Main Causes Of Acne Vulgaris

What are the main courses of acne?

To understands what causes acne, we must first understand what acne is:

Acne is a disease of a pilosebaceous unit which is made up of

1. A hair follicle which is lined up by epithelial cells that produces keratin. New cells are produced almost every 24 days. The dead cells are excreted through the follicular opening

2. Sebaceous gland that produces oil (sebum) that keeps the skin moisturized

3. Both the above open into a common duct that opens on the surface of the skin called a pilosebaceous duct

4. In the pilosebaceous unit there is a bacterium called Propionibacterium acnes that is normally found on every person

Many factors determine whether a person has acne prone skin or not

Several of these factors interlink with one another

In those people prone to acne 4 main things happen that lead to acne development

1. Genetic predisposition

2. Blockage of the pilosebaceous duct

3. Proliferation or multiplication of the bacteria that normally sits in the pilosebaceous unit

4. Over production or the sebaceous gland being over responsive to hormones that are secreted in the blood and reach the skin receptors
   - Other external factors that may cause acne includes oily cosmetics, hair products, medications like oral or topical steroids, smoking and in some people diet

How does it start forming?

1. There cells lining the hair follicles over produce keratin, which makes the dead skins that are usually excreted via the pilosebaceous duct to clump together leading to blockage of the pilosebaceous unit

2. There is also over production of the oil by the sebaceous gland, this together with the clumps of cells lead to blockage of the sebaceous unit
   - The blockage of the unit leads to formation of comedones that can either be open (called blackheads) or closed (called white heads)

3. Due to the blockage the bacterium found in the unit over multiplies releasing proinflammatory markers that lead to inflammation causing the red pimples with pus (pustules)

4. As the follicle expands due to the blockage the pilosebaceous unit can rupture into the surrounding skin, especially when a pimple is squeezed leading to more inflammation resulting in bigger pustules and nodules

5. It is important to note that your genes or DNA plays the biggest role in acne formation and therefore acne often runs in families
   - Your genes or DNA controls how much keratin your cells produce
   - Your genes also control how large and how much oil your sebaceous gland produces
   - Genes also controls your hormones that in turn causes sebaceous glands to enlarge and over produce oil. Hormones that controls acne are testosterone and DHT