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To understand what causes Acne, we need to talk about androgen. To start, androgen can enlarge the sebaceous glands in hair follicles, leading to greater amounts of oily sebum being produced and resulting in acne. Androgen is a hormone which promotes male characteristics such as facial hair growth and deepening of the voice. At puberty there is an increase of this hormone in both men and women causing a thickening of the outer layer of skin which may result in hair follicles becoming clogged with dead skin cells (keratin). Androgen hormones are present in females as well as males. A sudden increase in these hormones takes place at puberty.
Although the exact cause is unknown, some closed comedones may rupture, resulting in an inflammatory reaction caused by leakage of follicular contents (e.g., sebum, keratin, bacteria) into the dermis. This inflammatory response may result form the action of certain bacteria, such as proprionibacterium acnes, that live in the hair follicles and break down the triglycerides of the sebum into free fatty acids and glycerin. The resultant inflammation is seen clinically as erythematous papules, inflammatory pustules, and inflammatory cysts. Mild papules and cysts drain and heal on their own without treatment. Deeper papules and cysts may result in scarring of the skin. Acne is usually graded as mild, moderate, or severe, based on the number and type of lesions (e.g., comedones, papules, pustules, cysts).
Dirt is another common cause. When the pores are clogged, it gives the bacteria the opportunity to thrive. However, in a bid to keep the skin clean and the pores unclogged we can cause more problems by over-washing. Over-washing can cause the skin to get irritated and as the body tries to counter the irritation, the situation can worsen. If your condition is caused by bacteria in the pores, you would need an antibiotic to tackle the bacteria at source.
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