Acne

What Is It?

Acne is a common skin condition caused by inflammation of the hair follicles and oil-producing (sebaceous) glands of the skin. Hair follicles are the tiny tubes that hold the hair in the scalp.

Acne may begin during puberty, and affects about 80 percent of all adolescents. It occurs when skin cells are not being shed normally, and these sticky cells block the skin's hair follicles. This traps a body oil called sebum, which is produced by nearby sebaceous glands. The blocked, oil-filled follicle then causes the bacteria normally in the hair follicles to multiply. This leads to inflammation, redness and the formation of pimples (pustules).

In adolescents, acne flare-ups probably are related to a natural increase in androgen hormones during the teen years. Hereditary factors also contribute to the problem. Other factors that can lead to acne include the use of oily cosmetics, humidity, heavy sweating, and problems with the ovaries or adrenal glands. Acne also can be triggered by drugs such as lithium or steroids, both the type that are prescribed by physicians and potentially harmful "body-building" steroids, Acne is not related to diet or poor hygiene. In fact, too much washing can cause an acne flare-up to get worse.

Symptoms

Acne can cause:

• Blackheads and whiteheads (comedones) — Comedones are enlarged hair follicles filled with sebum. Blackheads are comedones that have opened to the skin's surface. The color of the sebum makes them appear black. Whiteheads are comedones that are closed on the surface.
• Pimples (pustules) — Pustules are inflamed hair follicles. The bacteria in the follicle multiply, attracting infection-fighting cells, which release substances that cause irritation and redness. The follicle then ruptures, and spills the contents into the surrounding skin, which causes more inflammation.
• Nodules and cysts — These are larger infections of the hair follicles that extend deeper into the skin, forming firm, deep bumps and swellings. Like pimples, they are caused by increased sebum production and the growth of bacteria, which cause irritation and redness.

In girls and women, acne often flares up at certain points in the menstrual cycle.

Diagnosis

Your doctor usually can diagnosis acne based on a simple physical examination. He or she will look for acne comedones, pustules, nodules and cysts on your face, chest, back, upper arms and shoulders. He or she also will ask questions about your medical history to try to identify contributing factors. You will be asked about your menstrual history, patterns of hair growth, cosmetics, facial cleansers and medications.