What causes acne?
Acne is a disorder of the sebaceous glands. These glands are regulated by hormones and, more specifically, the androgens. Due to changes in hormones such as during puberty, the sebaceous glands produce more oil. More oil production leads to a series of events that can result in open and closed comedones – blackheads and whiteheads – and possibly papules and pustules – red, raised bumps and pus-filled pimples.
The sebaceous glands of people who get acne are especially sensitive to a hormone called testosterone. This causes the glands to pump out an excess of oil. At the same time, the dead skin cells lining the openings of the hair follicles are not shed properly and clog up the follicles. These two effects combine to cause a build up of oil within the hair follicles. The acne bacteria live on everyone’s skin, usually causing no problems, but in those who are prone to acne, the build up of oil creates an ideal environment in which these bacteria can multiply. This triggers a chemical reaction and the formation of red or pus-filled spots. Sometimes the blocked follicles do not become inflamed. The term ‘blackhead’ is used when the blockage can be seen as a dark plug at the skin surface. A bumpy and flesh coloured blocked follicle lying just under the skin is called a ‘whitehead’.
Your body makes more androgen hormones as teenagers, under stress, before menstruation, with dairy produce, medicines and contraceptives and, during and after pregnancy.
- Androgens increase sebaceous oil gland activity
- Skin cells block sebaceous oil ducts – blackheads and whiteheads
- Acne bacteria multiply behind block
- Bacteria cause inflamed spots
Is acne hereditary?
Acne can run in families, but this does not necessarily mean that if your parents had acne you will get it too.
Acne in young children
Recent studies have shown that puberty is beginning earlier and earlier in today’s children and preteen acne is on the rise in children ages 10-12, and sometimes in those even younger. It brings with it many changes and among them, is acne. The onset and duration of puberty depends on many things including gender, nutrition and ethnicity. Girls usually begin puberty between the ages of 10-14 and boys will begin between the ages of 12-16.
How is acne diagnosed?
Acne is easily recognised by the appearance of the spots and by their distribution on the face, neck, chest or back. However, there are several varieties of acne and your dermatologist will be able to tell you which type you have after examining your skin. The most common type is called ‘acne vulgaris ‘.