What are Pimples and Acne?

Teen acne overview

Acne is a disease of the pilosebaceous units (PSUs). PSUs consist of a sebaceous gland connected to a canal, called a follicle, that contains a fine hair.

Acne lesion

Image source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Acne is caused when the hair, sebum, and keratinocytes that fill the narrow follicle produce a plug. The plug prevents sebum from reaching the surface of the skin through a pore and the bacteria Propionibacterium acnes (P. acnes), which normally live on the skin, to grow in the plugged follicles. The bacteria causes the surrounding skin to be inflamed leading to skin lesions.

Types of lesions

There are generally 4 types of skin lesions caused by the acne bacteria:

  • Comedo:

    • basic acne lesion which is an enlarged and plugged hair follicle;
    • whitehead is a closed comedo is an acne lesion staying beneath the skin which produces a white bump;
    • blackhead is an open comedo which has reached the surface of the skin and looks black.
  • Papules:

    • inflamed lesions appearing as small, pink bumps on the skin;
    • can be tender to touch.
  • Pustules:

    • known as pimples;
    • pimples are white or yellow pus-filled lesions.
  • Cysts:

    • severe form of acne known as cystic acne;
    • cysts are deep, painful lesions that can cause scarring.

Who gets acne?

Acne is most common in teenagers, but anyone can get acne, even babies and adults over 40. Three quarters of teenagers will develop teen acne some time during the teenage years.

The exact cause of teen acne is unknown. Studies have shown that acne is hereditary, which means that if your parents had teen acne, you have a higher chance of having it.

Teen acne can be triggered or worsen by:

  • hormonal changes relating to puberty;
  • hormonal changes from menstrual periods, pregnancy or birth control;
  • stress and anxiety;
  • greasy or oily cosmetic and hair products;
  • steroids;
  • excessive humidity or sweating.

Research does not show that chocolate, nuts, and greasy foods cause acne. Dirty skin also does not cause acne. However, diets high in refined sugars may be related to acne.

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