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What is acne?

Dr. Nancy Shannon

Medically reviewed by Dr. Nancy Shannon, MD, PhD on May 25, 2021

For most people, acne is an annoying phenomenon that never goes away quite as easily as they’d like it to. But what is acne, really? What causes acne? Most importantly, how can knowledge of what acne is and how it works help you to combat it? 

The first step towards clearing up your skin is knowing exactly what’s causing your problems to begin with. Here’s what you need to know about acne:

The Factors Causing Acne

A lot has to happen with your skin before any instances of acne actually appear on the surface. Acne ultimately begins with pores, the small holes dotting your skin that contain hair follicles and sebaceous glands that produce serum. You probably know sebum as the oil that can sometimes collect on parts of your face. When a pore gets clogged, be it with sweat, dirt, or dead skin cells, the sebaceous glands continue to produce sebum, which fills up the pore.

Once the pore is filled, the overabundance of sebum can cause the lining of the pore to become irritated and bacteria growth to flourish. This is what causes your skin to become inflamed and irritated during an acne outbreak. What causes the pore to become clogged in the first place varies greatly from person to person: overactive sebaceous glands, skin irritation, hormonal changes, and inflammation.

Types of Acne

Clogged pores don’t always result in the same types of acne, either. Some of the most common types of acne include:

– Whiteheads (“closed comedones”)

Whiteheads start the same as blackheads, but the pore actually becomes clogged at the surface level, causing the small white plug-like fixture to appear. 

– Blackheads (“open comedones”)

Blackheads are the result of the pore dilating after it’s been clogged, and the air oxidizing the keratin material in the pore, causing the appearance of small black spots to the naked eye. The black appearance is not dirt.

– Papules 

Whereas whiteheads and blackheads appear on the surface of the skin without inflaming it, papules are the bumps that become slightly raised. When a clogged pore continues to produce sebum unabated, the collected oils can break out of the pore and into the surrounding tissue. This irritates the skin around the pore, creating an inflammatory papule. 

– Pustules 

The collected sebum in a clogged pore can become a breeding ground for bacteria, causing pus to develop. If some of that fluid contained within a papule escapes to the surface, a pustule forms. 

– Cystic

If a pore becomes clogged, the clog itself usually develops near the top of the follicle close to the skin’s surface. If the clog develops deeper into the pore, cystic acne develops. Cystic acne can result in severe swelling on the area around the pore and will often appear significantly larger than the average papule or pustule. Because the root cause occurs so deep within the pore, cystic acne can also take some time to heal and may result in scarring.

– Fungal Acne

Even though “acne” is present in the name, fungal acne does not have much in common with other acne types. While most forms of acne come from clogged pores, fungal acne, also known as pityrosporum folliculitis, infects the pores directly. The fungus in question is yeast, which when left untreated on the skin can cause acne-like symptoms irritating follicles. While yeast is a common presence on the skin of most people, overgrowth is always possible. 

– Acne Mechanica 

If your skin is constricted, irritation and clogged pores will likely follow. The constriction that comes from non-breathable materials and tight-fitting clothing results in acne mechanica. Though acne mechanica is generally mild, it can be difficult to get rid of due to the fact that it often accompanies active lifestyles. Unwashed or constrictive sportswear and equipment usually exacerbate the conditions causing acne mechanica. 

Once you’ve got a firm understanding of what acne is, you’re probably wondering how you can treat it — that’s where we come in. Get in touch with a member of our medical team today to learn about which options may work best for you.

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