How acne starts

Acne can begin 2-3 weeks before the blemishes are visible on your skin. The secret to controlling acne is prevention—stopping the formation of acne before it becomes a visible pimple.

If you understand how acne begins, you can understand how to heal and prevent it.

Acne develops with your hair follicles, the lining of the skin duct surround hair follicles, and the sebaceous glands that produce oil. Your skin cells are in a continuous state of renewal. Usually, as the old cells die, they mix with your skin's natural oil and are sloughed off. Some people don't shed dead cells evenly and the cells become sticky. These sticky cells and oil form a plug, called a comedo, in the hair follicle—like a cork in a bottle.

This cork-like plug holds the oil and bacteria in the follicle, which begins to swell as your skin produces more oil. Your own white blood cells swarm around the follicle to kill the bacteria. The result is a pimple or red bump which appears within 2-3 weeks.

Your chances of getting acne are affected by many factors. The tendency to slough dead skin cells changes through life. The rate your skin produces oil is determined by your hormones. Because genetics play such a strong role in the development and persistence of acne, your family history is important. If one of your parents had severe acne, yours is more likely to be severe too. Early breakouts—before the age of 10—can indicate more severe acne later.

There are 2 types of acne: non-inflammatory and inflammatory acne.

Although all pimples start the same way, they may appear different on your skin. If the plug stays below the surface of the skin, it's called a closed comedo or whitehead. If the plug enlarges and pops out of the duct, it's called an open comedo or blackhead. This is not dirt and won't wash away. The color is due to a buildup of melanin, the dark pigment in the skin.

Most people have non-inflammatory acne, a relatively mild form with just a few whiteheads and blackheads.

With inflammatory acne, the whiteheads become infected with bacteria and swell, producing pimples and pustules. Severe inflammatory acne can cause disfiguring cysts and deep scars, and is usually treated with prescription drugs like Accutane or oral antibiotics such as tetracycline, sulfa, or erythromycin.

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