Acne is a disorder resulting from the action of hormones and other substances on the skin's oil glands (sebaceous glands) and hair follicles. These factors lead to plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur on the face, neck, back, chest, and shoulders. Although acne is usually not a serious health threat, it can be a source of significant emotional distress. Severe acne can lead to permanent scarring.
How Does Acne Develop?
Doctors always describe acne as a disease of the pilosebaceous units (PSUs). PSUs are found over most of the body, consist of a sebaceous gland connected to a canal, called a follicle, which contains a fine hair (see “Normal Pilosebaceous Unit” diagram). These units are mostly all over the face as well as the upper back, and chest.
The sebaceous glands make an oily substance called sebum that normally empties onto the skin surface through the opening of the follicle, commonly called a pore. Cells called keratinocytes line the follicle.
The hair, sebum, and keratinocytes that fill the narrow follicle might often produce what’s known as a plug. This is an early sign of acne. This plug stops sebum from reaching the surface of the skin through a pore. The mixture of oil and cells allows bacteria Propionibacterium acnes (P. acnes) that normally live on the skin to grow in the plugged follicles.
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