How do pimples and blackheads develop and why do they develop into an acne inflammation?

There are many myths about what causes acne and many of them are not true. But all doctors agree that acne is a hormonal disease.

We also know that some of us are more genetically predisposed to pimples than others and that certain medications, smoking, stress and inappropriate skin care can trigger acne. There is also evidence of a link between diet and acne.

This article focuses on the physiological causes of acne - it takes a look at what is really happening in the skin. We examine the many and complex factors involved in the development of blackheads and pimples and how they develop into acne.

It all starts with invisible microporm masks in the skin

A blackhead is a clogged hair follicle. A microporm mask is a microscopically small, subclinical (as yet invisible) blackhead mask. Micropormasks develop as the number of keratin-forming cells in the skin increases. This process occurs naturally without problems in healthy skin when the microporm worms dissolve. But for people with acne, the dissolution process also involves inflammatory reactions called microinflammations.

Microinflammation - the root of the acne cycle

Very small inflammations around the hair follicles are one of the main causes of acne.

Microinflammation - the root of the acne cycle

Acne is primarily an inflammatory disease. According to the latest research, micro-inflammation is one of the main causes of acne. It is believed that it is the result of the body's immune system reacting to bacteria, lipids and / or androgens (male sex hormone).

We know that there is an inflammation present in every step of the development of acne, not just when the pimples are visible on the surface of the skin.

The development process

Then comes seborrhea and hyperkeratosis

Internal factors such as hormonal changes (eg during puberty or the menstrual cycle) and medication as well as external factors such as environmental impact can lead to an increased production of both sebum (also called seborrhea) and corneocytes (also called hyperkeratosis), which causes blackheads and pimples. Both of these factors also play a role in the growth of bacteria, which eventually leads to papules and pustules associated with acne.

Seborrhea The sebaceous

glands release  an oily substance called sebum or sebum that keeps the skin and hair soft and supple. People with skin that easily gets pimples and acne tend to have high levels of androgens (male hormones) in their blood. Thus, their sebaceous glands may be more sensitive to androgens. These androgens contribute to the growth of the sebaceous gland and to an increased sebum production. The excess production of sebum is called seborrhea.

The excess sebum on the surface of the skin comes into contact with the natural process where the skin scales dead skin cells (desquamation). The composition of sebaceous lipids that build up in the sebaceous glands also triggers inflammation.

Hyperkeratosis

Hyperkeratosis is an abnormal thickening of the outer layer of the skin. It is caused by excess production of skin cells (also known as corneocytes) in the sebaceous gland orifice and by insufficient desquamation (peeling) of dead cells when excess sebum binds them in the surface of the skin. These cells form clots that block the sebaceous glands.

Propionibacterium acnes (or P.acnes), a bacterium that is normally harmless and lives on the surface of the skin, also plays a role in hyperkeratosis. It forms a biofilm (a thin layer) on the surface of the skin that interferes with the normal process of desquamation and contributes to the development of clots.

Blackheads and pimples develop

Sebum accumulates in the blocked sebaceous glands and the sebaceous gland wall bulges out and causes comedones (blackheads) and pimples:

Pimple

An inflamed (raised and colored) pimple that is filled with where and usually hurts. Pimple is the collective term often used to describe all types of pimples: comedones, papules and pustules.

Bacterial growth exacerbates the visible inflammation, leading to acne

The accumulation of sebum secreted by the sebaceous glands provides a perfect breeding ground for bacteria, especially P.acnes. It begins to colonize the mouth of the clogged sebaceous gland and causes the sebum to break down. The breakdown gives rise to substances that cause further inflammation and leads to the papules and pustules associated with acne.

In severe cases, the sebaceous gland wall ruptures in the later stages of inflammation. Lipids, fatty acids, corneocytes (cells), bacteria and cell fragments are released and can cause further inflammation in the surrounding skin.