Acne is an androgenically stimulated, inflammatory disorder of the sebaceous glands, resulting in comedones (whiteheads and blackheads), papules, inflammatory pustules and, occasionally, scarring. Virtually 100% of adolescents are affected to some degree, although only15% will seek medical advice. Males tend to be more severely affected, due to the association with male hormones (androgens).
Acne is caused by androgens (testosterone and andosterone) which stimulate the rate of keratin turnover in the sebaceous gland. The keratin plug, visible as a comedone, causes an accumulation of sebum in the gland. The presence of Propionibacterium acnes stimulates an inflammatory response to the sebum, which results in papule and pustule formation.
Risk factors include: Adolescence; Male sex; Androgenic steroids (e.g. steroid abuse and some birth control pills); Oily cosmetics, including cleansing creams, moisturizers, oil-based foundations; Rubbing or occluding the skin surface, as may occur with sports equipment (helmets and shoulder pads), holding the telephone or hands against the skin; Drugs (iodides or bromides, lithium, phenytoins); Systemic corticosteroids; Virilization disorders; and a Hot, humid climate.
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