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“Acne”. We hear it all the time, often in association with spotty-faced teenagers, but what does this condition really entail? Chronic and disruptive, it is something often spoken about but unfortunately, there continue to be many misconceptions surrounding it.

The first step to effectively treating acne is understanding it. “Common knowledge” associated with the condition tends to ignore critical examination and modern advances and as a result, information passed from generation to generation is often subpar, if not false.

So, what is the truth about this common condition?

Acne is a chronic, multi-factor, infectious disease of hair follicles and sebaceous glands. During puberty, the body creates androgen in the adrenal glands and in the testes or ovaries, dependent on your biological sex. Although often misnomered as the “male” hormone, androgen appears in both males and females.

Acne begins with androgen in the blood. Some people experience a predisposition that causes androgen to spread to the blood, and this causes some unpleasant side effects. One of these side effects is the hyperactivity of sebaceous glands on one’s skin. This hyperactivity is also known as sebaceous hyperplasia. 

In normal circumstances, sebaceous glands create sebum, which is an oily substance intended to lubricate the skin and prevent dryness and irritation. However, in circumstances of hyperactivity, there is an overproduction of sebum in the sebaceous gland, and this causes buildup and blockage within the glands and nearby follicles. The blockage then causes a comedo, also known as a whitehead or blackhead, that can then result in anaerobic conditions (Lack of oxygen) within the glands. This anaerobic environment encourages the multiplication of the bacteria Propionibacterium Acne (P. Acne) and can cause inflammation and infection of the comedones. As a result, the characteristics of acne lesions change.

This is a simplified explanation of the complex processes at play during the formation of acne. However, it does point to the general principle that there are a diversity of conditions and circumstances that must be met in order for acne to develop. Furthermore, acne itself exists in multiple stages and can manifest in various forms.

It is important that treatment understand and match this evolving nature of acne. Treatment should not depend on a single line of action to alleviate all symptoms but rather, should be developed as a specific regimen to treat one’s individual acne circumstances and symptoms. Additionally, it is important to note that given the chronic nature of acne, treatment should be ongoing even after symptoms lessen, so as to prevent any recurrence.