How Acne Develops

Acne, the most common hormone-induced skin change, occurs mainly during puberty. Acne covers a whole groups of diseases that affect the sebaceous glands, hair follicles and surrounding tissue. Acne Vulgaris, which affects around 80% of 11 - 30 year olds, can take many forms:

• Acne comedonica (black/whiteheads)
• Acne papulo-pustulosa
• caused by a bacterial invasion of the comedo and leads to inflammation, as well as papule and pustule formation
• Acne conglobata which in addition to comedones, papules and pustules, painful nodules and abscesses form which often leads to scarring

Either persisting or recurring acne beyond the age of 30, is becoming increasingly frequent. A genetic predisposition, stress, medication, exposure to occupational noxae, as well as the use of comedogenic and excessively greasy skincare products are the common causes.

Causes of Acne
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

Treatment
Acne will not be cured overnight. Results from any treatment develop over time (usually 6 to 8 weeks). Once skin starts improving, continuing treatment remains important. Effective acne treatments should reduce sebum production, increase cell turnover, and fight bacteria. Depending on the severity of the condition, a dermatologist may recommend the following:

Mild to Moderate Acne
Cleansing with a mild, sebum-reducing, antibacterial twice daily. A daily moisturizer specifically designed to fight the causes of acne which contain benzoyl peroxide, salicylic acid, or lactic acid. Topical prescription products containing derivatives of vitamin A (retinoids) may also work by increasing skin cell shedding. In addition, topical antibiotics such as tetracycline, which can cause increased UV sensitivity, or erythromycin can be applied to kill bacteria. For moderate to severe cases, oral antibiotics or contraceptives may be used.

Severe Acne
In conjunction with a combination of the above, a dermatologist may also prescribe isotretinoin (a synthetic derivative of vitamin A in pill form). This medication is used under dermatologist supervision and may have serious side effects. The drug treatment of severe acne often dries out and stresses the skin. During and after such treatment, the skin needs intensive care.

Acne often causes scarring, which many dermatologists treat with cosmetic procedures including peels, dermabrasion, intense light therapy and laser resurfacing. All of these treatments vary in intensity and could result in further scarring depending on the specific skin.

A Sebum (oil), dead skin cells and bacteria plugged within the hair follicle are exposed to the skin surface and turn black through oxidation are known as "blackheads"
B "Whiteheads" occur when openings of hair follicles become clogged and blocked with oil secretions, dead skin and bacteria
C Increased sebum build-up puts pressure on the follicle walls, which are further damaged by various bacterial substances (enzymes, free fatty acids).
D The trapped, bacteria-contaminated sebum overflows the surrounding tissue, causing inflammation.