The basic cause of acne is still unknown. It seems to be a multifactorial disease in which interaction of several factors play an important part in the pathogenesis. The primary event may be (a) obstruction of the sebaceous duct due to alteration in the pattern of keratinization within the follicle, (b) abnormal sebum production with excess quantities or altered composition or (c) increased bacterial colonization (proprionibacterium acnes and staphylococcus epidermi¬dis of pilosebaceous follicles which furnish the lipases responsible for hydrolysis of sebum triglycerides into free fatty acids. All three mechanisms may be involved. Obstruction of duct leads to forma¬tion of a comedone, the initial lesion of acne. A comedone can be located either in a closed follicle as a 'white head' consisting of lipid and keratin, or in an open follicle as 'black head' consisting of keratin and lipid with melanin deposition. The continual accumula¬tion of keratin and lipid may lead to rupture of the follicular wall and release of its contents into the surrounding dermis provoking an inflammatory tissue reaction.
Acne vulgaris begins when oil and dead skin clogs the pores of the face. It can also affect the neck, back, chest and shoulders. If the clogged pores get infected, the result is swelling, pus, inflammation, and tenderness.
By Anbhu Selvan
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