Pimples & General

What Causes Pimple Breakouts

There are basically four reasons why comedones (blackheads) or papules, nodules or

pustules (whiteheads) form on the scalp, face, neck, shoulders, back or upper arms. They

are an increase in sebum production, hormonal changes, changes inside the hair follicle and

bacteria.

Sebum Overload

Have you ever noticed that on particularly hot days or maybe after working out your skin acts

very oily? This oil, produced by the sebaceous glands, is called sebum and is your skin's

natural defense against dryness and environmental irritants. Think of it as a shield your skin

puts up to protect itself. Normally the sebum travels up the hair follicle and out onto the

surface of the skin.

Hormonal Changes

Acne usually appears for the first time when we hit puberty from age 11 on up. At this stage

of development, the body begins producing hormones called androgen causing the

sebaceous gland to enlarge. This enlargement is normal, however in people who develop

acne, the sebaceous glands have been over stimulated. This is especially evident in young

women at the beginning of their menstrual cycle, when the sebaceous glands are particularly

sensitive to androgens.

Hair Follicle Traffic Jams

As mentioned, sebum plays a major role in bringing dead skin cells to the surface where

they can be washed away. This normal process can sometimes be interrupted, especially by

hormonal changes. For example, at the onset of puberty, skin cells are shed much more

rapidly, and occasionally the sebaceous gland doesn't produce enough sebum to keep up

with the traffic flow. When this happens, the dead cells start to stick together and crash. A

major pile up occurs, the pore gets clogged and you guessed it, the comedone appears. At

the end of summer you may notice an increase of lesions due to excessive sun exposure.

After a sunburn, the breakouts which may have been temporarily controlled can sometimes

reappear with a fury when the skin is healed.

Bacteria Overdrive

As we know, good and bad bacteria exist on our skin and in our bodies and are a daily part

of our existence. In our hair follicles, there lives a little fellow named Propionibacterium

acnes (P. acnes). This bacteria actually ingests a portion of the sebum that the sebaceous

gland produces and helps to maintain a balance between too much and too little oil.

However, when the glands are producing too much sebum and the follicle gets clogged, P.

acnes goes into overdrive and multiples rapidly, producing chemicals that cause the follicle

to become inflamed and irritate the surrounding skin as well.

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