Terminology
The term acne has its roots in the Greek language. Quite simply, it means a skin eruption. In fact, the name acne refers to the occurrence of:
Pustules, which relates to the accumulation of pus in the top layer of the skin, called the epidermis, or beneath the skin in the dermis, and
Papules, which are similar to pustules, except that they do not contain pus.
Pustules and papules are both generally referred to as pimples.
The form of acne that is most common is that known as acne vulgaris, which means, quite simply, common acne. In fact, this is the form of acne that occurs most commonly amongst teenagers.
Associated with acne vulgaris is the presence of comedones, otherwise known as blackheads. This is a yellowish or blackish lump on the skin’s surface. A blackhead is a type of acne vulgaris caused by the accumulation of excess oils in the duct of the sebaceous gland. These protrusions essentially consist of keratin and sebum, which is an oily secretion from the sebaceous gland that darkens, upon contact with the air, to leave the appearance of a lump of dirt.
The term acne rosacea refers to the episode called rosacea, which produces red domed papules and pustules. This disorder can be easily confused with acne vulgaris. Further, it is possible for them both to co-exist.
Causes of Acne
When there are blockages in follicles, this can result in the formation of Acne.
Hyperkeratinisation is an abnormal condition of the cells lining the inside of a hair follicle, which is the part of the skin that grows hair by packing old cells together. It is the normal function of these cells to become separated from the skin lining at normal intervals. The dead cells are then squeezed out of the follicle as a result of the growing hair. However, in hyperkeratinization, this process is prevented from taking place and a number of these dead skin cells do not leave the follicle because of an excess of keratin, a natural protein found in the skin. This excess of keratin, which is associated with genetics, results in an increased adherence/bonding of dead skin cells together. This cohesion of cells will tend to either block the hair follicle, leading to keratosis pilaris, or clog the oily sebaceous glands, leading to acne.
Therefore, the earliest change relates to hyperkeratinization and formation of a plug of keratin and sebum, an oily substance produced by the sebaceous glands in the skin whose purpose is to lubricate the skin. Enlargement of the sebaceous glands and an increase in sebum production occur with increased androgen, which is a substance that controls the development of masculine characteristics, production at adrenarche, which is a process related to puberty and typically occurs between ages 6 and 10 years.
The microcomedo, or sebaceous gland, may increase in size to produce either an open comedo, otherwise called a blackhead, or a closed comedo, also known as a whitehead. Whiteheads are caused by skin pores being blocked by a combination of sebum, a naturally occurring oil, and dead skin cells. Under these conditions, inflammation can occur as a result of the commensal, which is a relationship between two organisms where one benefits and the other is not significantly harmed (like a bird living in a tree), bacteria Propionibacterium acnes, which is a slow growing bacterium that is linked to the skin condition acne.
Such inflammation can lead to inflammatory lesions, such as nodules, infected pustules and papules, which are represented by a solid elevation with no visible fluid, varying in size from a pinhead to 1cm. These lesions occur in the dermis, which is the layer below the outer layer of the skin, around the microcomedo or comedo, which causes redness and may result in scarring or hyperpigmentation, which is the darkening of the skin caused by increased melanin.
Acne – How To Succeed
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