How does acne occur?

Just below the surface of the skin are many small sebaceous oil glands, usually attached to hair follicles (pores which carry shafts of hair). The function of sebaceous glands is to produce an oily substance known as sebum to protect and water-proof the skin (Figure 2).

Acne is a chronic disorder of the hair follicles and sebaceous glands, characterised by black heads, pimple outbreaks, cysts, infected abscesses, and (sometimes) scarring. Acne begins with excess oil production, blocked pores and acne causing bacteria (Propionibacterium acnes or P.acnes). Inflammation then follows (Figure 3).

While sometimes it seems pimples appear overnight, the development of an acne breakout is an extended process. The face, neck, chest, shoulders and upper back are the areas mainly affected by acne because they have the highest number of sebaceous glands.