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The exact cause of acne is unknown, but doctors believe it results from several related factors. Acne is a disorder that causes outbreaks of skin lesions commonly called pimples. It is the most common skin disease. Although acne is not a serious health threat, severe acne can lead to disfiguring and permanent scarring.
The following are the common causes for severe acne:
Hormonal Changes
One important factor in the cause of severe acne is an increase in hormones called androgens (male sex hormones). Androgens enlarge the sebaceous glands in the skin. Second, they cause these glands to increase sebum (oil) production. The increase in androgens in both boys and girls during puberty cause the sebaceous glands to enlarge and make more sebum. This hormonal surge also contributes to the development of acne in teens. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.
Estrogens, which are the female hormones, actually can help to improve acne in girls. A woman's monthly menstrual cycle is due to changes in the estrogen levels in her body. This is why acne in a female may get better and then get worse as she goes through her monthly cycle. To control severe acne a doctor may recommend treatment with birth control pills, which contain the helpful Estrogens.
Hereditary Factors
Another factor of severe acne is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. Studies have also shown that many school-age boys with acne have a family history of the disorder. Certain drugs, including androgens and lithium, are also known to cause severe acne.
Sebum Flow in Hair Follicles
Hair follicles which exist on virtually all skin except for the palms of the hands and soles of the feet are a major factor for causing severe acne. Inside the follicle, the hair extends up from the deep layers of the skin and comes out of a pore. Near the surface, the oil gland (sebaceous gland) enters the hair follicle where it empties oil (sebum) at a relatively constant rate. The sebum lubricates the skin and provides a protective barrier to prevent drying. The increased production of sebum causes blockage of hair follicles, leading to the formation of small bacteria-filled cysts called comedones. If these comedones remain intact and do not rupture, they can progress into open comedones (whiteheads) or closed comedones (blackheads). When comedones rupture, an inflammatory reaction occurs and can spread into the surrounding skin on the face, chest, and back has an especially large number of sebaceous glands. These are the areas where acne occurs and forms plugs. These plugs serve as more "food" for the bacteria.
Bacteria
Bacteria that normally live on the skin also play a role in acne development. The bacterium known as Propionibacterium is responsible for causing severe acne. These bacteria produce substances that cause redness and irritation (inflammation). They also make enzymes, which dissolve the sebum (oil from oil glands in the skin) into irritating substances. These substances also make the inflammation worse.
Other Factors for the Cause of Severe Acne:
Oil from skin products (moisturizers or cosmetics) or grease encountered in the work environment (for example, a kitchen with fry vats.
Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms.
Environmental irritants, such as pollution and high humidity.
Squeezing or picking at blemishes.
Hard scrubbing of the skin.
Stress
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