Acne ( pimples) are skin changes associated with inflammation and disruption of the sebaceous glands. Acne often occurs on the face, as well as the upper back, chest, where there are most of the sebaceous glands (the so-called seborrheic zones).
There are many pores on the surface of the skin. These are the mouths of the hair follicles – the cases that surround the hair of the skin. The ducts of the sebaceous glands located under the skin open into the follicles. The figures below show the structure of a typical sebaceous gland.
The structure of the hair follicle: the mouth of the hair follicle (pore), opening to the surface of the skin, the sebaceous gland. The secret of the sebaceous gland envelops the hair and comes to the surface of the skin.
Causes of acne (pimples, blackheads and blackheads)
Acne is a complex disease of hair follicles and sebaceous glands. When the follicles of the sebaceous-hair ducts are clogged with a “cork” from a mixture of sebum and dead skin flakes, common acne develops (another name is comedones).
If the follicles are open, the plugs look like black dots on the face and are called open comedones.
Comedones are also closed (they do not communicate with the surface of the skin). These comedones are called whiteheads or whiteheads.
The production of sebum under the stopper of the closed sebaceous duct continues and is an ideal breeding ground for bacteria (propionic acne bacteria), which usually live peacefully and calmly in the sebaceous glands. The rapid growth of the bacterial population leads to the development of inflammation, which can manifest itself on the skin from small pimples to huge purulent pimples.
Numerous studies show that the root cause of acne is hyperfunction of the sebaceous glands.
What leads to this?
The most common cause of acne is natural age-related changes in hormonal balance (“hormonal surge”). Teenage acne is caused by steroid hormones, the main of which are androgens, male sex hormones that are produced not only in young people, but also in girls.
Androgen levels rise sharply during puberty. Under their action, in the course of complex chemical reactions in the skin, there is a sharp increase in the number of sebocytes – the secretory cells of the sebaceous gland. In fact, the number of “workers” in the sebum factory is increasing.
Provoking acne in adolescents, hormones not only increase the amount of sebum, but also change its composition, making it viscous and dense. Usually, sebum is liquid, and acne problems do not occur even with problem oily skin.
This is how plugs form in the ducts of the hair follicles. These are the causes of acne. First, microcomedones are formed, of which open and closed comedones. Comedone plugs block the exit of fat and waste products of the sebaceous glands.
Having received such an excess of food, propionic acne bacteria (Propionibacterium acnes) begin to actively multiply. These bacteria always live in the mouths of hair follicles and sebaceous glands. Normally, they do not manifest themselves in any way and only in isolated cases can cause acne and inflammation.
The waste products of these bacteria have a strong irritant effect when in contact with surrounding tissues. This is how inflammation develops. The ever-expanding hair follicle can rupture and form pustules.
Types of acne
According to the clinical classification, the following types of acne are distinguished:
- Juvenile (comedones, fulminant, nodular cystic and papulo-pustular acne).
- Adult acne (inverse, late, conglobate, acne that occurs when using anabolic steroids during bodybuilding).
- Formations resulting from the influence of external factors.
- Acneform rashes.
According to the severity, mild, moderate and severe forms of the disease are distinguished.
The following stages of development of pathology are distinguished:
- Lightweight. Comedones, single papules appear on the patient’s skin, there are no signs of inflammation. Therapy at this stage allows you to achieve a complete recovery.
- Moderate. Acne is represented by a large number of comedones. In addition, there are 10-20 inflamed papules. Treatment at this stage is more complex and prolonged (up to 8 weeks). The prognosis is favorable.
- Heavy. The symptoms are the same as in the previous stage, but the number of inflamed papules increases to 30-40 pieces. Long-term specialized treatment is needed.
- Extremely heavy. The skin has a large number of pustules, papules, nodular formations (from 40 or more). A long course of complex therapy is required.