It’s a condition that is caused by the overproduction of sebum. Sebum is an oily substance that forms in glands just under the surface of the skin called sebaceous glands. Sebum normally flows out hair follicles onto the skin to act as a natural skin moisturizer. The glands are connected to hair follicles that allow the sebum, or oil, to empty onto the skin through a pore. If hair follicles become blocked by sebum, dead skin cells, and bacteria, acne is the result.
It usually begins at puberty and worsens during adolescence . Nearly 85 percent of people develop pimples at some point between ages 12 to 25. As many as 20 million teens have the condition. It may appear as early as age 10, and even may be found in some newborns. Some people may continue to be affected by acne after age 30.
During puberty, there are increased levels of the male hormone androgen. High levels of androgen cause excess sebum to form. Sometimes the sebum combines with dead, sticky skin cells and bacteria called Propioni-bacterium acnes (P. acnes) that normally live on the skin. The mixture of oil and cells allows the bacteria to grow in the plugged follicles. When this happens, a hard plug called a comedo can form. A comedo is an enlarged hair follicle.
The exact cause is not known, but there are several risk factors that make acne more likely to occur:
- Age. Adolescents are more likely to have acne.
- Disease. Certain hormonal disorders such as polycystic ovarian syndrome make acne more likely.
- Hormonal changes. Acne can flare up before menstruation . An increase in the male hormone androgen during puberty (seen in both males and females) causes the sebaceous glands to overproduce androgen. Boys have more severe acne than girls.
- Heredity. Some individuals are genetically more susceptible.
- Drugs. Steroids and performance enhancing drugs, oral contraceptives, antibiotics, antidepressants, and tranquilizers such as lithium are known to cause acne.
- Cosmetics. Oily cosmetics can plug up hair follicles.
Other factors can worsen or cause it to flare up:
- Environmental irritants. Air pollution and high humidity can worsen acne, as can exposure to greasy environments such as working in a fast food restaurant.
- Friction. Rubbing the skin vigorously or exposure to constant friction from backpacks or tight collars can worsen acne.
- Personal hygiene. Picking at pimples or scrubbing the skin too hard can result in worsened acne.
A healthcare provider should be contacted under the following circumstances:
- Painful nodules and cysts are present.
- Over-the-counter medications have not been effective.
- Lesions are causing scarring.
- Is causing dark skin to have darker patches when lesions heal.
- Is causing embarrassment or self-consciousness.
- Is creating emotional upset.
Treatment consists of reducing the sebum production, removing dead skin cells, and killing bacteria with oral medication and drugs used on the skin (topical). The treatment depends on the severity of the condition.
Schedule an appointment with one of our medical providers to see which treatment is best for you.