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Acne Skin Care
What Is Acne?
Acne is a disorder resulting from the action of hormones and other substances on the skin's oil glands (sebaceous glands) and hair follicles. These factors lead to plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Although acne is usually not a serious health threat, it can be a source of significant emotional distress. Severe acne can lead to permanent scarring.
How Does Acne Develop?
Doctors describe acne as a disease of the pilosebaceous units (PSUs). Found over most of the body, PSUs consist of a sebaceous gland
connected to a canal, called a follicle, that contains a fine hair (see diagram).
Normal Pilosebaceous Unit
These units are most numerous on the face, upper back, and chest. The sebaceous glands make an oily substance called sebum that normally empties onto the skin surface through the opening of the follicle, commonly called a pore. Cells called keratinocytes line the follicle.
The hair, sebum, and keratinocytes that fill the narrow follicle may produce a plug, which is an early sign of acne. The plug prevents sebum from reaching the surface of the skin through a pore. The mixture of oil and cells allows bacteria Propionibacterium acnes (P. acnes) that normally live on the skin to grow in the plugged follicles. These bacteria produce chemicals and enzymes and attract white blood cells that cause inflammation. (Inflammation is a characteristic reaction of tissues to disease or injury and is marked by four signs: swelling, redness, heat, and pain.) When the wall of the plugged follicle breaks down, it spills everything(sebum, shed skin cells and bacteria) into the nearby skin leading to lesions or pimples.
People with acne frequently have a variety of lesions, some of which are shown in the diagrams below. The basic acne lesion, called the comedo (KOM-e-do), is simply an enlarged and plugged hair follicle. If the plugged follicle, or comedo, stays beneath the skin, it is called a closed comedo and produces a white bump called a whitehead.
A comedo that reaches the surface of the skin and opens up is
called an open comedo or blackhead because it looks black on the skin's surface. This black discoloration is due to changes in sebum as it is exposed to air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.
Types of Lesions
Other troublesome acne lesions can develop, including the following:
Papules – inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch
Pustules (pimples) – papules topped by white or yellow pus-filled lesions that may be red at the base
Nodules – large, painful, solid lesions that are lodged deep within the skin
Cysts – deep, painful, pus-filled lesions that can cause scarring.
Many thanks to the National Institute of Health for the information and diagrams used in this article.
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