Acne and Comedones

How does Acne Form ?

How to Prevent Acne Early

Acne is a follicular disease because it affects the follicles in the skin. It is caused by an abnormal pattern of skin shedding. This leads to impaction, blockage and distention of the pilosebaceous unit which subsequently blocks the “skin pores”. This is the process of comedogenesis (formation of comedones) which leads initially to microcomedones (precursors of black and whiteheads). These microcomedones are the earliest type of acne lesion. Prevention of these early lesions is the most important, as they are the easiest to deal with, but almost invisible to the naked eye.

These microcomedones progress to develop into either open or closed comedones, termed “blackheads” (open) or “whiteheads” (closed – white, because the sebum and debris clogging the pore becomes oxidized) respectively, and inflammatory lesions, such as pimples, macules, papules, pustules, and if severe, nodules and cysts. Numerous different inflammatory lesions may arise subsequently and either be present alone or all together.

References

1. James WD. Acne. (2005) N Eng J Med. 352:1463-1472.