Acne vulgaris is an extremely complex disease involving various defects in the skin. Elements of pathogenesis include abnormal epidermal keratinization, excess androgen secretion, defective sebaceous function, bacterial growth and inflammation. Although, in recent years, there has been a greater understanding of the disease there is still a great deal more to learn before we fully understand the causes of an acne pimple.

Acne begins with a fault in the follicular lining which causes the it to shed in sheets rather than particles which causes the material to have difficulty in exiting. This leads to the formation of a plug, called a comedo, consisting of keratin squamae and sebum. Comedones can be classed as "open" or "closed", A comedo is open when the black tip is visible without maxnification, open comedones are commonly referred to as blackheads. A comedo is closed when the black tip is not visible without the aid of maxnification, closed comedones are commonly referred to as whiteheads.

Although acne is common in teenagers comedones have been demonstrated before puberty. This leads us to assume that the activation of sebaceous secretion is not the key event (in triggering the formation of comedones). In the laboratory it has been proven that a number of compounds can induce comedones, such as coal tar and sulphur, but these are not really relevant to the natural formation of acne.

Acne is usually associated with inflammation as the follicle becomes red and enflamed. To make matters worse it has been noted that it is common, in severe cases of acne, for increased formation of comedones around the area of inflammation. Bacteria is also associated with acne and certainly bacteria can act upon sebaceous triglycerides releasing comedogenic fatty acids however studies have shown that prepubertal children also suffer from comedones and yet they do not have follicular microflora or sebum.

There does appear to be some correlation between sebum production and the severity of acne. It has been shown, in various studies, that teenage acne patients suffer from higher levels of bacteria in their follicles than the control subjects of the experiments. This is accounted for by the increased levels of sebum production seen in the teenage sufferers of acne when compared to the controls. However there is an amount of overlap between the two groups and another point worth noting is that the differences are less pronounced in older individuals with the disease.

Looking at the points above it is clear that further investigation is required in the causes of comedones before we can begin to fully understand the causes of acne. There does appear to be a family tendency to suffer from the disease as it is common to see the brothers and sisters of sufferers also suffering from the problem.

Certain factors are known to aggravate the the condition such as scratching (which can increase inflammation), use of opiates and opioids, use of anabolic steroids and abnormal hormonal activity. There are also a number of diet related factors such as the fact that an iodine rich diet can make existing acne worse.

While we do not fully understand the complex causes of the disease by avoiding things which will make it worse will help with recovery and there are a number of treatments available such as hormonal therapy, the use of oral contraceptives and antibiotics. Benzoyl peroxide (BP) is a topical disinfectant often used in skin care/acne creams but it can cause irritation.

Topical and oral erythromycin and topical clindamycin have been in use for a long time but, as the bacteria (P. acnes.) gains resistance it becomes less effective as a treatment. The tetracycline family of antibiotics are also used as they have an anti-bacterial action but also an anti-inflammatory effect.

As the medical establishment continues to grow more concerned about the over use of antibiotics it is important that we develop alternative treatments for acne. One of the most interesting skin care treatments that have been shown to be effective in treating acne is [url=/]microdermabrasion[/url].. However it is important to note that the treatment should never be used on active acne but only on skin clear of pimples.

The use of microdermabrasion has been proven to reduce the amount of open pores. The process involves the use of fine abrasive crystals which are blown onto the skin to remove dead skin cells and, in some cases the very top surface of the skin. Obviously by the clearing of the pores and the removal of dead skin matter there is less chance of the skin developing comedones. Thus, by treating areas that are not, yet, suffering from pimples the likelihood of a new pimple forming is decreased. As inflammation subsides and the pimple is healed that area of skin can then also be treated. By a process of elimination all of the skin can be treated.

Felicity Kennedy has been involved in the promotion and marketing of professional microdermabrasion machines and treatments since the procedure first appeared in the United Kingdom. During this time it was necessary to investigate all aspects of skin care including medical problems such as acne.

takes a frank look at the treatment, it's successes and failures. One of the most interesting points of the site is to highlight some of the common tricks of the trade to enhance before and after photographs and helps to explain what you should reasonably expect to achieve with this popular treatment.