Acne is the result of the combination of the production of skin oils and skin bacteria that enlarges hair follicles resulting in inflammation. Stimulation of the follicles by male hormone-like compounds is probably the most important step. It starts when greasy secretions from the skin`s sebaceous glands plug the tiny openings for hair follicles. This is what is commonly referred to as clogged pores. If the openings are large, the clogs take the form of blackheads: small, flat spots with centers darkened by exposure to air. If the openings stay small, the clogs take the form of whiteheads: small, closed, flesh-colored bumps. Both types of plugged pores can develop into swollen, tender inflammations, pimples or deeper lumps or nodules. Cysts associated with severe cases of acne (cystic acne) are firm swellings below the skin`s surface that become inflamed and sometimes infected.

Although acne primarily shows up in adolescence, about 20% of all cases occur in adults. Acne commonly starts during puberty between the ages of 10 and 13 and is normally worse in people with oily skin. Teenage acne usually lasts for 5 to 10 years, normally going away during the early 20s. It occurs in both sexes, although teenage boys tend to have the most severe cases. Women are more likely than men to have mild to moderate forms into their 30s and beyond.

Acne is most common on the face, but can also occur on the neck, chest, back, shoulders, scalp and upper arms. While diet, milk, poor hygiene or an uncontrolled sex drive may not cause acne, they can certainly aggravate the condition. More likely, heredity and hormones are to blame for most forms of acne.  

Common acne in teenagers starts with an increase in hormone production. During puberty, both boys and girls produce high levels of androgens, the male sex hormones that include testosterone. Testosterone signals the body to make more sebum, a waxy substance that helps the skin retain moisture. Excess sebum clogs the openings to hair follicles -- especially those on the face, neck, chest, and back, and bacteria grow in these clogged follicles. This makes blackheads or whiteheads form on the skin`s surface. This is a condition called non-inflammatory acne. Sometimes the follicle wall breaks under the pressure of this buildup. When this happens, sebum leaks into nearby tissues and forms a pustule – this is called inflammatory acne. Inflammatory acne can create cysts, and ruptured cysts leave temporary or permanent scars.

Other triggers for acne may be oral contraceptives. Steroids can also lead to severe outbreaks. Even infants are not totally immune to the woes of acne. Acne neonatorum and acne infantum occasionally affect newborns and infants, usually boys. A pimply rash appears on the face but normally clears within weeks with no lasting effect.

Adult-onset acne affects billions of men and women. Teen age acne has no bearing on your change to develop adult acne.

Experts believe that the way a person`s skin responds to an increase in sebum production may have a lot to do with their acne outbreaks. Bacteria occurs naturally in healthy hair follicles, however, if too much accumulates in plugged follicles, it may secrete enzymes that break down sebum and cause inflammation. Some people are simply more sensitive than others to this reaction. Sebum levels that might cause a pimple or two in one person may result in widespread outbreaks or even acute cystic acne in another person.

With more than 75 percent of teenagers and billions of adults affected, about 4 billion dollars are spent each year on the treatment of acne, sometimes with strong medications and chemicals.

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