ACNE (PIMPLES) Overview
WHAT IS ACNE?
Acne is a skin condition that occurs when your hair follicles become clogged with oil and dead skin cells. It often causes whiteheads, blackheads or pimples, and usually appears on the face, forehead, chest, upper back and shoulders. Acne is most common among teenagers, though it affects people of all ages.
Acne occurs when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty or due to other hormonal changes. Sebum (oil) is a natural substance that lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature, predisposing them to plug the follicular pore.
The plug can appear as a WHITEHEAD if it is covered by a thin layer of skin, or if exposed to the air, the darker exposed portion of the plug is called a BLACKHEAD. The plugged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin's surface produces a pustule; deeper inflammation results in a papule (pimple); if the inflammation is deeper still, it forms a CYST.
So acne appears on the skin as
- COMEDONES: these are occluded pores also known as blackheads or whiteheads
- PIMPLES OR ZITS: these are tender red bumps
- PUSTULES: (bumps containing pus)
- CYSTS: (deep pimples, boils)
Risk factors for acne include:
- Age: People of all ages can get acne, but it's most common in teenagers.
- Hormonal changes: Such changes are common in teenagers, women and girls, and people using certain medications, including those containing corticosteroids, androgens or lithium.
- Family history: Genetics plays a role in acne. If both parents had acne, you're likely to develop it, too.
- Greasy or oily substances: You may develop acne where your skin comes into contact with oily lotions and creams or with grease in a work area, such as a kitchen with fry vats.
- Friction or pressure on skin: This can be caused by items such as telephones, cellphones, helmets, tight collars and backpacks.
- Stress: Stress doesn't cause acne, but if you have acne already, it may make it worse.
Factors that may worsen acne
These factors can trigger or aggravate acne:
- Hormones: Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. And low amounts of androgens circulate in the blood of women and can worsen acne.
- Certain medications: Examples include drugs containing corticosteroids, testosterone or lithium.
- Diet: Studies indicate that certain dietary factors, including skim milk and carbohydrate-rich foods — such as bread, bagels and chips — may worsen acne. Chocolate has long been suspected of making acne worse. A small study of 14 men with acne showed that eating chocolate was related to a worsening of symptoms. Further study is needed to examine why this happens and whether people with acne would benefit from following specific dietary restrictions.
- Stress: Stress can make acne worse.