Development of Acne

Acne is a skin disease in which changes are seen in the normal maturation and development of the skin due to changes in the physiology of the individual through hormones and its interaction with the immune system and external insults, such as bacteria. There is initially a change in the keratinization pattern of the normal pilosebaceous unit of the skin. The keratinization material becomes more thick and dense, thereby blocking the secretion of the normal sebaceous glands sebum.

Comedones

These kerain plugs, are termed comedones. Comedones lead to the subsequent inflammation seen in acne, as there is now a change in the skins normal physiology, as there is blockage of the pilosebaceous units secretions. These subsequently build up within the skin, leading to an expanding mass of inflammatory debri, containing Propionibacterium acnes, which is a potent immune stimulator.

Inflammation

Once this mass expands to a threshold point, leakage of contents begins which recruit inflammatory cells to the area. Thses cells lead to skin inflammation, with the formation of the lesions of acne, papules, pustules, cysts and nodules.

Androgens

Androgens act by maturing the pilosebaceous units which begin to secrete even more sebum. Androgens are usually found in normal levels in the serum in patients with acne. It is believe to be the differences in individuals glands and tissues response to androgens to play a larger role, than the levels of the androgens themselves.

Propionibacterium acnes

Bacteria contain lipases which convery lipids and fat, into free fatty acids which are subsequently converted into agents that signal inflammation, such as interleukins and tumor necrosis factor. These cytokines, short-acting hormones, recruit inflammatory cells and active them to cause inflammation.