What is Acne?

Acne. Image courtesy: Mayo Clinic

While not dangerous, acne is usually a beauty concern. Let us answer some commonly asked questions about acne including what is Acne vulgaris? What symptoms are associated with it? What is acne made of? What is good for this skin condition? We have as well included several acne images.

What is Acne

It is pesky, can make you self-conscious, steal your self-esteem, and degrade your quality of life which brings us to the question, “What is acne?”

Acne develops when any underlying factor causes the sebaceous glands to produce excess sebum. This combines with dead skin cells to form a plug that blocks the hair follicle. The image below provides a good pictorial presentation of how acne forms:

Medically referred to as Acne vulgaris, acne is an inflammation of the skin that involves the hair follicles. It occurs when hair follicles – small pores in the skin from which a shaft of hair grows – get plugged.

The skin has tiny glands called sebaceous glands. These are found close to the surface of the skin and serve to keep the skin lubricated. To do that, the sebaceous glands secrete an oily substance called sebum.

Because sebaceous glands and hair follicles are connected, sebum naturally flows into the hair follicles and then along the long the hair strand, ultimately keeping the pore – and indeed the entire skin – lubricated.

In addition to the hormonal changes that occur during puberty, menopause etc., other causes of acne have been identified including poor diet, stress, and certain medications.

Although acne is not dangerous and is thus not a serious health concern, it is often a beauty concern and can leave you with glaring scars. It typically develops in areas with an abundance of sebaceous glands. Common trouble spots include face, neck, chest, shoulders, upper back, and upper arms.

NB: The sweat pores are not involved in acne. Only the pores associated with hair follicles are usually affected.

Different Types of Acne Spots – Kinds of Acne

Moving on from what is acne, what are the different variations of this common skin condition? Well, acne may manifest itself as whiteheads or blackheads, depending on exactly what happens inside the hair follicles.

  • Whiteheads: Whiteheads are formed when the plug in the hair follicle makes its walls to bulge without causing a significant opening at the skin surface if any. This results in a white spot as the name suggests.
  • Blackheads: Blackheads on the other hand form when the plug in the hair follicle makes the pore surface to open. When exposed to the air, the bacteria and sebum constituting the plug get oxidized and turn to the characteristic brownish-black color associated with blackheads.
  • Cysts: Cyst lumps are usually firm, painful, and extend deep into the skin. They are often pus-filled and are more likely to cause scarring after acne has cleared.
  • Pimples: These are on the other hand small, raised red spots with a white center that develop when the afflicted hair follicles get infected or inflamed as the Mayo Clinic says. Pimples are also referred to as pustules.
  • Papules: Tender spots that are pink in color but have no pus at the center are medically referred to as papules. Some people may also get nodules. These are large, painful solid lumps that – just like acne cysts – begin from deep within the skin. Nodules are also likely to leave a scar after healing.

According to WebMD, both whiteheads and blackheads (the two most common acne blemishes) can form cysts. Acne cysts are associated with more severe breakouts and form when skin pores get filled with sebum, bacteria, and dead skin cells as the American Academy of Dermatology says.

“While we commonly associate acne to pimples, acne can cause various types of blemishes including blackheads, whiteheads, papules, pustules (true pimples), cysts, and nodules”

What is Acne Inflammation?

Excess sebum (skin oil) not only play a role in clogging the pores but also creates a suitable environment for P. acnes bacteria to thrive.

This bacteria lives on human skin and is naturally harmless, but with the presence of excess oil-dead skin cell mixture, it can multiply rapidly leading to inflammation of the affected pores. This then causes red, swollen spots that are commonly seen among acne patients.

In some severe cases, the inflammation extends far into the skin, resulting in acne cysts. Cysts may be painful and are often associated with scarring after the breakout has cleared.

Acne Prevalence

As the National Institute of Arthritis And Musculoskeletal And Skin Diseases says, acne ranks first in prevalence among skin diseases. Acne can affect anyone regardless of his/her race or age.

Teenagers and young adults are more susceptible to acne, usually a result of hormonal changes that are taking place during these years. About 80 percent of the people aged between 11 and 30 have suffered acne flare-ups at some point in their lives.

Boys also tend to be affected more than girls as the UK Patient website says. Young males also tend to suffer from acne for longer than their female age mates. This is thought to be due to the presence of higher quantities of testosterone – the acne worsening hormone – in men.

While most cases of acne are mild, the site reports that 3 out of 10 teenagers suffer from serious breakouts that necessitate treatment to prevent scarring.

Despite the high prevalence of acne breakouts among teenagers and young adults, it is not uncommon to see older people (including those in their forties and fifties) develop acne due to factors such as the use of certain medications, menopause, smoking etc.

Hereditary Aspect of Acne

Acne has a hereditary aspect which means that you are at higher risk of breakouts if your parents are also prone to them or had acne at some point in their lives.

As the NHS Choices says, you are at higher risk of developing severe acne at an early age if your parents – the two of them – also had acne. The cited study also found that if one or both of your parents have suffered adult acne, you are at higher risk of developing it too.

Acne in Women

According to the UK National Health Service website, over 80% of acne cases occur in women. Sebum production usually surges when there are hormone level changes. This explains why some women get breakouts in the days preceding their periods.

Women also tend to get acne during pregnancy especially during the first trimester (3 months) of their pregnancy.

Menopause is also often accompanied by acne flare-ups. This is triggered by the hormonal changes that occur in the years leading up to menopause. You should thus not be surprised if you come across a woman in her 40s or even 50s suffering from acne.

Acne symptoms – Symptoms of acne

Acne vulgaris breakouts vary from mild to severe. Acne symptoms vary accordingly. Mild acne is often associated with nothing more than whiteheads and blackheads and an oily look of the skin.

In some cases, the pores get an infection leading to the formation of a pimple. This may be accompanied by other symptoms such as pain and the skin feeling hot to the touch.

Severe acne may, on the other hand, lead to the formation of dozens of hundreds of pimples and may involve particularly large areas of the skin. Other severe acne symptoms such as cystic lesions and scars may also develop. Cystic lesions are usually painful.

Dark spots are a common symptom of both mild and severe acne. They appear after the acne has healed and may linger on for as low as a few months or as high as several years.

Secondary symptoms of acne may include low self-esteem, depression etc.

Acne Images

To sum up our learning, we have included several acne images below. After all, a photo is worth a thousand words as it is commonly said. Take a close look at these pictures to see how acne typically looks like and probably compare them with your condition.

While all these acne images show facial acne, acne occurring in other parts of the body such as shoulders, chest, etc. are not that different.

Acne Cysts
Acne Cysts. Courtesy: AAD
acne whiteheads, blackhead and pimples
Acne whiteheads + a Pimple (left) and blackheads (right). Courtesy: WebMD
acne nodules
Acne nodules
Acne Papules
Acne Papules

Some More Acne facts

  1. Squeezing and picking at those spots can make the condition worse.
  2. Pressure from helmets (on the face), backpacks (on the shoulders, back, and chest), and tight collars (on the neck) can make acne worse.
  3. Pollution has been shown to worsen breakouts.
  4. Some cosmetic products can trigger or worsen acne breakouts. It is a good idea to ensure that cosmetic products are ascertained to be and labeled non-comedogenic.
  5. Scrubbing at the affected skin (more tempting if you have blackheads) won’t improve it. It will, in fact, worsen it. Instead wash your skin gently with a mild cleanser two times at most each day.
  6. Stress can worsen your flare-ups.

What Is Acne Purging?

I have been seeing more and more people talk about acne purging in online forums and blogs in the last few years.

This is a rather controversial topic but is essence what people refer to as acne urging is the initial worsening of an acne breakout after someone has started using an acne treatments products such as cleansers, chemical peels, and other treatments containing Beta-Hydroxyl Acids (i.e. glycolic acid, salicylic acid, or benzoyl peroxide), Retinoids, etc.

The explanation usually given is that such products open up clogged pores, control sebum production, and get rid of dead skin cells while at the same time killing any harmful bacteria accumulated in your pores. The resulting “gunk” result in even more whiteheads and inflamed red pimples.

Some experts, however, think that acne purging is just irritation of the skin before it gets used to the products involved.

The time it takes to go over the acne purging phase varies from one person to another depending on the severity of the original acne flare-up but a period of 4-6 weeks is reasonable.

Sticking to non-comedogenic products and proper acne care regime also helps to reduce the duration it takes for acne purging to clear. Your dermatologist may also administer some oral antibiotics over the first few weeks to combat this problem.

A word of caution: Acne purging is not to be confused with an allergic reaction which is notable for symptoms such as itching, rashes, and bumps. If an allergic reaction is suspected, discontinue using the product and schedule an appointment with your dermatologist.

If what is thought to be “acne purging” also seems to take longer than a few weeks, you should also seek medical attention to rule out irritation the likelihood that you are experiencing skin irritation from the use of the product.

What is good for Acne?

Now that we know what acne is and how it forms, it may delight you to know what is good for, or what helps acne in other words. Most cases can be controlled by using one of the many over the counter acne skin care products.

These are widely available without a prescription but may not be effective for more severe acne. Should that be the case, a visit to a dermatologist (skin specialist) is advised. Even severe cases can be controlled with appropriate treatment.

Before then, you will want to look for over-the-counter acne products with one or more of the following ingredients:

Over to You

I hope I have answered the question, “what is acne?” well enough for you. I have also covered some more related points including types, acne purging, symptoms and good care and treatment measures.

Now it is your time to share with us what experiences, challenges, or breakthroughs you have had with acne by dropping us a comment below.