What causes acne

Acne is a multifactorial disease. Genetic, racial, hormonal, dietary and envrionmental factors have been implicated in its development, while it is clear that its psychological implications may be severe. Although the role of heredity in acne has not been clearly denied, there is a great tendency toward more serious involvement if one or both parents had severe acne during their youth.

The sebaceous glands ( part of sebaceous follicles ) are under endocrine control and so it is not surprising that sebum production shows change according to age and sex of an acne patient. Sebum production is dramatically greater than that in females in normal individuals as well as acne patients. There is an increase in sebum generation with a peak at about age 40. Any approach to control androgens appear to be relevant to adult acne since the sebaceous follicle is an organ targeted by androgens.

Hormonal factors and acne : Hormones obviously play an important role in development of acne. Sebaceous glands ( part of sebaceous follicles ) are extremely sensitive to androgenic stimulation, and their enlargement usually precedes other obvious signs of puberty even beofore any sign of acne. They are under endocrine control and so it is not surprising that sebum production varies with age and sex. Increase in sebum production is associated with increase in free fatty acids rather than an increase in essential fatty acids. Males have a signficantly greater sebum production than females. Men's skin in many other respects is different than female's. For example it is under influence of different hormones. The sebum production continues to increase after puberty, reaching a peak in both sexes between 30 and 40 years, and thereafter there is a gradual decline. It is evident that the sebaceous gland is an androgen target organ and any measure pharmacologically to control androgens is a logical approach to treatment of acne. .

Emotional factors and acne : As with any disease whose course is prolonged and capricious, the importance of psychological factors in treament of breakouts has been repeatedly stressed and should be seriously taken into account when using topical treatments. There seems to be no doubt that stress such as final examinations regularly cause exacerbations in patients. This is probably the result of increased glucocorticoid secretion by the adrenal glands that seem to potentiate the effect of androgens.

Environmental factors and acne : Environmental factors also play a major role in determining the severity and extent of acne and affect topical treatments. In most cases the manifestations are worse in winter and improves during the summer, suggesting a salutary effect of sunlight. However, in some cases exposure to sunlight worsens the disease. The constant friction caused by protective devices such as a helmet, shoulder pads or pillows will make its management futile.

Related Information:

The influence of genetics and environmental factors in the pathogenesis of acne

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