Hormonal Acne and Its Causes
Since the follicular lining in the pilo-sebaceous unit is intact before adolescence, it has been postulated that if colonization of Proprionibacterium acnes happens in sufficient numbers they create antigenic molecules that promote the initiation of inflammation. Proprionibacterium acnes is able to synthesize proteinases, lipase, and hyaluronate lyase all of which may serve as the catalysts or initiators of the inflammatory infiltrate which is made of neutrophils and lymphocytes.
The key player in the cause of acne in adolescence is hormones. At this phase androgens interact with receptors on the sebaceous glands and cause activation of the sebaceous gland to hypertrophy and hence induce more sebaceous production of lipids and free fatty acids which distend the follicular conduct. More specifically, there is evidence for increased peripheral metabolic conversion of the androgen testosterone to dihydrotestosterone at the level of the skin in people suffering from acne.
How Acne Forms
The basic lesion in this condition called acne vulgaris is the comedo. When exposed to oxygen the comedo turns dark and forms what you know as a blackhead. The comedo is made by retention of layers of dead skin known as keratin in the lining of the follicles. In addition to hyperkeratosis (which is thickening or trapped layers of keratin), there is an accumulation of sebum. The combination of the keratin and the sebum leads to a blocking of the opening of the follicular conduct, and papules are made by inflammation around the comedones. Depending on the degree of inflammation, cars, pustules, cysts, granulomatous reactions, nodules, and keloids may appear.
Inflammatory Reaction
Airborne contamination and other harmful elements further aggravate the inflammatory response. As bacteria start to grow within the blocked pore your defensive system reacts by releasing granulocytes and macrophages, which are types of white blood cells that destroy the bacteria. The inflammation process is needed to eliminate the continuing effects of excess bacteria and signal the body to repair the damage to tissues. Often times the defensive response system can't stop the multiplication of acne bacteria due to lack of leukocytes or an impaired system.
Activity of the Sebaceous Gland
When a comedo is clogging the exit of the sebum ducts, the sebaceous glands continue to produce sebum, which accumulates in the sebum conduct augmenting the comedo in size. The expansion in size produces pressure and leads to a further intense inflammation reaction in the surrounding skin and produces swelling, redness, discomfort, and a mass (pimple, redhead, acne papule).
Growth of Acne Bacteria
The above conditions encourage the growth of bacteria and result in infection within the canal, the sebaceous gland, and surrounding tissue. The commencement of the infection produces further inflammatory changes, therefore starting a cycle of accentuated blockage of the outflow of sebum which leads to even more pressure, inflammation, and progressing infection making cysts and pustules to occur. The effect on skin tissues caused by these infections is very harmful and the healing process commonly results in a scar.
To find a good pimple remedy, you must remember that all individuals have different needs. Try various acne products, beginning with the milder one, until you find what works for you. A good skin treatment can be the end of your acne.
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Published February 15th, 2008
Filed in Teen
