Acne, a disease of the skin’s oil glands, is the collection of many raised bumps otherwise known as zits, pimples, and white or black heads. People with acne often times have social embarrassment and find that it affects their level of self confidence and image. Although it is considered non-life threatening, acne can represent a deeper hormonal imbalance within the body.

Sebum, an oily substance produced in response to testosterone (the male hormone), is excreted by the skin’s oil (sebaceous) glands. Pimples form when the gland is clogged with excess sebum and/ or dead skin cells (keratin) and they tend to occur in the areas rich in sebaceous glands, mainly the face, neck, back, and chest.

Testosterone is normally elevated in teenagers and hence why acne is more common with them. For women, adult onset acne or hormonal acne, usually worsens as part of their premenstrual pattern, thus showing a connection to an internal hormonal imbalance. Some women have poly-cystic ovarian syndrome and are not able to properly convert testosterone into estrogen properly. As a consequence these women end up with elevated levels of testosterone and acne being one of the main complaints. o

Closed commedones or white heads are formed when the oil gland is first clogged and is not inflammed yet. When the gland eventually opens onto the skin surface it is called an open commedone or blackhead. The black spot in the middle of the lesion is due to melanin, the bodies pigment, it is not from dirt.

When the clogged gland starts to break down and becomes inflammed, the typical raised red pimple is formed. These are called papules and are generally tender to the touch. Often times the papule has pus on the top of it, which is caused by the bodies white blood cells attacking the blocked hair follicle. These are called pustules.

Nodules are large, solid, and deep papules that are painful to touch. Cysts are the same, although it is pus filled and does not feel as hard when touched. Since these lesions are deeper in the skin they have a tendancy to scar if aggravated.