CAUSES of ACNE:
The Layers of the Skin
The skin is divided into two main layers: the epidermis and the dermis.
The dermis has two layers and is underneath the epidermis. It contains the collagen and elastic tissue that provide the structural support, blood supply and nerves to form the foundation for the epidermis. It also contains the hair follicles, sweat and sebaceous glands.
The epidermis is again divided into four layers which represent the stages of ageing of the skin surface cells, the keratinocytes, as they form at the bottom and progressively deteriorate and fall off at the top, forming as it does, the major physical barrier of the skin of the body. It is also the origin of the hair, sweat and sebaceous glands that become anchored in the dermis below. Amongst the numerous keratinocytes are the melanocytes; cells that form the pigment of the skin that protects from ultraviolet radiation.
Acne Vulgaris
Acne is a very common disorder. It begins around puberty and affects the skin particularly of the face, chest and upper back. It usually begins on the forehead and is only a mildly inflamed or non-inflamed. Later more inflamed changes form on the cheeks, chin and nose. Headbands and chin straps may cause inflammation to develop. A range of chemicals applied to the skin or hair and some medications may aggravate acne.
Keratin (a protein forming a major constituent of the outermost layer of the skin, hair and nails) and sebum (the oily substance secreted by the sebaceous glands of the skin) plug the hair and sebaceous gland follicle (cavity), expanding it to form what is called a 'comedo' or 'comedones'.
If the comedo is connected to the surface of the skin it is a 'blackhead' (open comedone) and usually doesn't cause inflammation and the dark oily material can be expressed from them.
If, however, the canal is blocked (closed 'comedone') a 'whitehead' forms. The contents of the 'whitehead' are not easily expressed but they are liable to rupture into the surrounding dermis causing inflammation and the pustules and nodules of acne. When severe it forms cysts and scars.
The cause of acne is unknown but raised androgen, male hormone, levels play a part. The production of sebum in sebaceous glands is important. A common skin bacterium Propionibacterium acnes which, with the yeast Pityrosporum Orbiculare, cause the sebum to form free fatty acids leading to the rupture and inflammation of the cyst.
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