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The term acne is normally used too lightly, as the term "acne" in reality should only be applied where the skin has formed lesions and cysts and where deep nodules are present. A singular pimple or whitehead does not really constitute acne as such, but still needs to be treated properly, so as to prevent the skin from becoming infected and to prevent it escalating, where cysts and lesions start to set in.
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Although medical practitioners can prescribe a selection of acne medications, which may or may not be effective, with some of them carrying potentially dangerous side effects, they sometimes neglect the psychological effect that this skin condition can have on younger patients.
Although medical science tends to have the idea that it has all the answers to most questions, it simply is a fact that even medical science does not hold the key nor answer to all medical problems - including acne - and there are many areas where science simply does not know the answer.
Some people refer to plugged pores - blackheads and whiteheads, as well as pimples - as acne, but as stated earlier, this really only applies to cysts and deep nodules. It is this type of problem that normally leads to serious permanent scarring, although less intense problems can also leave scars.
One point that we need to make right away regarding acne, pimples and other skin blemishes, is that you will most definitely make the situation worse by squeezing, popping, scratching or constantly picking at them, and this action may lead to you causing permanent scarring. These actions will most definitely cause more inflammation and tissue damage - which is the precursor to causing scarring.
You will need to have self control and discipline - keep your hands away from these skin problems - rather have them attended to by your dermatologist or trained beauty therapist.
The question of "how is acne formed?" is asked by millions of people suffering from skin problems and acne - and in order to try and answer this question, we have compiled this summary.
One of the major causes of acne is the over production of sebum (oil) of the skin when combined with an obstruction (usually trapped dead skin), causing the oil to be contained within the follicle and causing acne.
Although alpha and beta hydroxy acids are useful in fighting acne, since they help to counter the external blockage of the pore, these are not the ultimate weapon to use for fighting acne, since other factors also contribute to the onset of acne.
The most prominent place where acne manifests is in the medial facial zone, where 4 to 10 times more sebaceous (oil) glands are found than in any other part of the body.
At the onset of puberty the production of hormones begin to stimulate the development of the sebaceous glands.
This is controlled by the male hormone, testosterone, which is present in both males and females. Testosterone is changed by the enzyme type I 5a-reductase to dihydrotestosterone.
During this time, cell growth is also stimulated - especially the cells in the hair - causing accelerated hair growth and accelerated growth of the cells in the oil glands. These combined actions can cause an excess of oil flow, as well as a thickening of the follicle wall, which can cause a blockage in the follicle.
This blockage contains cell debris and wastes, triglycerides as well as waxes - causing a micro-comedo.
To explain the progress of and formation of acne, we have used schematics to illustrate, which you may find useful.
The above-mentioned is the first step in the progress of acne, and in order to prevent it from progressing any further, the obstructions in the follicle must be eliminated and normal sebum flow must be established.
The environment created by the micro-comedo encourages bacterial growth - particularly propionebacteria: P. acnes and P. granulosum. The bacterium P. acnes is present in 75% of comedones and P. granulosum is present in severe forms of acne.
Propionebacteria are Gram-positive and anaerobic, which ferment glucose and produce lipases, which hydrolyze the triglycerides present in the comedo, it furthermore contains neuraminidase, which renders the follicle walls fragile - resulting in their rupture and release.
When the follicle walls rupture and the contents flows out, it can cause the increase of inflammation and may contaminate the surrounding area.
The growth of P. acnes causes chemotaxins, which in turn attract neutrophils and lymphocytes. The neutrophils and lymphocytes surround the follicle wall and by means of the release of lysosomal hydrolase, destroy the bacteria - but although this action comes about to try and neutralize the infection, it
also is the cause of scars and tissue lesions.
At this stage, the acne is highly visible with accompanying inflammation, papules as well as pustules.
Another factor that is of importance in the development of acne, is the presence ofstaphylococci and corynebacteria bacteria.
The presence of a yeast infection - specifically with respect to yeasts of the genus Pityrosporum - also exacerbate the process once it has begun (Pityrosporum-related folliculitis).
In practical terms - when whiteheads, blackheads and other less serious skin complaints start to show, mostly from the inception stages of puberty, it is important to control bacteria (and yeast) infection, in order to prevent it progressing further to full blown acne - particularly P. acnes.
Causes of acne and skin problems |
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An overproduction of oil and an obstruction of the follicle gateway to the skin, because of increased skin cell growth, starts to cause a problem at the start of puberty, due to the production of hormones. |
Whiteheads and miniature cysts |
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The combination of the three factors above start the formation of closed comedones (whiteheads) and miniature cysts. |
Blackheads and open comedones |
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These then develop into blackheads or open comedones and the inflammation is controlled by the body's own defense mechanisms |
| Pustules, papules and nodules |
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However, when the follicle remains blocked, the trapped wastes - being cell debris, triglycerides and waxes - become a breeding ground for bacteria and some yeast infections. This breeding ground then develops into pustules, papules and nodules. |
To treat acne and skin problems properly, a holistic approach should be followed in order to prevent less serious skin blemishes becoming more aggressive acne, and if acne is present, a treatment program should be established to help clear up the problem. There are three key parameters that should be looked at:
- Hyperseborrhea (over production of sebum - oil)
- Hyperkeratinization of the infundibulum (blocking of the follicle and a build-up of waste material on the skin)
- Bacterial proliferation (bacterial and yeast infection and accompanying inflammation)
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To have a look at the clinical test results, please click here.
Other pages with acne information 
We have divided the pages dealing with acne and pimples into various categories, which you can access by following the hyperlinks:
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