Here's more than you probably ever wanted to know about acne:
What is acne?
Acne is a condition of the skin that shows up as various types of bumps including whiteheads, blackheads, pimples, and cysts. Most teens get the type of acne called acne vulgaris, which shows up on the face, neck, shoulders, back, and chest.
The pores of your skin contain oil glands, which lubricates your hair and skin. Sometimes a pore may become 'clogged' with too much oil, dead skin cells, and even bacteria, causing acne. See below.
If a pore becomes clogged, closes, and then bulges out, you have a whitehead. If a pore becomes clogged but stays open, the top may darken and you're left with a blackhead. Sometimes when the walls of the pore become damaged it allows bacteria and dead skin to work their way under the live skin. This leaves you with a red, but small infection called a pimple. Clogged pores that are open deep in the skin cause cysts which are generally infections larger than pimples. See below.
Types of Acne
When you read about acne or other skin diseases, you encounter words or phrases that may be confusing. For example, the words used to describe the lesions of acne—comedo, papule, pustule, nodule and cyst—are understandable only if you know each word’s definition. It also is helpful to have a photo that is characteristic for each type of lesion.
Here is a brief summary of definitions of words used to describe acne, with accompanying photos. Let’s begin, though, with the definition of lesion, an all-purpose word:
Lesion—a physical change in body tissue caused by disease or injury. A lesion may be external (e.g., acne, skin cancer, psoriatic plaque, knife cut), or internal (e.g., lung cancer, atherosclerosis in a blood vessel, cirrhosis of the liver).
Acne lesions range in severity from comedones (blackheads and whiteheads) to nodules and cysts. Here is a brief definition of acne lesions:
Comedo (plural comedones)—A comedo is a sebaceous follicle plugged with sebum, dead cells from inside the sebaceous follicle, tiny hairs, and sometimes bacteria. When a comedo is open, it is commonly called a blackhead because the surface of the plug in the follicle has a blackish appearance. A closed comedo is commonly called a whitehead; its appearance is that of a skin-colored or slightly inflamed "bump" in the skin. The whitehead differs in color from the blackhead because the opening of the plugged sebaceous follicle to the skin’s surface is closed or very narrow, in contrast to the distended follicular opening of the blackhead. Neither blackheads nor whiteheads should be squeezed or picked open, unless extracted by a dermatologist under sterile conditions. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci and other skin bacteria.
Papule
A papule is defined as a small (5 millimeters or less), solid lesion slightly elevated above the surface of the skin. A group of very small papules and microcomedones may be almost invisible but have a "sandpaper" feel to the touch. A papule is caused by localized cellular reaction to the process of acne.
Pustule
A dome-shaped, fragile lesion containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria. A pustule that forms over a sebaceous follicle usually has a hair in the center. Acne pustules that heal without progressing to cystic form usually leave no scars.
Macule
A macule is the temporary red spot left by a healed acne lesion. It is flat, usually red or red-pink, with a well defined border. A macule may persist for days to weeks before disappearing. When a number of macules are present at one time they can contribute to the "inflamed face" appearance of acne.
Nodule
Like a papule, a nodule is a solid, dome-shaped or irregularly-shaped lesion. Unlike a papule, a nodule is characterized by inflammation, extends into deeper layers of the skin and may cause tissue destruction that results in scarring. A nodule may be very painful. Nodular acne is a severe form of acne that may not respond to therapies other than isotretinoin
Cyst
A cyst is a sac-like lesion containing liquid or semi-liquid material consisting of white blood cells, dead cells, and bacteria. It is larger than a pustule, may be severely inflamed, extends into deeper layers of the skin, may be very painful, and can result in scarring. Cysts and nodules often occur together in a severe form of acne called nodulocystic. Systemic therapy with isotretinoin is sometimes the only effective treatment for nodulocystic acne. Some acne investigators believe that true cysts rarely occur in acne, and that (1) the lesions called cysts are usually severely inflamed nodules, and (2) the term nodulocystic should be abandoned. Regardless of terminology, this is a severe form of acne that is often resistant to treatment and likely to leave scars after healing.
Who gets acne?
Close to 100% of people between the ages of twelve and seventeen have at least an occasional whitehead, blackhead or pimple, regardless of race or ethnicity. Many of these young people are able to manage their acne with over-the-counter (nonprescription) treatments. For some, however, acne is more serious. In fact, by their mid-teens, more than 40% of adolescents have acne severe enough to require some treatment by a physician.
In most cases, acne starts between the ages of ten and thirteen and usually lasts for five to ten years. It normally goes away on its own sometime in the early twenties. However, acne can persist into the late twenties or thirties or even beyond. Some people get acne for the first time as adults.
Acne affects young men and young women about equally, but there are differences. Young men are more likely than young women to have more severe, longer lasting forms of acne. Despite this fact, young men are less likely than young women to visit a dermatologist for their acne. In contrast, young women are more likely to have intermittent acne due to hormonal changes associated with their menstrual cycle and acne caused by cosmetics. These kinds of acne may afflict young women well into adulthood.
Acne lesions are most common on the face, but they can also occur on the neck, chest, back, shoulders, scalp, and upper arms and legs.
What causes acne?
An important idea to remember as you study the condition of acne is that everyone is different, therefore, what may cause acne on you, may not on someone else.
As I mentioned earlier, acne is generally caused by the build up of oil and dead skin in a pore; but what causes this build up of oil and dead skin?
Natural hormones
Hormones are constantly produced by your body throughout your entire life, however, during the teenage years they tend to be the most active and most rapidly changing.
Plugged skin
If a large number of skin cells exist on a regular basis they can close the oil glands or pores, creating blackheads or whiteheads, as discussed earlier.
Bacteria
When bacteria is present on the skin it can easily infect the oil glands and pores. Bacteria thrives on the oil and can grow rapidly beneath plugged skin creating bad infections. This can create your 'classic' pimple or cyst; cysts are deeper, worse than a pimple and more likely to cause scaring.
Family background
If a parent had acne as a teenager, he/she can bet their kids will also have sensitive skin, especially during the adolescent years. Family background can tie into the other three causes listed above. e.g. Hormones and extra skin can be a character trait passed down.
