What is acne ?

Acne is a skin disorder characterized by plugged pores or pilosebaceous unit. Pilosebaceous units are made up of sebaceous glands (oil glands) and hair follicles in the dermis or middle layer of the skin. There are lots of oil glands in the body but they are concentrated in the nose and cheek areas. The function of the oil gland is to lubricate and make the skin moist by generating oil or sebum. The sebum then flows through the follicles or tiny tubes that starts beneath the skin and leads to the surface of the skin.

Pores get plugged due to increased development of keratin (hyperkeratinization) and increased production of sebum. These plugged pores called “comedo” often contain dead skin cells, naturally occurring “Propionibacterium Acnes” bacteria and sebum. P. Acnes bacteria feed on sebum which means that the higher the sebum content of the oil gland, the greater is the bacterial population. If the bacterial population is very high they would cause inflammation and infection of the oil gland which results in redness and pus. When the population of acne causing bacteria is low but the pores are blocked, it would simply result in “bumps” at the skin surface.

Types of Acne Lesions

Mild to Moderate acne spots:


In this type of lesion the pore is blocked completely which traps sebum, bacteria and dead skin cells. The blocked pore takes a “whitish” appearance on the surface. Oftentimes, acne sufferers would want to pop whiteheads. It is not advisable to pop whiteheads since it may lead to further complications. The appearance of whiteheads is usually of short duration compared to blackheads.


This type of acne lesion is a result of partially blocked pore. The partial blockage allows some of the trapped sebum, bacteria and skin cells to be purged slowly to the surface. As the name implies, they are black in color which is the reaction of the skin pigment melanin to oxygen in the air. Blackheads takes a longer time to disappear compared to whiteheads.

Other acne lesions include:


They appear as, small ,solid bumps on the skin which is slightly elevated above the skin surface. Groups of very small papules may be invisible but they have a “sandpaper feel” when you touch them. Papules do not contain pus and this is what differentiates them from pustules.

Pustules: (pimples)

At the top they are filled with pus and usually they have a red base. They look similar to a whitehead, the only difference is that pustules are inflamed appearing like a red circle with a yellowish center when viewed from the top. They are commonly called as “zits” which is very tempting to pop.

Severe Acne have the following lesions:


Basically, these are pimples which are bigger than 5mm. They are can be painful and grows as large bumps beneath the skin surface. Scarring is very common with this type of lesion. These lesions last for several months.


These are painful sac-like, pus-filled lesions that may cause scarring. It is similar to a nodule but it is pus-filled and they usually have a diameter of 5mm or more. Do not squeeze cysts as they may cause scarring.


Also known as pseudo scars because they somewhat look like a scar but unlike “true scars” they leave no permanent scar or mark. They are temporary flat, light red or pink spots that have been left from a previously healed lesion. They may last from several days to a few weeks. Sometimes they are raised slightly from the surface of the skin.

Acne References

http://dermnetnz.org/acne/acne-causes.html “Causes of acne” (Last updated 08 Aug 2007)

http://www.acneguide.ca/basics/acne/what_causes_acne.html “What Causes Acne?”(Last modified: Friday, 16-Feb-2007″)

http://www.nlm.nih.gov/medlineplus/acne.html “Acne” (Topic last reviewed: 13 September 2007)

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