ACNE Literature


Acne, also known as Acne Vulgaris, is thought to be caused by multiple factors. It is a skin condition that occurs when hair follicles become plugged with oil and dead skin cells. Overproduction of a normal oil on the skin, called sebum, increases under the influence of hormones. The plugged follicle can become inflamed and have increased growth of normal skin bacteria, Propionibacterium acnes.
Acne is most common among teenagers, though if effects people of all ages. Acne effects very large percentage of all people at some point in their lives. Usually, it begins at puberty and can persist into the 30s and beyond. People of all Ethnic backgrounds get acne.

Signs and Symptoms:

Acne results in a variety of lesions. The most common acne locations include the face, neck, chest, and back, where the most sebaceous glands are located. “Blackheads” (open comedones) and “whiteheads” (closed comedones) are follicular plugs that are either sitting below the skin surface(whitehead) or a plugged follicle oxidised from being exposed to the air (blackhead).
*Papules are small pink to reddish-brown bumps.
*Pimples which are Pustules with pus-filled lesions and pus at their tips
*Nodules or cysts are deeper pus-filled lesions.


Acne signs vary depending on the severity of your condition:
*Whiteheads (closed plugged pores)
*Blackheads (open plugged pores)
*Small red, tender bumps (papules)
*Pimples (Pustules), which are papules with pus at their tips
*Large, Solid painful lumps (nodules) under the skin
*Painful, pus-filled lumps (Cysts) under the skin

Mild Acne consists of a few papules/pustules and/or comedones.
Moderate Acne has an increased number of lesions.
Severe Acne has numerous blackheads, pustules, papules and may have painful inflamed nodules.


The Pathogenesis involves multiple factors
Main four causes of Acne:
• Excess oil production - Increased sebum production
• Hair follicles clogged by oil and dead skin cells
(Follicular hyperkeratinisation)
• Bacteria - Proliferation of Propionibacterium
• Inflammation


typically appears on the face, forehead, chest, upper back, and shoulders because these areas of skin have the most oil glands. Hair follicles are connected to oil glands. The follicle wall may bulge and produce a whitehead. The plug may open to the surface and cause a blackhead. A blackhead may look like dirt stuck in pores, but actually the pore is congested with bacteria and oil, which turns brown when it is exposed to air.

Pimples are raised red spots with a white centre that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cyst like lumps beneath the surface of your skin.

Factors that may worsen Acne:

Hormonal Changes: Androgen are hormones that increases in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone Changes during midlife, particularly in woman, can lead to breakouts too. For many women, Acne can persist for decades, with flares common a week before menstruation.

Certain Medications: Examples include drugs containing corticosteroids, testosterone, or lithium.
Family History: Genetics plays a role in acne. If both of your parents had acne, you are likely to develop it too
Age: usually begins at Puberty
Diet: Carbohydrate-rich food, chocolate and greasy foods may have a worsen effect on Acne.
Stress: Stress doesn’t cause Acne, but if you Acne already, stress may make it worse.


Acne can result in permanent scars.
People with darker skin types are more likely to experience these acne complications:

Scars: Pitted skin (acne scars) and thick scars (keloids) can remain long term after acne has healed.
Skin Changes: After Acne has cleared, the affected skin may be darker (hyperpigmented) or lighter (hypopigmented) than before the condition occurred.

Emotional effects:
It has been suggested that persons with moderate-to-severe skin problems/ Acne suffer from poor body image, lack of self-confidence, low self-esteem and experience social isolation and constriction of activities. As part of emotional impact, increased levels of anxiety, anger, depression, and frustration are also observed in persons with Acne.

Psychological effect in adolescence:
Acne is extremely common during adolescence, and it can impose a heavy emotional and psychological weight on teenagers with it. Acne has been associated with a higher incidence of depression, anxiety, suicidal ideation and suicide attempts, poor self-image, poor self-esteem, and social impairment. Even though Acne might not appear to cause severe morbidity, mortality, or physical disability, it nevertheless must be approached and managed as a serious health condition that can have a significant effect on a person’s quality of life in the teenage years and beyond.