What Is Acne?
Acne is an inflammatory skin disease of the oil glands and hair follicles that is marked by the eruption of blackheads, whiteheads, pustules, cysts, scarring, and, in the case of dark skinned patients, unsightly dark spots. Acne affects almost everyone — more than 90% of all adolescents, nearly 50% of all adult women and 25% of all adults. Crossing gender lines as well as national borders, it’s one of the most widespread medical conditions in the world. Yet there’s still no cure. But there is hope. Acne is not curable, but it is treatable. We know more about controlling this condition than ever before. The secret to managing acne is prevention. Once a treatment has been found that works, it’s important to stick with it. Even after pimples disappear, you may need to continue treatment to keep new blemishes away. It’s also crucial to begin treatment as soon as the first signs appear, because the sooner you address your acne, the less likely you are to experience permanent damage to your skin. Of course, in order to stop acne, we must first find out how it starts.
What Causes Acne?
One of the most important things you can learn about acne is this: It’s not your fault. Contrary to popular belief, acne is not caused by anything you’re doing — what you eat, how often you wash your face or work out — but by a combination of factors at work far beneath the surface of your skin.
A Healthy Follicle
A blemish begins approximately 2–3 weeks before it appears on your skin’s surface. It starts in your sebaceous hair follicles — the tiny holes commonly called pores. Deep within each follicle, your sebaceous glands are working to produce sebum, the oil that helps keep your skin moist and pliable. As your skin renews itself, the old cells die, mix with your skin’s natural oils, and are sloughed off. Under normal circumstances, these cells are shed gradually, making room for fresh new skin. But sloughing is different for everyone. Some people shed cells evenly; some don’t. Uneven shedding causes dead cells to become sticky, clumping together to form a plug — much like a cork in a bottle. This plug, or comedo, traps oil and bacteria inside the follicle.
A Plugged Follicle
The plug traps oil and bacteria within the follicle, which begins to swell as your skin continues its normal oil production. Your body then attacks the bacteria with a swarm of white blood cells. The whole process takes 2–3 weeks, culminating in a pimple.
Inflamed Acne Lesion
Why me? There is no one simple “cause” of acne — the condition is influenced by many factors, many which are out of your control. The regularity with which you shed skin cells can change throughout your life. Your hormone balance affects the rate at which you produce sebum, which is often in flux — especially for women. Research has also shown that genetics play a big part in the development and persistence of acne, so your family history is a valuable prediction tool as well. One of the best weapons in the fight against acne, however, is knowledge; if you know what causes it, it’s easier to formulate a good plan of attack. There are five primary culprits contributing to this process. Each of these factors may vary dramatically between individuals. While you don’t have control over these factors, understanding them can help you in your search for the proper treatment.