What is Acne (Pimples)? Acne Symptoms, Causes, and Treatment

Acne (pimples) is a dermatological condition commonly seen as a part of life worldwide. This condition can develop in various parts of the body, but it most frequently occurs in the hair follicles and sebaceous glands under the skin. Although there is no consensus on a precise grading system, it can be graded using photographic methods and lesion counts. Acne is generally divided into four severity levels based on its morphology: inflammatory and non-inflammatory lesions. These levels are comedonal acne, mild or moderate papulopustular acne, severe papulopustular acne or moderate nodular acne, and severe nodular acne/conglobate acne. The severity and treatment of acne depend on whether it involves inflammatory lesions. The formation of acne is influenced by disrupted sebaceous gland activity, increased sebum production, follicular channel blockage, bacterial colonization, and activation of the immune system.

What is Acne (Pimples)?

Acne is a skin problem caused by blockages in the hair follicles and sebaceous glands under the skin. The problem is fundamentally triggered by androgens (hormones secreted by the adrenal glands) and sebocytes (cells that produce oil in the sebaceous glands), which stimulate the production of sebum. Sebaceous glands multiply skin cells and produce more immune-regulating cells. Bacteria present in the hair follicles and sebaceous glands trigger inflammation and encourage the blockage of pores in the skin. Acne affects about 85% of people during adolescence but can also occur at any stage of life. Acne that occurs after the age of 25 may either persist from adolescence or develop as acne tarda in adulthood. Acne tarda commonly appears in women as a few, highly inflamed pimples on the chin. Pimples typically appear on the forehead, chin, neck, back, chest, and shoulders. They can be inflammatory or non-inflammatory. Inflammatory pimples have a yellowish appearance at the tip. Closed comedones have a white tip, while open comedones have a black tip.

What Are the Symptoms of Acne (Pimples)?

Acne is a common problem that people often encounter. The symptoms of acne vary depending on the condition of the pimples. These different types of acne include:

Blackheads
Whitehead pimples
Painful, large, hard lumps under the skin
Painful, pus-filled pimples under the skin
Small, red pimples

The symptoms of these different types of acne typically start with redness and pain in the affected area. Over time, the pain and redness may increase, and dark spots and scars can develop.

Causes of Acne (Pimples)

Acne, which frequently begins during puberty, affects 15-20% of individuals in moderate to severe forms. Those who experience acne during adolescence may continue to face acne lesions in later life, possibly up until the age of 30. While genetics is often considered the primary cause of acne, factors such as diet, environmental influences, and lifestyle also play a significant role.

When pores on the skin become blocked, it creates an ideal environment for bacterial growth. As bacteria multiply, inflammation occurs, leading to acne formation. Some of the key causes of acne include:

Heredity
Disruption in sebaceous gland activity and excessive oil production by the skin
Disorders in androgen metabolism
Hormonal changes
Certain medications
Pimple squeezing or irritation
Unhealthy and harmful diet
Diet high in carbohydrates and fats
Use of inappropriate cosmetics
Neglecting skin hygiene
Blocked pores from oil and dead skin cells
Mechanical irritation
Irritation from moisture or sun exposure

Changes in hormone levels increase the likelihood of hormonal acne. Many factors contribute to this, including irregular sleep patterns, sedentary lifestyle, or insufficient water intake, all of which can affect hormone levels and lead to acne development.

Stress

Menstrual cycle
Deficiency of vitamins A and E
Excess intake of B vitamins
Puberty
Birth control pills
Pregnancy
High levels of progesterone

The first occurrence of acne in the life cycle is typically referred to as puberty. During this time, androgen hormone levels rise, increasing sensitivity. As a result, the amount of oil produced in the skin also increases. This excess oil leads to an oily appearance, and, in addition, cells, dust, or cosmetic products accumulate in the openings of sebaceous glands, causing blockages in the pores. This marks the initial stage of acne development. This condition may remain as blackheads or whiteheads, and when bacteria present in the pores multiply, inflammation can occur, leading to swelling and redness. This commonly happens in areas of the face, back, forehead, chin, nose, or shoulders, where the skin has higher oil content.

While excessive stress cannot be directly linked to acne, a person under stress may unconsciously pick at their scalp, face, back, or shoulders, or play with existing pimples. This can cause a small pimple to worsen and create scars, which can persist even with treatment. As a result, not only does this affect the skin, but it also has psychological impacts on the individual.

Excess androgen hormone production during the menstrual cycle also leads to an increase in acne. This commonly occurs on the face, forehead, chest area, chin, and neck.

One of the key causes of permanent acne after puberty is the excessive use of cosmetics. Acne can develop immediately or months after using these products. Therefore, when choosing cosmetics, it is essential to select the one that is most suitable for your skin and causes the least amount of acne.

Processed carbohydrates and fat consumption during adolescence also increase acne formation.

Long-term use of oral medications, particularly antibiotics, can cause acne as a side effect. Acne caused by antibiotics can become resistant to treatment. The excessive use of steroids and B vitamins also increases the risk of acne or worsens existing acne.

Skin type is another important factor in acne formation. Oily skin is more likely to develop acne, and large pores also trigger acne formation. Acne is more common in males during adolescence, while adult acne develops in females. Adult acne tends to leave more scars and inflammation.

Acne (Pimples) Treatment

The treatment and duration of acne vary from person to person, and acne is a treatable condition. Therefore, it is essential to consult a specialist to determine the appropriate treatment method based on the type of acne.

The treatment plan will depend on the individual's health condition, medications, age, and the severity of the acne. There are many oral and topical medications available for acne treatment. However, these medications should be used with caution, and their usage should be within the recommended limits. Before starting acne treatment, it is important to assess the psychological and physical impact of acne on the person's quality of life. The primary treatment methods used in acne treatment are as follows:

Antibiotics
Maintenance therapy
Retinoids
Benzoyl peroxide
Phototherapy
Drainage
Laser treatment
Adapalene
Azelaic acid

Acne Scars

For most people with acne, scars from pimples and wounds can be permanent. Treating acne scars is challenging, and there is no guarantee of complete resolution. It is crucial to consult a doctor before starting acne treatment. Early treatment is essential, and the severity, spread, and duration of acne play a critical role in determining the course of treatment. The patient's immune system also plays an important role in treating acne scars. The primary skin renewal methods used in acne scar treatment include:

Dermabrasion
Laser
Chemical peeling

If you also have acne scars and are bothered by them, you can visit a specialist healthcare facility for a dermatology examination. Based on the doctor’s recommendation, you can begin the treatment method that best suits your skin’s needs.

Last Updated Date: 17 April 2024

Publication Date: 17 April 2024

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