Acne

Acne is a chronic inflammatory skin condition that occurs when the hair follicles in the pores become clogged with oil (sebum), dead skin cells, and sometimes bacteria. Acne most commonly appears on the face, chest, shoulders, and upper back—areas of the body that contain a high concentration of sebaceous (oil) glands.

While acne is often seen as a temporary concern during puberty, it can persist into adulthood. Some individuals experience acne well into their 30s, 40s, or even later, making it a condition that requires both dermatologic intervention as well as long-term management strategies.

Acne is multifactorial, meaning several elements contribute to its development:

• Excess oil production: Increased sebum production can clog hair follicles, particularly during puberty or hormonal shifts.
• Clogged pores: Dead skin cells not adequately shed from the skin surface can accumulate inside pores.
• Bacteria: Cutibacterium acnes (formerly Propionibacterium acnes) can grow in blocked follicles and contribute to inflammation.
• Hormones: Androgens (male sex hormones) stimulate the sebaceous glands, leading to increased oil production.
• Lifestyle factors: Diets high in sugar or dairy, certain medications, stress, and improper skincare routines may exacerbate acne. Sugary foods increase insulin levels which can cause increased oil production and breakouts. Stress can raise hormone levels increasing oil production.

Acne varies based on type and severity. Common types of acne include:

• Blackheads: open comedones caused by clogged pores that are exposed to air and oxidize.
• Whiteheads: closed comedones that form when pores are blocked but not exposed to air.
• Papules: small, red, tender bumps that indicate inflammation.
• Pustules: similar to papules, but with a white or yellow center filled with pus.
• Nodules: large, painful lumps beneath the surface of the skin that are more solid and inflamed.
• Cysts: deep, pus-filled lesions that can be painful and often lead to scarring.

Some patients may experience only mild breakouts, while others struggle with widespread and/or persistent lesions. The condition can also lead to post-inflammatory hyperpigmentation or permanent scarring if not managed appropriately.

A diagnosis of acne is typically made during a physical examination with Dr. Neely Khan. The assessment includes evaluating the type, distribution, and severity of lesions. In some cases, additional work-up may be warranted, especially if hormonal imbalances are suspected or if acne is resistant to standard treatments.

A detailed patient history, such as age of onset, menstrual patterns, use of cosmetic or hair products, family history, and medication use can provide valuable insights into the cause and aid in diagnosis and management.