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Acne is the name given to the condition which involves an inflammation of the sebaceous glands which are attached to the hair follicles. Sebum from the glands drains into the top part of the follicle, then on to the skin's surface. Important aspects in the development of acne are an increase in the production of sebum, blockage of the escape of sebum from the gland, and subsequent inflammation of the gland. Blockage produces blackheads (comedones) or whiteheads (closed comedones) depending at which level it occurs. A red spot (papule) or pustule develops it inflammation is present. The most vulnerable areas are the face, upper back and chest where the sebaceous glands are concentrated.
Causes Increased sebum production is to a great extent caused by androgens - male hormones present in lower levels in women than in men. At puberty there is a surge in androgens in both sexes, and this is why acne often occurs at this time of life. A slight imbalance of androgens can cause acne at other times, too.
In women, nestrogens, which suppress the production of sebum, are usually produced in balance with progesterones, which are more akin to androgens. The worsening of acne before the menstrual period is probably due to high progesterone levels. Women sufferers taking a contraceptive pill, which alters these balances, may find that it affects their acne. The oestrogen content in combined pills may alleviate acne. Some synthetic progesterones, however, in either combined or progestogen-only pills may act like male hormones and thus make the acne worse.
Anxiety can aggravate acne. It seems that stress may increase the production of some hormones which affect the sebaceous glands. Acne is not contagious, it does not imply a lack of cleanliness, nor is it spread from one area to another by the fingers.
