Incidence of acne:  Close to 100% during a life-span
Highest incidence:  During teenage years (Acne Vulgaris)  Testosterone activates sebum production
Other high incidence group:  Menopausal women

  Although diet, stress, hormones, medication and certain environments can all help trigger acne, ultimately three main factors are needed to to set the stage for acne: Sebum, Bacteria, and Enclosure.

SEBUM

Sebum is an oily substance that lubricates the surface of the skin and hair. Sebum is made of wax monoesters, triglycerides, fatty acids and squalene. Excess sebum provides nutrients for bacteria.

BACTERIA

Bacteria is the second factor in causing acne. Propionibacterium acnes - also known as P. Acnes - is the bacteria that causes Acne Vulgaris, the most common type of acne. The bacteria, through its enzymes, digests sebum and breaks down long-chain fatty acids into short-chain fatty acids.

ENCLOSURE

The third factor, enclosure, is created by the thickening of the wall of the sebaceous duct, as well as the formation of keratinecous/horny plugs. This closed environment prevents sebum from wicking to the surface of the skin, trapping it instead.

ENCLOSURE + SEBUM

Enclosure and sebum together, without bacteria, can create closed comedones...

BACTERIA + SEBUM

Bacteria plus sebum, without enclosure, can create irritation.

ENCLOSURE + BACTERIA + SEBUM

Only when all three factors are present can the result be full blown acne.

ACNE VULGARIS

Acne Vulgaris is very common in teenagers, as it's a direct result of increases in the male hormone androgen. Although Acne Vulgaris normally develops during puberty, it can be triggered at any age. It is characterized by a variety of lesions being visible at any given time.

ACNE COSMETICA

Acne Cosmetica is a condition caused by comedonic ingredients found in hair styling products, conditioners, certain sunscreens and make-up. Acne Cosmetica lesions are of the same shape and size, and can be avoided by switching to non-comedogenic products.

ACNE EXCORIEE

Acne Excoriee is a condition caused by neurotic picking of the face. This nervous picking, and the marks caused by it, are usually linear in appearance. This type of acne is worrisome because picking with unclean hads and fingernails can be a source of secondary infections.

ACNE CONGLOBATA

Acne Conglobata is a severe hereditary acne that generally causes scarring on the face and back. It appears as irregularly joined nodules; at earlier stages hard, then with a soft fluid feel.

ACNE DETERGENTS

Acne Detergents is an acne caused by the overuse of abrasive cleansers.

ACNE MALLORCA

Acne Mallorca is caused by excessive sun exposure. It's often seen in men who work outdoors.

ACNE MECHANICA

Acne Mechanica is caused by mechanical irratation. An example of this is the acne caused by the chinstraps of football players.

ACNE MEDICAMENTOSA

Acne Medicamentosa is an acne caused by medications.

CHORACNE

Choracne is caused by constant exposure to certain industrail chemicals, such as aromatic halogenated compounds, and the hydrocarbons found in motor oil.

STEROID ACNE

Steroid Acne is an inflammation of the hair follicles caused by internal steroids or from topical corticosteroids on the face.

CYSTIC ACNE

Cystic Acne is a severe type of acne condition created when the sebum - together with dead skin cells and bacterials products - ruptures through the follicle wall, causing an inflammatory reaction that may end in scarring. It appears as a large rubbery nodule, often skin colored and surrounded by red inflamed tissue, 5-200mm in size.