What is Acne?

Acne is the name given to a complex process that may be virtually invisible in some individuals, or cause extreme gross disfigurement in others. Adolescents usually suffer the most from acne, and in medical studies there is almost 100% incidence of acne, with only the level of severity differing from person to person. Females may also find that acne will persist well beyond the teenage years. Many women who were nearly acne free as adolescents find they suffer with it through their 20’s, 30’s and beyond.

There is not a single known cause for acne, however there are a number of factors that do contribute to the course of the disease:

  1. Heredity. This is an important factor in determining the size and activity of sebaceous glands. The presence of the disease is believed to be genetically based.
  2. Increase in sebum (oil) production. Sebum production is a critical factor in the development of the disease as it is significantly increased due to higher levels of hormones at the onset of adolescence, and is fed on by Propionibacterium acnes (P acnes bacteria).
  3. Bacteria. It is the P acnes bacteria that produces toxic substances that attack the follicle and eventually incites it to rupture.The presence of other factors such as increased sebum, follicular retention, hormone changes, and inherited follicular characteristics that contribute to the bacteria’s ability to produce the by-products that accelerate and aggravate the disease.
  4. Hormones. Normal hormone levels need to be present for acne to occur. People who have severe acne have normal (and sometimes abnormal) hormone levels. It is the follicles with hereditary characteristics that make the follicles more reactive to normal hormone changes.
  5. Retention Hyperkeratosis. This is the abnormal build-up and retention of cells in the follicles of individuals prone to acne. Instead of the cells being naturally shed and pushed to the surface by various cellular secretions, these cells get stuck together to form a solid mass, causing a follicular blockage. This blockage allows the P acne bacteria to feed and grow, as it cannot survive for long when subjected to oxygen.
  6. Diet and Stress play a significant role in acne. When we do our consultation we go over everything that can contribute to your acne.

Types of Acne Lesions

During the acne cycle, acne can progress in one of two directions:

  • Non-inflammatory lesions, which can be invisible or resemble a small, firm whitish bump under the skin. These can turn into blackheads if the follicle opening dilates to accommodate the growing mass. It was once thought that the blackened appearance was caused by oil oxidizing, but the colour is actually melanin (pigment) that is contained in the follicle matter. When squeezed, only the upper most contents are eliminated, which is why for the most part, astringents, masks, scrubs, extractions etc. have temporary effects and do not interrupt the acne process.
  • Inflammatory lesions such as papules, pustules, nodules and cysts. The severity of an inflammatory lesion ususally depends on where the rupture occurs in the follicular wall.
  • Papules rupture at the top of the follicle, just under the epidermis producing a solid red bump. These lesions usually clear rapidly as the rupture is not very deep.
  • Pustules can start as a papule and liquefy. The rupture in the follicle is close to the top, resulting in a lesion that is not serious and generally heals without scarring.
  • Nodules can appear as fairly large subsurface lesions. These can be initially painful to the touch, but unlike papules and pustules, the follicle ruptures at a lower point. The inflammation is therefore deeper and involves more tissue. The rupture in the follicle wall is like an explosion that often pushes toxic material into nearby follicles, causing them to become part of the inflammatory process, taking longer to heal.
  • Cysts are hollow cavities that are encapsulated by a shell-like structure and are unlikely to resolve without serious intervention. Cysts usually slowly enlarge over time, stretching the walls so thin that it is extremely vulnerable to rupturing. When a cyst ruptures, it causes a deep and widespread inflammation, resulting in the destruction of underlying tissue and will invariably leave a scar.


It used to be believed that acne was solely a bacterial issue, to be treated by a doctor. While antibiotics do help, there are other options that have offered just as much, or more relief from the stigma of acne.

We offer customized Facial treatments to help alleviate and interrupt the acne process using industry leading products and techniques.

Bren will perform a personalized assessment to determine which option is best for you.

Before and After

Acne - Before and After

Acne - Before and After