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Acne

Implicated in a wide range of conditions and illnesses, hormones also play a role in the development of acne. Androgens, male hormones that are secreted in different amounts by both men and women, play an important role in most cases of acne. Androgens stimulate the hormone-sensitive sebaceous glands, which produce oil, known as sebum. Sebum, in turn, has been called "the fuel that feeds the flame of acne."

Genetics also seem to play a role. There are some families in which severe acne is inherited. Unfortunately, the exact genetic component is not known yet.

If the acne does not respond to home and over-the-counter treatments after two months, it is a good idea to see a dermatologist before the condition produces scarring and/or takes an emotional toll. Dermatologists have numerous prescription medications and procedures available.

Acne is a very common skin problem that shows up as outbreaks of bumps called pimples or zits. These usually appear on the face, neck, back, chest, and shoulders. Acne can be a source of emotional distress, and severe cases can lead to permanent scarring.

What Causes Acne?

Acne begins when the pores in the skin become clogged and can no longer drain sebum (an oil made by the sebaceous glands that protects and moisturizes the skin.) The sebum build-up causes the surrounding hair follicle to swell.

Hair follicles swollen with sebum are called comedones. If the sebum stays beneath the skin, the comedones produce white bumps called whiteheads. If the sebum reaches the surface of the skin, the comedones produce darkened bumps called blackheads. This black discoloration is due to sebum darkening when it is exposed to air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.

Bacteria called Propionibacterium acnes (P. acnes) that normally live on the top of the skin can enter the clogged pores and infect the sebum. This causes the skin to become swollen, red, and painful.

Infected sebaceous glands may burst, releasing sebum and bacteria into the surrounding skin, creating additional inflammation. In severe cases, larger nodules and cysts may form in the deeper layers of the skin.

What Are the Different Types of Acne?

Acne can be categorized by its severity:

Mild acne describes a few scattered comedones (whiteheads or blackheads) with minimal inflammation (no pustules).
Moderate acne describes a denser collection of comedones as well as red, inflamed, pus-filled lesions (pustules).
Severe acne, also called nodular or cystic acne, describes widespread and deep lesions that are painful, inflamed, and red. This form of acne is likely to lead to scarring if left untreated.