According to the American Academy of Dermatology, about 40 to 50 million Americans have acne. Although most people think teenagers or young adults are who get acne, it can actually occur at any age, regardless of gender. Acne may not be life-threatening, but for some people it can be severe and disfiguring. People who have acne can also experience depression and low self-esteem.
Acne is caused by infection and inflammation of the hair follicle and sebaceous glands, or oil glands, in the skin. This is made worse by the shedding of dead skin cells, which plug up the hair follicle. Also, increased oil production in the skin makes the perfect breeding ground for acne-causing bacteria, Propionibacterium acnes. When the pores become plugged up with oil and bacteria, inflammation gets worse and causes a painful, red acne bump. Acne can appear on the face, neck, back, chest, shoulders and buttocks, and can leave red or brown marks or permanent scars.
Teenage acne occurs at puberty when androgen hormones increase and cause the skin’s oil glands to increase in size, producing more acne-causing oil. Normally, oil is supposed to keep our skin healthy and provide moisture, but when it’s over-produced, it can contribute to clogging pores and feeding the bacteria that causes acne, making acne worse. In women, androgens are released during pregnancy, around the time of your period, or with certain hormonal contraceptives like the birth control pill. Androgens can also contribute to oil production and worsen acne and dark marks. Bad hygiene habits, like waiting days to shower, not washing your face or picking at your acne with dirty hands can exacerbate acne and acne scars (resist the urge!). Even stress can trigger an acne breakout or make any active acne worse.
Acne blemishes are characterized into inflammatory and non-inflammatory. They include the following:
● Non-inflammatory acne:
○ Blackheads – pores filled with oil, dead skin cells and bacteria that react with oxygen and turn dark
○ Whiteheads – pores filled with oil and dead skin cells that are covered with layers of skin
● Inflammatory acne (more likely to scar):
○ Papules – red inflamed skin lesions that can be painful
○ Pustules – this type of blemish is your traditional “pimple” and is usually filled with pus that’s white or yellow
○ Cysts – pus-filled pimples found deep in the skin that are often painful and require medical attention
It is important to distinguish between these different types of acne blemishes because they are treated with different medications and some cause scarring more than others. If you have mainly inflamed acne lesions, it is important to see your dermatologist right away as early treatment could prevent these from turning into scars. You can find more information on scarring and treatment options here.