Why Does Acne Keep Coming Back?? (Causes of Acne and Types of Acne)

Hello

I am Seo Min-ho, the Director of Episode Clinic.

I'm going to write a post that takes an in-depth look at acne.

If you read this carefully, you'll understand why I get acne and what I need to do to prevent it. 

I’ll explain this in a way that’s easy to understand at a glance. Please take just 5 minutes to read this carefully!!

1. Why do we get acne, anyway?

Those pesky pimples...Why do they keep popping up?

Many people think thatacne issimply “caused by excess sebum.” 

However, it is actually a skin condition that results from amuch more complex process.

Structure of the Sebaceous Gland

Every day, new dead skin cells are produced within the skin, and sebum is secreted by the sebaceous glands. 

This sebum is a substance that is essential for protecting the skin and keeping it moisturized. 

However, when dead skin cellsfail to shed normally from the pore openings and accumulate for various reasons, 

Sebum cannot be expelled and remains trapped inside the pores.

Microcomedones (clumps of sebum and dead skin cells trapped inside a blocked pore)

In dermatology, this condition—where sebum and dead skin cells begin to accumulate gradually inside the pores—is called a microcomedone.

In fact, this stage is when acne actually begins.

When pores become clogged like this, it creates an environment where the acne-causing bacteria (Cutibacterium acnes)can easily multiply. 

As the bacteria multiply, an inflammatory responseoccurs, leading to the red pimples or pus-filled pimples we commonly see.

Increased sebum production -> Clogged pores due to dead skin cells -> Proliferation of acne-causing bacteria -> Inflammatory response

2. What are the different types of acne?

Sebum builds up in clogged pores, where acne-causing bacteriathrive, leading to the development of full-blown acne.

Although no inflammatory reaction has developed yet , a non-pustular acne lesion that has grown in size will progress to a pustular acne lesiononce an inflammatory reaction occurs.

Let's take a look at the different types of acne.

1)비화농성 여드름

(1) 화이트헤드

모공이 닫힌 채로 피지가 차 있는 닫힌 면포

(2) 블랙헤드

모공이 열려 피지가 공기와 접촉해 검게 보이는 열린 면포

At this stage, the acne is still non-inflammatory (comedonal acne). This is commonly referred to as "whiteheads."

However, if an inflammatory reaction begins to develop inside it, it progresses into what we commonly refer to as a pustular pimple.

2)화농성 여드름

(1) 구진성 여드름(papule)

여드름 병변과 비염증성 여드름 병변의 중간 형태

구진이란 염증성 이며 피부의 단단한 덩어리로 직경이 0.5cm~1cm 정도 됩니다.

작고 딱딱한 붉은 색의 병변으로 안에 고름은 잡히지 않은 상태로 나타납니다. 

(2) 농포성 여드름(pustule)

염증성 여드름 병변으로 고름이 차있는 융기된 주머니

농포란 농포의 전 단계인 구진과 비슷한 크기로 작고 둥그런 모양이지만

안에 고름을 포함하고 있는 것이 구진과 다른 점입니다.

고름이 잡힌 들어선 여드름은  본인이 짜게 되면 더 큰 염증을 유발할 수 있으므로 손대지 않는 것이 좋습니다. 

(3) 낭종성 여드름(cyst)

여드름의 가장 깊고 염증이 심한 형태 중 하나

낭종형 여드름은 피부 속에서 큰 염증 덩어리와 고름 주머니(낭종)가 형성되는 상태를 말합니다.

항생제와 염증 조절 등 적극적인 치료가 필요합니다.

(4) 결절성 여드름(nodule)

단단한 염증성 결절(nodule)이 형성되는 중증 염증성 여드름

결절성 여드름은 보통 일반적인 여드름보다 염증이 깊고 크며, 통증이 있고 흉터를 남길 가능성이 높은 형태입니다.

3. 여드름의 진행 순서

Microcomedones → Non-inflammatory acne (whiteheads / blackheads) → Inflammatory acne (papular / pustular / cystic / nodular)

Therefore, when treating acne, it’s not just about treating the visible pimples, but rather, 

It is very important to effectively manage the process by which pores become cloggedbefore reaching this stage.

4. 정리

Now that you know why acne occurs,

In the next post, we'll look at ways to prevent acne.