not the cause of this black color.  Both blackheads and whiteheads can remain in the skin for a long period of time.

Other forms of acne are:

• Cysts – painful, deep lesions filled with pus that can leave scars
• Pustules (pimples) – papules which have yellow or white lesions filled with pus which are red around the base.
• Papules – lesions that are inflamed which look like smallish pink bumps tender to touch. 
• Nodules – painful, big, hard lesions located deep in the skin.

What Causes Acne?

The specific cause of acne is not known.  However, many doctors conclude that it is caused by several factors.  One such factor is a rise in the amount of male sex hormones called androgens.  Puberty causes this hormone to be produced in greater quantities in both girls and boys.  The sebaceous glands (oil glands) become larger and create more sebum (oil).  These acne causing hormonal changes can also occur during pregnancy and when one stops taking birth control pills.

Another assumed cause is heredity.  Many researchers now believe that the tendency to have acne is inherited from our parents.  As an example, some studies indicate that a significant number of school-age boys with acne come from a family in which the disease is prevalent.  Some prescription drugs, such as male hormones and lithium, have been shown to produce acne.  Cosmetics that are greasy can change the cells in the follicles causing them to clump and this produces a blockage.

Items That Make Acne Worse

• Rising hormone levels in adult women and adolescent girls 2 to 7 days prior to menstrual periods
• Oil from cosmetics or moisturizers or greasy substances at one’s place of work (for example, a commercial kitchen with frying vats)
• Pressure from backpacks, sports helmets or other sports equipment, tight collars, or tight sports uniforms
• Environmental conditions, such as high humidity and pollution
• Picking or squeezing skin erruptions
• Intense scrubbing and washing of one’s skin
• Stressful conditions

Who Gets Acne?

Acne is no respecter of age or race.  It appears most frequently from the ages of 12 to 25. Acne usually disappears by the age of 30.  Adults can also develop acne from the age of 50 on and is often associated with a skin condition called rosacea.

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