Acne: How it is created and how is it treated?

Acne is a condition that most people have experienced at some point of their lives. 80% of people exhibit some form of acne (mild or severe) during adolescence or in adult life. Acne can be caused by both endogenous factors (hormonal imbalance, heredity) and exogenous factors such as stress.
The adult acne occurs more often in women than in men and this is mainly due to hormonal changes in their bodies and the environmental pollution, smoking, and diet also play a very important role. It appears after the age of 25 years old in people who have not coped in the past, teenage acne, or occurs again after puberty.
But what is it that causes the appearance of acne?
After long-term dermatological research and study of all possible stimulating factors, it has been shown that there are 4 main causes behind the emergence of the problem of acne.

• Hypersecretion of sebum from the sebaceous glands caused by androgens
• The increased production and accumulation of keratinocytes, which leads to clogging of the pores of the leather and the creation of comedones
• The presence of μικρόβιων (P. Acnes) that causes infections
• Inflammation

Let's analyze the causes separately.

The hypersecretion of sebum from the sebaceous glands
Excess sebum is often associated with enlarged pores. In addition, the problem may not be the quantity but the type of sebum. The viscous and sticky sebum is leaking with greater difficulty in the epidermis compared with the more thinning sebum.
To really understand how we can influence this condition of the skin, it must be understood what is really going on in the skin and leads to hypersecretion of sebum . Testosterone, a hormone which is produced in both sexes, is secreted in the body and enters the sebaceous glands, where the enzyme 5-a reductase converts to dihydrotestosterone. Dihydrotestosterone stimulates hypersecretion of sebum in the sebaceous glands. However, recent studies have shown that the hormone levels are not solely responsible for the production of sebum. We know that the 5-a reductase may result in an increased response of the sebaceous glands to testosterone, causing excessive production of sebum even when there are lower levels of hormone. Unfortunately, the cause of this phenomenon is unknown. However, explains why you may receive excess sebum when testosterone levels are not elevated.

Accumulation of keratinocytes
In a normal follicle, dead keratinocytes are continuously updated to the surface of the skin. However, when there is acne, there is a υπερπολλαπλασιασμός of the cell. In combination with the hypersecretion of sebum, caused aggregation of cells and bacteria and restriction of resources (hyperkeratosis). It is created, i.e., an ideal anaerobic environment to thrive bacteria and to form comedones .

The presence of microbes
The bacteria in the sebaceous glands secrete enzymes (lipase) which break down triglycerides in the sebum into fatty acids and glycerol. The free fatty acids produced have an irritant action on the sebaceous glands resulting in the creation of closed φαγέσωρων that can be converted into open comedones (blackheads).

Inflammation
The inflammatory lesions are created when it is destroyed the wall of the φαγέσωρος with the result of leakage into the dermis of free fatty acids and κερατοποιημένων cell υπολειμάτων, while the white blood cells invade the area causing inflammation.

What is the correct response to the problem of acne?
For proper and effective treatment of acne, you need to target the four key causes of the problem. Thus, the treatment should focus on addressing the obstruction of the sebaceous glands, reduce sebum secretion, control of the bacterial population and, finally, in the treatment of inflammation. The selection of the appropriate treatment is very important in order to not further deteriorate the condition.