Facial Acne

Ah acne, the bane of every teenage existence. Everyone tells you you'll grow out of it, and most of us do, but what if you don't? And worse still, what if you start to develop acne as an adult? Chances are, you're going to want to find out what's causing it, and how to make it stop, as quickly as possible.

What Causes Acne?
Acne happens when the pilosebaceous unit, which is made up a sebaceous gland, a hair follicle and a hair - essentially, a pore ' stops working properly. Because we have more pores on our faces, necks, shoulders and chests, these are the places where acnes breakouts tend to occur.

Inside of the pilosebaceous unit, sebaceous glands work away, producing sebum, the natural oils that your body produces to keep skin and hair from getting dried out. When we start puberty, our hormones start to fluctuate. One of the effects that this can have is an increase in sebum production. Once puberty ends, sebum production usually slows, however this is not always the case.

As your skin renews itself, it naturally sheds its skin cells. These dead cells then build up inside the hair follicle and combine with the oil being produced. Eventually, the follicle fills up with oil and cells. Once this happens the sebum can reach the surface of the skin where it spreads out and moisturizes, keeping the skin healthy.

Unfortunately, sometimes hair follicles collapse on themselves, blocking them and trapping oil inside of the pore. The exact cause of this is not known, and it is impossible to tell why this occurs in some pores and not others.

A collapsed pore will lead to one of two things:


  1. Pimples: These occur when bacteria called Propionibacterium acnes get into the trapped oil and begin to multiply, causing a small infection. As your body fights the infection you get inflammatory acne, characterized by the familiar red bumps and pustules, or whiteheads.
  2. Comedones or Blackheads: If there is no bacteria present in the blocked pore, the blockage will simply become a plug. These plugs oxidize from being exposed to oxygen, creating the familiar black color that we refer to as blackheads.


What Causes Acne?
The exact causes of acne in both teens and adults are not known. Contributing factors could include:


  • Diet
  • Hormones
  • Vitamin deficiencies
  • Genetics
  • Stress


It's likely that the true cause of acne is a combination of all of these factors.

Women and Acne
While females are less likely than males to develop severe acne during adolescence, it is more common for a woman to develop acne in their 20s and beyond. Premenstrual acne is common, due to the elevated levels of androgens that most women experience just before the start of their periods. Androgens control the release of sebum from the sebaceous gland. Oral contraceptives can help to control this type of acne by reducing the amount of androgens present in the body.

Types of Acne
There are several types of acne. Acne Vulgaris and Acne Rosacea are the most common, but there are also other types:


  • Acne Vulgaris is the most common kind of acne. Sufferers of acne vulgaris will get several types of pimples including whiteheads, blackheads, papules, nodules, cysts and pustules.
  • Acne Rosacea appears similar to acne vulgaris, and the two can be easily confused. Rosacea appears as a rash, usually on the forehead, nose, cheeks and chin, which can be accompanied by pimples and other skin blemishes. Rosacea may also cause blood vessels to become more visible. If left untreated, it can cause growth of excess tissue and swelling of the nose, called rhinophyma. More women suffer from rosacea, but cases in men tend to be more severe. If you think you have rosacea, see your doctor for treatment options.
  • Acne Conglobata, more common in males, this is the most severe form of acne vulgaris. Symptoms are widespread blackheads and numerous large lesions, sometimes interconnected. This form of acne can cause scaring and severe, irreversible damage to the skin. Conglobata is found on the face, back, chest, upper arms, buttocks and thighs. As with all acne, the cause is not known. Usual age of onset is between 18 and 30 and the condition can stay active for several years. Usually requires aggressive treatment to control.
  • Acne Fulminans is a sudden onset of acne conglobata, usually occurring in young men. Symptoms include nodulocystic acne and severe scaring. Acne fulminans is unique in that it includes fever and aching of the joints.
  • Pyoderma Faciale only affects females, usually between the ages of 20 to 40 years old. Characterized by large, painful nodules, pustules and sores, which may leave scarring, pyoderma faciale begins abruptly, and may occur in women who have never had acne before. It is confined to the face, and usually does not last longer than one year.
  • Gram-Negative Folliculitis is a bacterial infection, which causes cysts and pustules. It could be caused by long-term antibiotic acne treatments. Occurs rarely in both males and females.
  • Nodulocystic acne is characterized by numerous deep, inflamed bumps (nodules) and large, pus-filled lesions that resemble boils (cysts). Nodules are tender to the touch and feel firm. The severe inflammation can cause the acne to become very red or even purple. Scarring often results.


Acne Treatments
In addition to the many over-the-counter creams and gels available, there are also doctor prescribed acne treatments available to acne sufferers of severe acne. They include:

  • Isotretinoin, marketed under the names Accutane or Roaccutane, is often prescribed and has been proven effective for acne treatment. However, it does have serious side effects, including joint pain, and should never be taken by women who are pregnant, nursing, or thinking of becoming pregnant.
  • Oral steroids are rarely prescribed, and then only for extremely severe cases.
  • Birth control pills can be effective in the treatment of mild acne in some women. Success rates vary and not all brands will help to prevent acne.
  • Topical antibiotics, Clindamycin, Erythromycin and Sulfacetamide
  • Oral antibiotics, Erythromycin, Tetracycline, Doxycycline and Minocycline
  • Tretinoin (Retin-A) comes in cream, gel and liquid. It is an edible form of Vitamin A, often used to treat blackheads.


For tips on how to prevent and treat acne without a prescription, check out Bye Bye Blemishes.

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