Acne is a chronic and inflammatory skin condition that occurs when your hair follicles become plugged with oil and dead skin cells that cause whiteheads, blackheads, spots, or pimples, especially on the face, shoulders, back, neck, chest, and upper arms.
Effective acne treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.
Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems.
Four main factors cause acne:
- Excess oil (sebum) production. Human skin has pores that connect to oil glands under the skin, called sebaceous glands that are tiny glands on the surface of the skin. Follicles connect the glands to the pores. Follicles, that an individual hair grows out of it, are small holes that produce and secrete liquid. The glands produce an oily liquid that lubricates the hair and the skin, producing an oily substance, called sebum. The sebum carries dead skin cells through the follicles to the surface of the skin.
- Hair follicles are clogged by oil and dead skin cells. A small hair grows through the follicle out of the skin. Pimples grow when these follicles get blocked, and oil builds up under the skin. The whitehead is created when the plugged follicle is close to the surface of the skin and when the plugged follicle is opened to the skin and darken, is called blackheads. But actually, the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air.
- Skin cells, sebum, and hair can clump together into a plug. This plug gets infected with bacteria and swelling results. A pimple starts to develop when the plug begins to break down. Propionibacterium acnes (P. acnes)is the name of the bacteria that live on the skin and contribute to the infection of pimples.
- Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cystlike lumps beneath the surface of your skin.
Certain things may trigger or worsen acne:
- Hormonal changes. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone changes during midlife, particularly in women, can lead to breakouts too. A range of factors triggers acne, but the main cause is thought to be a rise in androgen levels. Androgen is a type of hormone, the levels of which rise when adolescence begins. In women, it gets converted into estrogen. Testosterone is the main androgen hormone which Rising levels cause the oil glands to produce much more sebum than the skin needs making the skin glow. The enlarged gland produces more sebum. Excessive sebum can break down cellular walls in the pores, causing bacteria to grow.
- Menstruation – some women have an eruption just before their period
- Pregnancy – frequently during the first 3 months of their pregnancy
- Polycystic ovary syndrome
- Genetics – if the parents had acne, it´s likely that the children also develop it.
- Certain medications. Examples include drugs containing corticosteroids, testosterone, birth control pills, lithium ( used to treat depression and bipolar disorder), or some drugs used to treat epilepsy. Prolonged use of antibiotics can also damage the flora in the gut and impact skin health.
- Studies indicate that consuming certain foods — including carbohydrate-rich foods, such as bread, bagels, skim milk, whey protein, diets high in sugar and chips — may worsen acne.
- Emotional Stress. Stress doesn’t cause acne but may worsen the existing acne because increases the cortisol levels.
- Smoking which causes acne in older people
- Regularly wearing items that place pressure on an affected area of skin, such as headband or backpack
- Grassy makeup and skincare products, like lotions or creams
- working in an area where you routinely come in contact with grease (like a restaurant where there are greasy food surfaces and frying oil).
- Apply oily skincare products, such as pomade and waxes
- Air pollution and certain weather conditions ( like high humidity)
Dr. Anca Mincă, dermatologist
Spitalul Clinic Colentina, Bucharest