Why do I get Acne?
Acne, commonly referred to as pimples, consists of comedones
(black & white heads), inflammatory nodules and cysts. It is one of the
most common skin conditions. Acne can affect any age group but it is most
common in adolescents. Incidence is so prevalent in this group that is often
referred to as a physiological condition.
Acne is caused by complex interaction of changing hormones,
sebum, overgrowth of germs and inflammation. The description below is the cause
of almost all cases of acne.
Increased sebum production:
We have oil producing glands called sebaceous glands just underneath
the skin. They form part of the hair follicle (Pilosebaceous unit). These
glands make oil called sebum which keeps the skin supple and smooth. Sebum
comes out on the skin surface through the same pore as the hair.
During teenage years, due to hormonal changes sebaceous
glands are stimulated resulting in more sebum production. This results in oily
skin and higher incidence of acne.
.
Clogging of pores:
Skin consists of 3 layers. The outer layer is called
epidermis and consists of dead cells. These cells rise to the surface and the
body shed them. When the body produce lot of sebum, dead skin cells stick
together inside the pore resulting in clogging of the pore. If the pores are open,
they are called blackheads and if closed they are known as white heads.
Bacterial colonisation and inflammation:
Skin is colonised by diverse microorganisms most of which
are harmless or even beneficial to their hosts. They are called commensals. Propionibacterium
acnes is one of them.
Trapped sebum due to clogging of pores is ideal for
Propionibacteria to multiply. Immune system reacts to large number of this
bacteria resulting in release of inflammatory cells causing inflammation. Thus,
skin becomes red and painful. The acne lesion(pimple) becomes larger and filled
with pus (pustule). In some cases, pustules, can grow to form small nodules and
cysts.
Causes of acne flare
up:
·
Picking and squeezing the acne lesions cause
further inflammation and scarring.
·
Thick or greasy make up possibly make acne worse
by blocking the pores. It is better to use oil free products (non-comedogenic)
in acne prone skin.
·
Contraceptive pills containing progesterone only
make acne worse.
·
Excessive sweating or humid conditions may make
acne worse.
·
Creams containing corticosteroids can make acne
worse.
·
Oral medications like anti epileptics can cause
acne flare up.
·
Hormonal abnormalities as seen in Polycystic
ovarian syndrome (PCOD) can cause acne or leads to flare ups.
·
It is thought that some foods especially diet
high in sugar and milk products cause acne flare up but research has found no
evidence to support this.
I hope this article helped you to understand causes of acne.
In the next article, I will discuss the treatment of this skin condition.