The Acne Development Cycle
Fundamentally, it is important for most people to know how
acne develops. Usually, it starts in plugged pores in the surface
of the skin. Pilosebaceous units are located in the dermis,
the middle skin layer, which are composed of sebaceous glands
where acne lesions can arise.
Pilosebaceous are not found in the bottoms of the feet and
the palms of the hands and this is why acne cannot be generated
in these parts since there are no hair follicles and oil glands.
However these units are present all over the body.
The most dense presence of pilosebaceous units are found
on the face, neck and the shoulders, making them more prone
to irritation, thus the acne affliction. Primarily, acne is
caused by the obstruction of the passages in the pilosebaceous
canals. These conditions are brought about by varying reasons:
The foremost reason in acne development is the excessive
production of the sebum. This in effect may clog the pilosebaceous
canals. Again this is due to the male hormone androgen. In general,
any fluctuation or changes in the balance of this hormone for
whatever reason will result in acne production.
The hair follicle wall starts to overproduce once it is stimulated
by the overproduction of sebum, this condition is called as
ductal hypercornification. Dead cells combined with excess sebum
will clog the pores of the skin and will begin to accumulate.
Once this situation occurs Propionobacterium acnes, a bacteria
present in the skin which is responsible in starting irritation,
may thrive on the clogged canals and invade them. These may
attack the immune system, which in turn may kill the white blood
cells. Consequently, the infected area will react to the white
blood cells and the present bacteria which will ultimately trigger
the onset of the acne breakout.
The acne will develop over the period of two or three weeks
before it will rise to the surface of the skin. It will develop
from simple blemishes on the sebaceous glands through the hair
follicle. Simultaneous with this ongoing process, two other
processes happen in the hair follicles. The excess sebum mixes
with old or dying skin cells and will be excreted through the
pores. On the other hand, the rejuvenation process starts whereas
the old cells die, giving way to the regeneration of new skin
cells.
Under normal circumstances, the shedding of the old cells
keep pace with the production of new ones. This condition varies
in different people. For some, the shedding is evenly distributed
throughout the skin surface. In many people however, the shedding
is uneven, allowing time for the dead cells to accumulate in
the follicles, thus effectively clogging the pores with combined
dead cells and bacteria.
Moreover, acne can either be inflammatory or non-inflammatory.
The most common form is the comedo, a non-inflammatory type.
When the pore of the comedo is closed while the clog gets trapped
inside, whitehead is produced. These are characterized as white,
small bumps.
On the other hand, an open pore allows the clog to pull through
the skin, this condition is called as blackheads. The common
notion that blackheads are black because of the accumulation
of dirt is not true; this is primarily because of the trapped
pigment melanin.
Though these types of acne are non-inflammatory, once they
get irritated they may develop into inflammatory types which
are reddish and swollen in appearance. These include papules,
nodules, pustules, cysts, scars and maculae, which may typically
take some time to heal.
Papules are red pimples or lesions. Pustules are basically pimples
but their pus is filled-up at the center. Nodules are generally
deep-seated acne and may take up to 2 months before they heal.
The most serious type of acne is a cyst which is rare but they
can reach well up to centimeters in diameter. This is considered
as a severe form of acne and needs immediate, serious medical
attention.
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