Under normal circumstances, the outermost layer of dead cells lining your hair follicles is shed each day. These cells are "washed" to the surface of your skin by your oil-gland secretions. In those people having the inherited tendency to develop acne, the lining cells of the follicles not only seem to stick to each other more but appear to be shed in greater numbers. As a result, shed cells tend to clump together and, instead of being easily "washed" to the surface of your skin, begin to form plugs at or near the openings of your pores. Open comedos, or blackheads, are plugged follicles where the plug rests within the opening of the pore and remains exposed to the skin surface. By contrast, closed comedos, or whiteheads, are plugged pores where the plug lies just beneath the skin surface. Although blackheads may be more unsightly, whiteheads, as you will soon see, are the true troublemakers. Whiteheads may best be thought of as small, potentially explosive packets of TNT resting under the skin. Whiteheads remain ready and waiting for the right stimuli to detonate them into potentially scarring pimples and cysts.

Since whiteheads are clogged pores with no openings to the skin surface, shed skin cells and oil-gland secretions within the follicles continue to accumulate. Bacteria called Propiono-bacterium acnes, which normally inhabit your pores, begin to break down the accumulating debris within the follicles into irritating substances called fatty acids. As the fatty acids and other debris continue to accumulate, the follicle walls continue to expand like balloons under the skin until they finally rupture and spill out their irritating contents into the surrounding skin. Acne pimples, pustules, and cysts are the result.


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Acne Blemishes

Nobody knows the exact causes of acne blemishes. However, inheritance factors (genes) appear to play an important role. In other words, acne appears to run in certain families. If your parents have had acne, you are more likely to also. Racial factors also play a role; in general, white people tend to have more severe forms of acne than black people.

Most people mistakenly believe that acne blemish is an infection of the skin. It isn't. Instead, it is what doctors refer to as an inflammation of the skin. An inflammation is any irritating condition that is accompanied by redness, tenderness, swelling, heat, and pain. An infection, on the other hand, is a form of inflammation caused by bacterial, fungal, or viral germs.

Hair follicles are present on everyone's skin, although in most women, facial hairs can be so extremely fine as to be almost invisible to the naked eye. (You may be able to see these fine hairs if you look carefully at your face with a magnifying glass.) Acne primarily develops in those areas where your pores contain larger, more actively secreting oil glands. These areas include your face (particularly your chin, forehead, and cheeks), neck, back, chest, and shoulders.