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Medical background:
Hair follilce


Anatomy of the hair follilce : H
hair follilce exist on virtually all skin except for the palms of the hands and soles of the feet.
inside the follilce, the hair extends up from the deep layers of the skin and comes out of a pore. near the surface, the oil gland (sebaceous gland )enters the hair follicle where it empties oil (sebum)at a relatively constant rate. the sebum lubricates the skin and provides a protective barrier to prevent drying.
skin on the face,chest,and back has an especially larg number of
sebaceous glands.these are the areas where acne occurs.
Acne vulgaris pathophysiology
1-Androgen stimulate sebum production N.B. sebum composition :

-triglycerides
-cholesterol esters
-waxes
-fatty acids
2- sebum is excellent growth medium for propionibacterium acnes
3- keratinous obstrucation of sebaceous follicle outlet (intrafollicular hyperkeratosis)
Comedones form from keratin & sebum collection :
1 - closed comedone
(white heads) block pilosebaceous canal encourage anaerobic bacteria to grow (propionibacterium acnes)
produce lipase which lyses triglycerides to free fatty acids.: local irritation
inflammatory lesions (papules pustules-nodules-cysts)

2 - open comedones
( black heads)
seldom become inflamed

 

 
Inflammatory lesions :
-papules (small red bumps)
-pustules (white or yellow "squeezable"spots
-inflamed nodules
Non-inflammatory lesions :
-open comedones ( black heads)
-closed comedone(white heads)
-uninflamed nodules(sometimes called cysts)
acne vulgaris may occure in face chest,and back areas of abundant sebaceous glands
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