Acne is a chronic, inflammatory skin condition that causes spots and pimples,especially on the face, shoulders, back, neck, chest, and upper arms. Some people get one or two spots once in a while, whereas some others get frequent breakouts with lots of pus-filled pimples. If the second sounds more like you, it may be acne – a chronic or long-term condition that affects many teens and adults.

Acne is a broader term, and is a more serious condition that is persistent in nature. Also known as acne vulgaris, this skin disease occurs as hair follicles are clogged with dead skin cells and oil from the skin. They manifest as blackheads or whiteheads, pimples, greasy skin, and sometimes even scarring.

Those red spots that you might see when you get out of bed and wash your face in front of the mirror are nothing but pimples! They are not really an outbreak, but a few spots that pop-up once a while, or during specific seasons. You most likely will experience some pain if you touch them, but try to keep your hands away from them as much as possible, to prevent them from spreading.

Whiteheads, blackheads, pimples, cysts, and nodules are all types of acne.

It is the most common skin condition in the United States, affecting up to 50 million Americans yearly.

It commonly occurs during puberty, when the sebaceous glands activate, but it can occur at any age. It is not dangerous, but it can leave skin scars.

The glands produce oil and are stimulated by male hormones produced by the adrenal glands in both males and females.

Acne appears on the skin as
occluded pores (“comedones”), also known as blackheads or whiteheads,
tender red bumps also known as pimples or zits,
pustules (bumps containing pus), and occasionally as
cysts (deep pimples, boils).
One can do a lot to treat acne using products available at a drugstore or cosmetic counter that do not require a prescription. However, for tougher cases of acne, one should consult a physician for treatment options.

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It often causes whiteheads, blackheads or pimples, and usually appears on the face, forehead, chest, upper back and shoulders. Acne is most common among teenagers, though it affects people of all ages.

What Are Acne And Pimples? How Are They Different?
What Are Acne And Pimples? How Are They Different?

Effective treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.

Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems.

Types of acne spots
There are 6 main types of acne spots that include:

Blackheads – open clogged pores where oil turns brown when exposed to air
Whiteheads – closed clogged pores that are firm and won’t pop
Papules – small red bumps that feel sore to touch
Pustules – pus filled papules with a white tip
Nodules – large painful lumps under the skin
Cysts – large lumps filled with pus that look similar to boils
What Causes Acne?
Several factors contribute to the development of acne. The primary problem is change in the development of cells inside the hair follicle, leading to the formation of a plug or (comedo). The plug disrupts the normal movement of hair, skin cells, and grease (sebum), resulting in enlargement and eventually rupture of the hair follicle. A ruptured hair follicle spills its contents of oil and debris into the skin where it leads to swelling and causes redness (inflammation).

Propionibacterium acnes, a type of bacteria that normally lives in the skin hair follicles, also plays a role in acne. These bacteria produce substances that cause redness and irritation (inflammation). They also make enzymes, which dissolve the sebum from the oil glands in the skin into irritating substances. These substances also make the inflammation worse.

Certain hormones called androgens are an additional factor in causing acne. Androgens are male hormones that are present in both men and women but are present at higher levels in men. Androgens do two things: First, they enlarge the sebaceous glands in the skin. Second, they cause these glands to increase sebum (oil) production. The increased sebum production exacerbates plug formation and serves as more “food” for the bacteria. Androgens surge at puberty, which is why teens develop armpit and pubic hair and why boys develop facial hair and deeper voices. This hormonal surge also contributes to the development of acne in teens.

What Are Acne And Pimples? How Are They Different?
What Are Acne And Pimples? How Are They Different?

Estrogens, which are the female hormones, actually can help to improve acne in girls. A woman’s monthly menstrual cycle is due to changes in the estrogen levels in her body. This is why acne in a female may get better and then get worse as she goes through her monthly cycle. A doctor may recommend acne treatment with birth control pills, which contain the helpful estrogens.

Because severe acne can run in some families, there seems to be significant hereditary predisposition to serious disease.

Anatomy of the hair follicle: Hair follicles exist on virtually all skin except for the palms of the hands and soles of the feet. Inside the follicle, the hair extends up from the deep layers of the skin and comes out of a pore. Near the surface, the oil gland (sebaceous gland) enters the hair follicle where it empties sebum at a relatively constant rate. The sebum lubricates the skin and provides a protective barrier to prevent drying. Skin on the face, chest, and back has an especially large number of sebaceous glands. These are the areas where acne occurs.

Acne lesions: There are two major types of acne lesions: noninflammatory and inflammatory. Noninflammatory acne lesions include blackheads (open comedones) and whiteheads (closed comedones). Open and closed comedones along with papules and pustules are referred to as papulopustular acne, a form of inflammatory acne. Nodular acne is the most severe form of inflammatory acne.

Noninflammatory acne: Open comedones result from the enlargement and dilation of a plug that forms from oil and skin cells inside the hair follicle.

The hair follicle pore remains open, exposing a black plug (known as a blackhead). The dark color is not dirt inside the pore. Instead it is the oil inside the pore, which has become exposed to the outside air.

A closed comedo forms if the hair follicle pore remains closed. The plug in a closed comedo or whitehead is therefore not exposed to the outside air, and no black color develops. The closed comedo simply appears as a tiny, sometimes flesh-colored or white bump in the skin.

Inflammatory acne: Inflammatory acne lesions consist of red blemishes, pimples also called zits (papules, pustules), and larger, deeper swollen tender lesions (nodules).

Papules are closed comedones, which have become red, swollen, and inflamed.

Pustules are closed comedones, which become inflamed and begin to rupture into the skin, forming pustular heads of various sizes.

Nodules represent large, tender, swollen acne lesions, which have become intensely inflamed and rupture under the skin. If untreated, these can produce scarring.

Hormonal factors
A range of factors triggers acne, but the main cause is thought to be a rise in androgen levels.

Androgen is a type of hormone, the levels of which rise when adolescence begins. In women, it gets converted into estrogen.

Rising androgen levels cause the oil glands under the skin to grow. The enlarged gland produces more sebum. Excessive sebum can break down cellular walls in the pores, causing bacteria to grow.