The American Dermatologist Association finds that over 60 million Americans have active acne. 17 million adults are diagnosed with acne every year, so it is not just for the stereotypical teen-ager. Over 50% of women 25 years and older have acne, and only 11% of acne sufferers seek help. 
    Generally speaking, “acne” refers to the condition known as Acne vulgaris, the most common form of acne. Contrary to popular belief, it has little to do with cleanliness.  Although it is important to keep our skin clean, acne is not caused by dirt.  There are many common triggers, although heredity and hormones are often at the root of most acne problems.  Additional triggers may include stress (which relates to hormonal changes), cosmetic and skin care products, environment, medications, pregnancy, and diets high in dairy products as well as carbohydrates.
    To explain how we develop an acne breakout is simple.  Our facial follicles, often called pores, become blocked with sebum (oil) and an accumulation of dead skin cells. This in turn blocks oxygen from getting in, allowing the bacteria, Propionibacterium acnes, to grow within the skin.  A “whitehead” is formed when the sebum and bacteria fill a follicle below the skin surface. A “blackhead” occurs when the pore is open to the surface, allowing the sebum to oxidize, turning it black/brown in color.  A “ blackhead”  is not caused from dirt and cannot be washed away. 
    If the follicle wall ruptures below the skin surface, an inflammatory acne lesion will appear.  This is called a papule and often appears red, raised and inflamed.  A pustule often forms within several days as a result of the dead white blood cells that were present to assist in fighting the inflammation. You should never pick or squeeze any acneic lesion, as this can result in the spread of bacteria in the lower layers of the skin and possibly leave a scar.
    A cyst is a sac-like lesion containing liquid material consisting of white blood cells, dead skin cells and bacteria.  It is larger than a pustule, often severely inflamed, painful, extending into the deeper layers of the skin, and may result in scarring.  Cystic acne is considered severe and should be treated by a dermatologist.
    There are many options available for acne management. A treatment plan will vary based on individual history, lifestyle, grade of acne and overall condition of the skin.  Contact a qualified and licensed esthetician in your area if you suspect you have mild to moderate acne and wish to seek education and treatment. A dermatology consult is recommended for more severe cases.