Acne is an inflammation that occurs in pilosebaceous follicles, manifesting itself with little pustules (commonly known as “zits”) on the skin, especially on the face, neck, chest, and back.

Amongst the reasons for this inflammation there are stress and hereditariness, as professor Antonio Costanzo, Dermatology Supervisor at Humanitas, explained in an interview.

“A predisposition inherited from one’s parents may cause the inflammation of  pilosebaceous follicles. Initially blackheads (comedones) develop, then zits (pustules) that, in the most serious cases, can become nodules or cysts. Stress can make acne worse, and, consequently, its increase can cause new stress: in this way a vicious cycle begins. In addition to this, external factors such as hygiene, pollution and eating disorders can also occur. However, it is a fact that the Mediterranean diet, rich in foods with a low glycemic index (such as fish), in vitamins (such as fruits and vegetables), in unsaturated fatty acids (such as olive oil) and in mineral salts, plays a protective role against acne”.


Prepuberal Acne (acne during puberty) and Late Acne

The two main types of acne are prepuberal acne and late, adult-age acne. Prepuberal acne appears on the onset of sexual development and then may heal or continue through adult age. Late acne, instead, appears in adults even if they never suffered from it in their teenage years.

“The onset of hormones during the adolescence causes the sebaceous glands to grow in volume and the beginning of the production of sebum. Sebum is an oily secretion that protects skin against infections. However, in predisposed people sebum can be irritating and bring about the development of a blackhead, that works as a cork or a stopper in hindering the flow of sebum from the gland to the skin’s surface. In this case, the fats contained in sebum decompose and become irritant”.

Prof. Costanzo also advises “against squeezing blackheads or pimples, because this increases the chance of developing scars; instead, it is better to ask a dermatologist for advice and avoid makeshift remedies”.


Medication Against Acne

“Recent studies show that bacteria work as activators of the innate skin immune system, so one way to reduce acne-related inflammations is by reducing the bacterial load in follicoles. It is possible to use specific topical or oral antibiotics to achieve this result. The critical point to address is the sebaceous gland. In fact, restoring the correct sebum secretion may solve acne once and for all. To this you may use medications that change the growth rates of sebaceous glands’ cells, the so-called retinoids (really effective derivatives of vitamin A), even though they should only be used under medical supervision”, prof. Costanzo explains.