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Acne is a disorder of the hair follicles in which blackheads (comedones) develop in the skin. Increased flow from oil (sebaceous) glands in the dermis combined with increased shedding of dead skin cells can cause the oil-cell mixture to block the follicle openings, resulting in comedones. If clogged follicles become infected with bacteria, inflammation and closed, pus-filled comedones (pustules) may develop.
There is a genetic predisposition for acne; that is, people whose family members have acne are also likely to have it.
Stress may also affect acne; the condition often worsens during times of stress and improves during more stable periods.
Many people believe that poor dietary habits can cause acne. Foods with high fat content, such as chocolate, are thought to affect the skin follicles. However, there is no clinical evidence to support this. Studies show no connection between junk food and acne. Some people find that certain foods, such as dairy products, worsen acne. Patients who have a high carbohydrate diet, consume large quantities of milk, and eat pasta and white bread, tend to have more acne. High sugar diets known as high-glycemic also tend to have greater outbreaks of acne.
Propionibacteria acnes is the common bacterial cause of skin infection that accompanies acne. These bacteria are present whether the patient has adolescent, persistent or adult-onset acne.
Inflammation that persists can result in the formation of a large, often painful acne cyst or nodule (collection of inflammatory cells). When a cyst heals, it can leave a pitted, discolored scar, known as a pockmark. Scars can be treated with dermabrasion, laser resurfacing, or collagen injection.