Hello. I am Dr. Jung Ji-in, a dermatologist. I would like to explain acne, a common skin condition that many people, from adolescents to adults, worry about, over several episodes. In this first session, we will explore why acne occurs, as well as the various types, conditions, and causes of acne.
Why Does Acne Occur? Analyzing the Main Causes
The primary causes of acne are genetic factors and hormonal changes. Adolescent acne, in particular, is greatly influenced by hormones. In addition, various factors such as individual factors, skin type, cosmetics used, diet, and lifestyle can also play a complex role.
While the causes are diverse, the main mechanism by which acne occurs in the skin is deeply related to the sebaceous glands. Sebaceous glands are distributed throughout the body, except for the palms and soles of the feet, especially on the face, neck, chest, and upper back, and are one of the important organs that prevent skin dryness and protect it.
Acne occurs when the sebaceous glands excessively proliferate or sebum secretion becomes active due to various causes, and the pores become clogged due to keratinization of the pores. When sebum and dead skin cells block the pore opening, an environment conducive to the proliferation of acne bacteria is created, and acne appears as an inflammatory response to this.
How Does Adult Acne Differ from Adolescent Acne?
Recently, the proportion of adult acne patients has been continuously increasing. Adult acne can be exacerbated by various causes, including makeup or cleansing issues, skin irritation, certain medications, food, and hormonal imbalances.
Generally, adult acne is often less severe than adolescent acne, but it differs in its distribution. While adolescent acne primarily concentrates on the T-zone of the forehead and nose, adult acne tends to appear severely on the U-zone, which includes the area around the mouth and jawline. This is because, in adults, even if sebum secretion is not vigorous, it is heavily influenced by hormones, and acne tends to occur more in the dry areas around the mouth and jaw.
Individuals with polycystic ovary syndrome, hormone-related diseases, or exposure to certain chemicals or medications may also experience severe acne for their age.
The areas around the mouth and jaw where adult acne frequently occurs are relatively difficult and challenging to treat. They are more susceptible to red erythema and pigmentation, and tend to persist for a relatively longer period.
What Type of Acne Do I Have? Non-Inflammatory vs. Inflammatory Acne
Acne can be broadly divided into non-inflammatory acne and inflammatory acne. It is rare for only one type to appear; most cases involve a combination.
Non-inflammatory acne primarily refers to the early stages of acne.
- Closed Comedones (Whiteheads): This is a form where pores are clogged and sebum is trapped, appearing as small bumps on the skin surface.
- Open Comedones (Blackheads): This is a state where dead skin cells and sebum accumulate, and the pore opening is open, appearing black due to oxidation in the air. It is not black because it is dirty.
These two are relatively early stages before visible inflammation appears, and they are the seeds that can develop into inflammatory acne, so extraction and Scaling are necessary at this stage.
When it develops into pustular acne, which causes inflammation, it's a different story. This refers to red, pus-filled inflammatory acne, and it is absolutely not recommended to extract it at home. Improper extraction can spread inflammation to the surrounding areas, increasing the likelihood of scarring, and often it doesn't come out well. In such cases, it is best to visit a dermatology clinic for medication, professional care, extraction, or laser treatment.
Why Do Acne Scars Occur and How Do They Appear?
Acne scars do not simply result from inflammatory acne alone. Various factors complexly contribute to scar formation, and different types of scars are prone to developing depending on the area.
For example, depressed scars are prone to forming on the temples, while raised scars or dark pigmentation are common around the jaw and mouth. Notably, even individuals who do not typically develop keloid scars in other areas tend to develop tough, firm keloid-type acne scars along the jawline.
Today, we explored why your acne occurs and what types there are. If you have any additional questions about today's content, please feel free to inquire at any time.