Acne is a very common skin problem which arises when our pores become blocked with bacteria trapped inside them. It comes in a number of different forms and affects just about everyone at some stage in their life and is most often seen during our teenage years. The red and inflamed bumps which sometimes form can be quite painful and painless white pimples are unsightly.



The surface of the skin is covered in pores which are tiny openings more accurately referred to as hair follicles. Deep inside each pore, near the base of the follicle, there are sebaceous glands which produce natural oil known as sebum which helps to protect the skin and to maintain its flexibility.

Normally hair grows through the surface of the skin while the oil or sebum oozes out of the pores and is spread around the area and removed through normal washing. At the same time skin cells grow and die and either simply fall away, are rubbed off or are again removed by washing. However if the pores of the skin become blocked then this natural process is interrupted and with the addition of bacteria into the equation the result is acne.

We usually think of acne in terms of the white pimples and these are a mixture of white blood cells, dead skin cells and bacteria. In some cases the trapped pus present creates a red and inflamed area around the white pimple or whitehead. We use the term 'pus' here because it is short for 'pustule' which is a particular form of acne which arises when the wall of the follicle bursts causing white blood cells to rush into the area as natural part of the healing process.

Instead of white pimples we also see black pimples which are, not surprisingly, called blackheads. What many people do not realize however is that these too are a non-inflamed type of acne which arises when the material within the blocked pore pokes through the surface of the skin. In this case the dark color is not dirt as many people believe, but is in fact the result of the combination of dead skin cells and sebum oxidizing when exposed to the air.

In what most of us would see as classical acne however the material trapped in the blocked pores simply pushes up the surface of the skin forming a white bump, but does not actually break the surface of the skin.

One common form of acne (especially in babies, although it can effect people of all ages) is known as 'milia'. Here dead skin cells which normally simply fall from the surface of the skin or are removed by washing become trapped under the skin.

These are just some of the varieties of acne which are described by the general medical term 'comedones' and the clinical difference between these varieties of acne is essentially a case of whether the formation is open or closed.

Although for most people acne is generally not severe, it can develop to form what are known as papules, nodules or cysts. In simple terms, a papule arises when the walls of a hair follicle burst near the surface and they are generally small and do not contain pus. When a break in the follicle wall occurs nears its base a hardened lump known as a nodule forms. Finally, a cyst is the term used for a larger reddened bump which forms, which is usually quite soft and can be very painful.

One important point about acne is that it is not simply one condition, but a series of different condition which require different treatments. Accordingly, it is extremely important not simply to know that you have acne, but to understand just what sort of acne you have so that you can choose the most appropriate treatment.