Acne: What is it?

Acne is the term used to describe a disorder which impacts on the hair follicles and oil glands in the skin, resulting in closed pores, as well as outbreaks of lesions, usually referred to as zits or pimples, on the back, chest, face, neck and shoulders.

The pilosebaceous units, which are located on almost all of the body but particularly on the chest, face and upper back, are affected by acne. These pilosebaceous units are essentially a sebaceous gland that is linked to a canal known as a follicle, which holds a fine hair. When these PSUs are healthy, they create an oily substance referred to as sebum, which releases onto the surface of the skin via an opening in a follicle referred to as a pore. The follicle is lined with cells called keratinocytes.

The effects of acne

However, when someone is suffering from acne, the hair, keratinocytes and sebum may become plugged up, resulting in the sebum being unable to get to the skin’s surface. The mixture of cells and oils enables bacteria which normally reside on the skin to start growing within the plugged follicles. This causes inflammation – heat, pain, redness and swelling.

When the plugged follicle wall finally breaks down, the sebum, skin cells and bacteria are emptied into skin that is nearby which results in pimples or lesions. The great majority of people will no longer suffer from acne by the time they are in their 30s, but there are some individuals who continue to have the condition well into their 40s and 50s. Acne is experienced by people of all ages and races, although it is most commonly experienced by young adults and adolescents. Around 80 percent of people between 11 and 30 years of age experience an outbreak of acne at some time.

Types of acne

A number of different kinds of lesions, or pimples, can be caused as a result of acne, including:

• A comedo; a hair follicle that has become plugged and enlarged.

• An open comedo, often commonly referred to as a blackhead, which is a plugged follicle that opens up upon reaching the skin’s surface. On the surface it appears to be black not because it is actually dirty, but because the sebum is discoloured by the air.

• A closed comedo, often commonly referred to as a whitehead, which remains underneath the skin and results in a white bump.

• Nodules, which are painful, solid and large lesions that are lodged deep inside the skin.

• Papules, which are inflamed lesions that generally take the form of small, pink skin bumps that may be tender when touched.

• Pimples or pustules, which are papules that are topped by yellow or white lesions that are filled with pus and appear red at their base.

• Cysts, which are painful, deep lesions that are filled with pus and can result in scarring.

What causes acne?

Although the precise cause of acne has yet to be determined, there are a number of related factors that can contribute to its development. One factor is an increase in male sex hormones known as androgens. These increase in girls as well as boys in puberty, and result in the enlargement of the sebaceous glands so that they can produce more sebum.

Ceasing taking birth controls and pregnancy can also cause hormonal changes that result in acne. People whose parents suffered from acne are more likely to suffer from the condition as well, according to researchers, and acne can also be caused by some drugs such as lithium. Greasy makeup may also play a part, as this alters the cells in the follicles and results in them sticking together, causing a clogging of the pores.


Treatment can prevent the development of new lesions, prevent scarring and help to heal existing lesions. A number of problems related to the development of acne, such as bacteria, inflammation, the abnormal clumping of the cells within follicles, and an increase in the production of oil, can all be helped with medication. This can take the form of prescription medicine, such as antibiotics and Vitamin A derivatives. Topical medicines that can be bought over the counter include gels, creams, pads, lotions and soaps, which can be applied directly on the skin and include benzoyl peroxide, salicylic acid, sulphur, and resorcinol.