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The first changes, the skin goes through, during the activation cycle of acne outbreaks are excess amounts of sebum that the sebaceous glands release. This is due to many factors but stress and hormonal changes can be the cause of the over-production. Larger numbers of sebaceous glands are found on the mid-back, chest, forehead, nose and chin which can explain why these areas are more affected by acne.

Sebaceous glands are located deep within the skin. Each gland is connected to a follicle that contains a hair. An oily substance called sebum is released by the sebaceous glands, and its purpose is to lubricate the follicle and the surrounding skin. These glands are found virtually in every part of the body.

Hormones (specifically androgen hormones) stimulate the sebaceous gland to produce sebum. In males and females, androgens are also produced by the adrenal glands. During puberty and stressful situations, the adrenal glands release an surplus of hormones causing an enlargement of the oil glands.

Sebum and dead skin cells can accumulate in the follicle causing it to clog. The blockage forms blemishes such as whiteheads and blackheads which are the two most frequent comedones.

P. acnes (Propionibacterium acnes) are bacteria that are a part of the skins natural defense mechanism. The purpose is to keep other harmful bacteria away. When follicles or pores are clogged, P. acnes are trapped inside. The bacteria can breed inside the blocked follicle and change its chemical structure causing irritation and inflammation of the dermis.

The effects of outbreaks

The consequences of acne outbreaks can lead to red, puffy, sensitive or even itchy skin.

Acne vulgaris is the most frequent type of skin blemishes. It can have different intensities. The most common comedones (whiteheads and blackheads) are usually characteristics of mild acne stages.

Big and painful masses under the skin are usually characteristics of more severe stages of acne vulgaris. These are called cysts or nodules and are the most common types of severe acne. The rupture of nodules and cysts can create big openings that can lead to acne scarring.

Mild, moderate or severe acne can have an impact on your skin. Individuals that suffer from acne tend to pick at the infected areas not knowing that this can trigger more skin blemishes.

Patients are often not aware that irritation and inflammation of skin blemishes can be self inflicted events. Care and attention to skin problems are essential to maintain a smooth, supple and blemish-free skin surface.