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Since the follicular walls in the pilo-sebaceous unit is intact before puberty, it has been theorized that if colonization of Proprionibacterium acnes happens in sufficient numbers they produce antigenic molecules that stimulate the initiation of inflammation. Proprionibacterium acnes can synthesize proteinases, lipase, and hyaluronate lyase all of which can serve as the catalysts or initiators of the inflammatory infiltrate which is composed of neutrophils and lymphocytes. Hormonal Cause of Acne The key player in the cause of acne in puberty is hormones. At this stage androgens interact with receptors on the sebaceous glands and promote activation of the sebaceous gland to hypertrophy and hence form more sebaceous production of lipids and free fatty acids which dilate the follicular canal. More specifically, there is evidence for enhanced peripheral metabolic conversion of the androgen testosterone to dihydrotestosterone at the level of the skin in persons having acne. How Acne Forms The first lesion in this condition called acne vulgaris is the comedo. When exposed to oxygen the comedo turns dark and forms what you know as a blackhead. The comedo is created by retention of layers of dead skin called keratin in the walls of the follicles. In addition to hyperkeratosis (which is thickening or retained layers of keratin), there is an aggregation of sebum. The mixture of the keratin and the sebum produces a blocking of the opening of the follicular canal, and papules are made by inflammation around the comedones. Depending on the degree of inflammation, granulomatous reactions, nodules, cysts, pustules, cars, and keloids can develop. Development of Acne Inflammatory Reaction Airborne contamination and other harmful elements further exacerbate the inflammatory response. As bacteria start to proliferate within the clogged pore your defensive system responds by releasing granulocytes and macrophages, which are types of white blood cells that destroy the bacteria. The inflammation process is needed to eliminate the continuing consequences of excess bacteria and signal the body to repair the damage to tissues. Often times the defensive response system can't stop the multiplication of acne bacteria due to lack of white blood cells or an impaired system. Activity of the Sebaceous Gland When a comedo is blocking the outlet of the sebum ducts, the sebaceous glands continue to produce sebum, which accumulates in the sebum canal augmenting the comedo in size. The expansion in size produces pressure and leads to a further intense inflammation response in the nearby skin and produces redness, swelling, discomfort, and a mass (pimple, redhead, acne papule). Growth of Acne Bacteria The above factors encourage the growth of bacteria and result in infection within the duct, the sebaceous gland, and nearby tissue. The commencement of the infection makes further inflammatory alterations, therefore beginning a cycle of accentuated blockage of the outflow of sebum which produces even more pressure, inflammation, and progressing infection making cysts and pustules to appear. The effect on skin tissues caused by such infections is very damaging and the healing process usually ends in a scar. Treatments For Acne To find a good pimple solution, you must remember that all individuals have different needs. Try a variety of acne products, starting with the milder one, until you find what works for you. A good skin treatment can be the end of your acne.
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