How Acne Develops

Fundamentally, it is important for most people to know how acne develops. Usually, it starts in plugged pores in the surface of the skin. In the dermis, the middle skin layer, pilosebaceous units are located which are composed of sebaceous glands where acne lesions may arise.

Pilosebaceous are not found in the bottoms of the feet and the palms of the hands this is why acne cannot be generated in these parts since there are no hair follicles and oil glands. However these units are present all over the body.

The most dense presence of pilosebaceous units are found on the face, neck and the shoulders, making them more prone to irritation, thus the acne affliction. Primarily, acne is caused by the obstruction of the passages in the pilosebaceous canals. These conditions are brought about by varying reasons:

The foremost reason in acne development is the excessive production of the sebum. This in effect may clog the pilosebaceous canals. Again this is due to the male hormone androgen. In general, any fluctuation or changes in the balance of this hormone for whatever reason will always result to acne production.

The hair follicle wall will start to overproduce once it is stimulated by the overproduction of sebum, this condition is called as ductal hypercornification. Dead cells combined with excess sebum will clog the pores of the skin and will begin to accumulate. Once this situation occurs Propionobacterium acnes, a bacteria present in the skin which is responsible in starting irritation, may thrive on the clogged canals and invade them. These may attack the immune system, which in turn may kill the white blood cells. Consequently, the infected area will react to the white blood cells and the present bacteria which will ultimately trigger the onset of the acne breakout.

The acne will develop over the period of two or three weeks before it will rise to the surface of the skin.  It will develop from simple blemishes on the sebaceous glands through the hair follicle. Simultaneous with this ongoing process, two other processes happen in the hair follicles. The excess sebum mixes with old or dying skin cells and will be excreted from through the pores. On the other hand, the rejuvenation process starts whereas the old cells die, giving way to the regeneration of new skin cells.

Under normal circumstances, the shedding of the old cells keep pace with the production of new ones. This condition varies in different people. For some, the shedding is evenly distributed throughout the skin surface. In many people however, the shedding is uneven, allowing time for the dead cells to accumulate in the follicles, thus effectively clogging the pores with combined dead cells and bacteria.

Moreover, acne can either be inflammatory or non-inflammatory.

The most common form is the comedo, a non-inflammatory type. When the pore of the comedo is closed while the clog gets trapped inside, whitehead is produced.  These are characterized as white, small bumps.

On the other hand, an open pore allows the clog to pull through the skin, this condition is called as blackheads. The common notion that blackheads are black because of the accumulation of dirt is not true; this is primarily because of the trapped pigment melanin.

Though these types of acne are non-inflammatory, once they get irritated they may develop into inflammatory types which are reddish and swollen in appearance.  These include papules, nodules, pustules, cysts, scars and maculae, which may typically take some time to heal.
 
Papules are red pimples or lesions. Pustules are basically pimples but their pus is filled-up at the center. Nodules are generally deep-seated acne and may take up to 2 months before they heal. The most serious type of acne is cyst which are rare but these can reach well up to centimeters in diameter. This is considered as a severe form of acne and needs immediate, serious medical attention.