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Understanding acne – What happens in acne?

Introduction and background

If not understood properly, acne can be seemed as a complicated and complex disease that is not only harder to treat but even tougher to live with. A basic understanding about the common terminologies of acne is essential for getting sufficient knowledge that will help you treat acne in a faster and safer way.


What is sebaceous gland?

Within every hair follicle is a tiny pit with a group of cells that are called a sebaceous gland. This gland produces an oil known as sebum, and its purpose is to oil the hair shaft and to spread out over the top of the skin, sealing in the moisture of the skin so that it stays healthy, soft, supple, youthful and wrinkle free.


What is sebum?

The human skin has thousands of pores. These small openings in the skin produce sebum, a type of natural lubricating oil, which is normally sloughed off along with dead skin and empties onto the skin via the hair follicle.


What is a pilosebacious unit (PSU)?

A Pilosebaceous unit is a term used for a combination of the hair follicle and its sebaceous gland. Found just under the skin, PSUs are numerous on the face, upper back, and chest, and con¬tain sebaceous glands that are con¬nected to hair follicles.


What is hormone?

Hormones are chemical messengers secreted by special glands of our body (endocrine glands) directly into the blood. Hormones are responsible for some vital function of our body such as growth, development, puberty and other important matters.


What happens in acne – Understanding the process

Acne comes about when unwanted oils get trapped inside the pores of the skin. When the pores are clogged with these oils, not to mention the dirt and the dead skin cells that often line up the pores throughout the day, irritation can occur.
In simpler words, acne is a disease that affects the skin’s oil glands. The small holes in your skin (pores) connect to oil glands under the skin. These glands make an oily substance called sebum. The pores connect to the glands by a canal called a follicle. Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows through the follicle and out to the skin. When the follicle of a skin gland clogs up, a pimple of acne grows.
However, technically speaking, the process is much more complex and needs further details to be fully understood as sometimes, the hair, sebum, and skin cells all clump together into a plug. The bacteria in the plug cause swelling. Then when the plug starts to break down, a pimple grows.
The following paragraphs will help you understand two important components in the overall development of acne i.e. skin hardening and bacterial infiltration.


The process of cornification or hardening of skin in acne

If we look into more details, acne disorder develops as a result of a blockage in hair follicles.
Keratin, sebum, cellular debris, and bacteria are the materials forming the plug or comedone, and this obstruction is the earliest noticeable change in acne. The cause is a failure of cells lining the hair follicle to separate normally and flow to the surface of the skin.
Instead, these cells, called keratinocytes, shed too frequently, stick together in clusters with the sebum, and form an obstruction. The cells have also transformed into inert bodies of keratin, called corneocytes, and the accumulated material is a ready nutrient source for bacteria. This process is called “cornification” or hardening, and is a common denominator of all acne disease.


The process of” bacterial infiltration in acne

The heightened flow of sebum at adolescence, combined with obstruction and ensuing enlargement of the follicle, eventually lead to acne lesions. The comedone plug furthers the inflammation process by cutting off exposure to oxygen in the follicle. The notorious acne bacteria called as P. acnes now will grow and multiply much faster here than it normally would on the surface of the skin.


Body parts commonly affected by acne

Acne typically appears on the ‘T-Zone’ consisting of a forehead, nose and chin. Contrary to the popular belief, acne does not only occur on the face, although they are much visible there as our body contains numerous oil glands which produce oil to moisturize the surface of the skin. Within the depths of each gland, oil is carried to the surface by tubes visible on the surface as pores. The highest density of these glands is located on the face, especially at the nose, forehead and mid-cheeks, and then on the neck, at the back and on the shoulders.

Therefore, while acne may crop up in different parts of the body, the location and size of oil glands explains in part why acne tends to most commonly affect these sites.


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