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What is acne?

 

 
Acne is an inflammatory skin disease which affects the tiny pores which cover the face, arms, back and chest and the oil glands attached to them. 
It is an abnormal response in the skin to normal levels of the male hormone, testosterone, in the blood. Both men and women have testosterone circulating in the blood, but in the acne sufferer, this hormone has a profound effect on the skin. This abnormal response is self limiting and eventually acne does get better without treatment, but there is no way of predicting how long this can take, and it may take years or even decades! Acne can also leave scars which are permanent and are easier to prevent than to treat. 

In the skin, the disease attacks two structures: 

1. The pore through which the hairs emerge from the skin - here dead skin cells become more "sticky" and partially block the pore.

2. The oil or sebaceous gland - more oil is produced, which gives rise to a generally oily complexion. 

The partial blockage in the pore restricts the flow of oil onto the skin surface. This results in solidification of the oil which fills the hair channel forming a blackhead. The black of the blackhead is not due to dirt, but a change in pigment in the blockage in the pore. If the partial blockage becomes complete, the oil builds up around the hair and hair root and becomes infected with bacteria normally present on the skin. The bacteria break down the oil to very inflammatory chemicals which cause redness, pus formation and pain - the "zit". 

If the inflammation is deep and severe, or if the spot is manipulated or squeezed, the pus can burst deep into the skin rather than onto the surface. This deep-rooted inflammation and infection results in scarring and cyst formation. 

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