How Acne Develops

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This article was Medically reviewed by A. Michael, MD

There are several internal and external factors that can lead to acne, but in general, it is mainly caused by increased secretion of oil and buildup of dead skin cells and other debris. Acne develops through the following steps:
  • The skin follicle becomes blocked and oil and debris accumulate, creating a plug that blocks the gland.
  • This expands and forms a whitehead. However, the pore can open up and form a blackhead.
  • As oil and debris build up, whiteheads may eventually burst and become inflamed, leading to cystic (or inflammatory) acne.
Up to date, it is not known what triggers these events or why some follicles are affected and others are not. The exact cause of cystic acne is still being debated on. Even though the initial colonization by P. acnes still plays an important part in the
initiation of this skin disorder, the exact triggers of acne, as well as the progression of this disorder, have not yet been clearly established and validated. Currently, a few of the bacteria related factors of acne have now been recognized and include the following:
  • acnes colonizing the pilosebaceous unit
  • Inflammation of the affected area
  • Seborrhea: Seborrhea is the greasy secretion given off by the sebaceous glands that have ducts which open up inside the hair follicles, and is caused by a yeast. The yeast grows in greasy secretion. The presence of the yeast results in overactivation of the sebaceous glands and the person develops red as well as irritated skin
  • Fol­licular desquamation: also known as hyperkeratosis, which means the skin comes thick due to irritation.

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