One of the most average forms of acne is known as acne vulgaris, caused by changes in the pilosebaceous units (skin structures comprising of a hair follicle and its associated sebaceous gland). Acne lesions are commonly referred to as pimples, spots or zits. Most people know of these acne lesions more commonly as pimples and zits.
Acne usually begins during pubescence, especially among Western societies most likely due to a higher familial predisposition. It is considered to be an abnormal reaction to normal levels of the male hormone testosterone. Most individuals will see their acne vanish as they grow older and these responses begin to diminish or at least decrease, as a person enters their twenties. There is, however, no way to predict how long it will take for it to vanish entirely, and some individuals will continue to suffer from acne decades later, even as they enter their 30’s and 40’s.
The most common form of acne is known as “acne vulgaris”, meaning “average acne.” This takes place when dead skin cells combine with the skins natural oils to block the pores of the hair follicles. Oil secretions build up below the closed pore, this creates a perfect setting for the P. acnes bacteria that causes acne to multiply. When this happens, the pore becomes inflamed and produces a visible bump. The most affected areas of the body tend to be a person’s face, neck, shoulders, and back.
The average acne lesions are: comedones, papules, pustules, nodules and inflammatory cysts. These are the more common pimples and zits that are red in color and can contain pus. Unfortunately, sometimes when acne goes away, scars remain.
Aside from scarring, its main effects are psychological, such as reduced self-esteem and depression. Most individuals are insecure during their teenage years which are when acne is most average.
Causes of acne
Exactly why some individuals get acne and some do not, is not fully known. However, there does seem to be a genetic factor.
Hormonal activity, such as menstrual cycles and pubescence
Stress, through increased output of hormones from the adrenal (stress) glands.
Overactive sweat glands in addition to the other hormone factors listed
Accumulation of dead skin cells.
Bacteria in the pores, to which the body becomes ‘allergic’.
Scratching your skin can cause irritation and lead to acne formations
Using any type of steroids.
The focus has mostly been on hormones or sebum as the leading cause of acne. However, lately focus has been given on the amount of narrowing in the hair follicle as an addition cause of acne. Abnormal shedding of the cells lining the follicle, abnormal cell binding (“hyperkeratinization”) within the follicle, and water retention in the skin (swelling the skin and so pressing the follicles shut) have all been put forward as important mechanisms. A few of the hormones attributed to acne production include testosterone, IGF-1, Dihydrotestosterone, and dehydroepiandrosterone sulfate.
Acne development in people older than their early 20’s is not very common and is often confused with another condition known as Rosacea that can cause similar symptoms. True acne vulgaris in older adults may be a feature of an underlying condition such as pregnancy and disorders such as polycystic ovary syndrome or the rare Cushing’s syndrome.