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Acne - What Causes Acne?

Acne. It’s a problem everyone faces at some point in their lifetime, but that doesn’t make it any more reassuring when you’re in the midst of a breakout. However, knowing the differences between the various types of acne can make treatment – and resolution – a lot easier.

Acne is a blanket term for many different kind of blemishes. Blackheads, whiteheads, zits, pimples – these are all names we’re familiar with. But do they really mean the same thing? The basic answer is no.

What Causes Acne?

There are three major contributors to the cause of acne: sebum (oil) production, bacteria, and the shedding of dead skin cells. The sebaceous glands, also known as oil glands, are constantly monitoring and producing the oil that lubricates our skin and hair. These glands are connected to our hair follicles. The glands produce the sebum, and then the sebum usually travels up the hair shaft and to the skin. Acne occurs when the other contributors, dead skin cells and bacteria, are also present.

Our skin is constantly shedding dead skin cells to make room for the living skin cells. Some of these dead cells are reluctant to be sloughed off, and remain attached to the new skin. When the oil travels up the hair shaft and mixes with the dead skin cells, a soft plug is formed, creating the start of a blackhead or whitehead. When certain types of bacteria are present, the acne may escalate into a more severe form.

Additional factors, such as hormones and hereditary characteristics, as well as medications can also aggravate or alleviate breakouts. However, the American Academy of Dermatology reports that contrary to popular belief, stress, diet and poor hygiene actually have little to do with the onset of acne breakouts.

The Different Types of Acne

The different types of acne can be broken down into five categories.

Comedones – Pronounced “kom-uh-dones”, this category is the mildest of all acne groups and is comprised of what are commonly referred to as blackheads and whiteheads. Blackheads are what occur when the pore is left open. The melanin in dead skin cells reacts with exposure to the sun, causing the debris to turn darker. Whiteheads are a result of the pore being closed over. This pressure often causes the walls of the follicle to rupture, causing the skin to become irritated and red.

Papules – Papules are tiny red bumps that do not have a visible head on the tip and usually occur in the area where fine, thin hair grows, such as on the cheek or along the hairline. When bacteria is present below the surface, causing a mild infection, the skin turns red. The American Academy of Dermatology defines as papule as less than 5 millimeters in size and a slightly elevated above the skin.

Pustules – Pustules are similar to papules, but they contain a white, pus-filled tip on the top of their surface. They range in size, but are usually swollen, red, and tender. They are usually formed when a papule is not treated and allowed to grow.

Nodules – Nodules are just as the name would suggest. They are large, hard, and often painful lumps beneath the surface of the skin. Formed by bacteria and secretions in the deepest layers of the skin, nodules require medical intervention to be properly treated. Often, this form of acne leads to scarring.

Cysts – The most severe of all acne, cysts resemble large boils and produce large, pus-filled lumps beneath the surface of the skin. Often the follicle ruptures, spreading the bacteria within the skin, forming these painful, red blemishes.

For information on treating acne, please read:

  • Women’s Guide to Coping With Adult Acne

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