Acne may be a life-long process, and usually starts before puberty, or at the onset of puberty. However, it can begin in adulthood or even in elderly people. The areas that are typically affected are the face, neck, upper chest, back and the shoulders.

Acne affects both males and females. At the age of 18, acne is more frequent in men than women. Beyond the age of 23 it is more common in women. The severe inflammatory form of acne is more often in men at any age. Scars rarely occur in females, except when the lesions are manipulated by the patient.

What causes acne?

The increased production of the hormone androgen in puberty triggers a higher production of sebum by the sebaceous glands in the skin. The sebum is a natural subtract for bacterial growth, and allows the bacteria to increase dramatically in numbers, especially Propionibacterium acnes (P.acnes). The sebum is transformed by P. acnes in both free fatty acids, and other chemicals that produce the inflammation process.

The combination of increased androgen and pro-inflammatory chemicals causes a higher cohesion of the epidermal cells in the pore areas. This action forms what are commonly known as pimples – the characteristic lesions of acne.

There are closed and open pimples: a closed pimple is a closed pore with a tiny plug.
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