Acne

Strictly speaking, acne has no exactly defined cause. Rather, several factors together encourage the development of acne.

The internal factors include genetic disposition, puberty, discontinuing the pill, fluctuations in the menstruation cycle, pregnancy, and psychological state. Other factors that influence the appearance of the skin include, for instance, smoking, alcohol, drugs, oily cosmetics, and stress. The disposition to acne can be inherited. If both parents had acne in puberty, their children are also frequently affected.

Four factors are primarily responsible for the formation of spots and blackheads with acne:

1. The production of excessive skin sebum (sebum)

In puberty, the increased discharge of male sexual hormones (androgens) stimulates the sebaceous glands that then produce more sebum.

2. Cornification disorder of the sebaceous follicle

The influence of male hormones also results in faster growth of the horny cells in the excretory duct of the sebaceous gland and thus, to an increased accumulation of horny cells. A plug of horny cells (microcomedo) is formed that prevents the sebacous gland secretion from being discharged. The microcomedons are not visible for the human eye at first glance and are seen as the preliminary stage for the symptoms of inflamed acne (pustules, papules, lumps). The cornification disorder in the sebaceous gland excretory duct ultimately results in an open or closed blackhead (comedo).

3. Bacterial colonisation

The accumulated sebaceous gland secretion is an ideal breeding ground for bacteria, primarily for a certain skin germ that occurs deep in the sebaceous gland channel: Propionibacterium acnes. It is part of the natural bacteria flora of human skin and is normally harmless. However, it multiplies particularly well in comedones. In order to feed off the sebum, it produces an enzyme (lipase) that breaks down the sebaceous gland secretion. This results in an increased number of free fatty acids. These and other toxic substances released by the bacterion can be seen as responsible, alongside other factors, for an inflammatory process being triggered or strengthened.

4. Inflammation

Different reactions of the immune system result in inflammatory reactions. These lead to spots (pustules and papules) which develop from inflamed microcomedones. The reactions caused by the immune system have a very decisive significance for the development of the acne. Although it has not yet been possible to clarify the exact link, there is a whole series of tests that can better explain the development and course of the acne. Overall, these are very complex events that involve many immunological factors at the same time.