Causes of Acne

Acne and blemishes not only affect teenagers, but also an increasing number of adults.

Three factors play a decisive role in the development of acne and blemishes:

• Increased sebum production (seborrhoea)
• Clogging of follicular ducts or pores (follicular hyperkeratosis)
• Bacterial colonization

Too Much Sebum - Seborrhoea

Hormones trigger an increase in sebum production, which occurs during puberty, but also when hormones fluctuate throughout the menstrual cycle, after discontinuing the use of oral contraceptives (the pill) or during pregnancy. A genetic predisposition, as well as stress also play an important role.

Clogged Pores - Follicular Hyperkeratosis

Clogging of the follicle delays drainage of the excess sebum and leads to comedone formation. Whiteheads are closed comedones, whereas Blackheads are open comedones. The comedones may damage the connective tissue surrounding the follicle, destroying elastic fibers which cannot be regenerated. These expanded follicles remain clearly visible as enlarged pores.

Bacterial Colonization

An increased number of acne bacteria may cause inflammation in the surrounding tissue. Bacterial cleavage of sebum lipids increases the amount of free fatty acids within the follicle. Some of these fatty acids irritate the skin and can cause comedones too. In addition, microbial enzymes damage the follicle. If the follicle ruptures, the clogged sebum penetrates the surrounding connective tissue and causes an inflammatory reaction leading to the possible development of papules, nodes and pustules.

The most common form of acne is vulgaris or simplex, which may occur in different forms:

• Acne comedonica (pimples)
• Acne papulo-pustulosa (comedones and perfollicular inflammation with papules and pustules)
• Acne conglobata (comedones, papules, pustules and painful abscesses, which often leave scars after healing)