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What causes Acne?
Acne is the most common skin condition bothering most of us. Acne manifests during or right after puberty. But then sometimes acne occurs in babies as well as adults. Acne occurs by the obstruction of specialized glands located on face, chest, neck and back. The various grades of acne are mild, moderate and severe. In severe types, acne persists for years causing disfigurement of skin and leading to scarring.
After several decades of research, we now know what causes acne. Several factors contribute to the development of acne: excess sebum production; bacterial infection (Propionibacterium acnes) and inflammation and hormonal changes. Acne is a skin condition characterized by comedones, papules, pustules and cysts or nodules. Acne occurs in sebaceous glands under the skin that lie closely along the hair follicle. These sebaceous glands secrete an oily substance called sebum. When the pores of these glands become clogged with shed skin cells, excess sebum or bacteria, acne is formed.
So, what really causes acne?
There are a number of causes of acne which are as follows:
1. Hormones: The cause of acne is unclear but research suggests that hormones are to blame. Most adolescents have acne because a male hormone stimulates the sebaceous glands at puberty. Androgens (testosterone) increase the size of sebaceous glands and cause excess production of sebum. Pores can become clogged with dead skin, sebum and bacteria leading to the formation of a microcomedone (microscopic lesion). In women, fluctuations in estrogen during the menstrual cycle change the sensitivity of sebaceous glands to androgens.
2. Sebum: Sebaceous glands in skin produce oil. Pores enlarge to accommodate to adjust the flow of oil produced. With increase in oil production pores enlarge and if they do not function properly then increase in oil production may cause more problems and bacteria begin to overpopulate.
3. Heredity: Among contributing factors are also heredity. If your parents suffered then chances are that you may also.
4. Allergy: Sometimes food allergy may also lead to inflammation causing acne.
5. Propionibacterium acne: this bacterium is usually found in low numbers on normal skin. It is highly sensitive to antibiotics but the problem is that these antibiotics cannot reach to it, as it lies deep in oil rich environment of skin. Hence the bacterium becomes resistant to antibiotic treatment. Resistant Propionibacterium, widely distributed on acne-prone skin may be difficult to eradicate.
6. Changes in the hair follicle: During puberty the skin cells lining the follicle shed more quickly, mix with the increased levels of sebum and increase the likelihood of the pores becoming clogged. The clogged pore replete with sebum provides an ideal environment for the rapid growth of Propionibacterium acnes which secrete chemicals into the skin that stimulate an inflammatory response.
References:
1. Webster G.F. "Inflammation in acne vulgaris". J Am Acad
Derm 1995; 33: 247-253.
2. Kligman A.M. "An overview of acne". J Invest Derm 1974; 62:
268-287.
3. Leyden J.J. "Therapy for Acne Vulgaris". The New England
journal of medicine 1997 April; 336:1156-1162.
4. Webster G.F. "Acne Vulgaris". BMJ 2002 August; 325:475-479
5. Knor T. "The Pathogenesis of acne". Acta Dermatovenerol Croat.
2005; 13(1): 44-9.
6. Brown, et al. "Acne Vulgaris". Lancet 1998; 351:1871-6.
7. Shalita A.R. "Clinical Aspects of Acne". Dermatology 1998;
196:93-4.
Acneiform
facial eruptions
