Acne is a disease of genetic and hormonal nature afflicting the pilosebaceous unit (hair shaft, hair follicle, sebaceous gland). There are three main factors that cause acne:
There are three main factors that cause acne:
- increased keratin productionincreased
- increased oil production
- proliferation of bacteria
Acne normally appears around 14 years of age in girls and around 16 in boys. There is also a significant increase in hormonal acne around the age of 30-35 in women. There are up to 400-900 sebaceous glands per square centimeter. The areas of highest concentration are:
- anterior and posterior regions of the trunk.
There are sebaceous glands located all over the body aside from the palms and soles. Patients have an increase of keratin production (protein of the skin surface), which leads to the blockage of the pilosebaceous opening, interfering with the elimination of sebum (oil that bathes the hair). We use treatments such as: Retin-A, Renova, Differin, and Tazorac to control keratin production. During puberty, and for women around the age of 30, there can be significant hormonal changes that result in increased sebum production. When the amount of sebum is too great and clogs the opening of the sebaceous gland, acne results. Treatments such a birth control pills, Spironolactone, Accutane and Photodynamic Therapy (PDT) mainly focus on reducing oil production in the sebaceous gland. Bacteria, such as Propionibacteria acnes, are also normally present. These can play a significant role in the inflammation process, and are part of the formation of pustules, although their exact role has not been delineated. Benzoyl peroxide and antibiotics are used to help decrease the bacterial numbers. Topical solutions such as Benzocaine have proven just as effective as oral preparations and are preferred due to less systemic side effects.