Author: Phr. Lim
Acne is a disease of follicles.
Over production of follicular keratin leads to obstruction of the follicle with sebum and keratin. It will further lead to inflammation and proliferation of bacteria (P. acnes).
Microcomedo (white head, black head)
Accumulation of sebum and keratin forms a closed comedo (a white head). The follicular orifice is opened with continued distension, forming an open comedo (a black head). Rupture of this follicle contributes to acne.
Role of androgens
Androgens contribute to the development of acne through stimulating the growth and secretory function of sebaceous glands, increase the risk of obstruction of the follicle.
Diet
Traditionally, high-calorie foods particularly those oily and spicy foods are thought to be increase risk of getting acne. There is some evidences show that milk and other dairy products which contain natural hormones, may cause oily skin and obstruction of pores which lead to acne.
Stress
It is commonly believe that psychological stress can exacerbate acne.
Body Mass Index
Researchers found a statistically significant association between rising BMI and increased risk for acne.
Family History
The risk of among individuals with affected first-degree family members is 3 fold higher!
External Factors
Soaps, detergents, and astringents remove sebum from the skin surface but do not alter sebum production. Repetitive mechanical trauma caused by scrubbing with these agents may worsen the disorder by rupturing comedos, promoting the development of inflammatory lesions. Therefore patients are advised to seek for consultation from doctors and pharmacists on the choices of soaps.