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Acne is caused when tiny holes in the skin, known as hair follicles, become blocked. Sebaceous glands are tiny glands found near the surface of your skin.1 The glands are attached to hair follicles, which are small holes in your skin that an individual hair grows out of.1

Sebaceous glands lubricate the hair and the skin to stop it from drying out. They do so by producing an oily substance called sebum.1

In acne, the glands begin to produce too much sebum. The excess sebum mixes with dead skin cells and both substances form a plug in the follicle. If the plugged follicle is close to the surface of the skin, it bulges outwards, creating a whitehead. Alternatively, the plugged follicle can be open to the skin, creating a blackhead.1

Normally harmless bacteria that live on the skin can then contaminate and infect the plugged follicles, causing papules, pustules, nodules or cysts.1

Further, hormonal changes, such as those taking place during the menstrual cycle or pregnancy, can also lead to episodes of acne in women. Hormones also thicken the inner lining of the hair follicle, causing blockage of the pores. Cleaning the skin does not help in removing such blockage.2

References:
  1. Acne – Causes – NHS. Available at: https://www.nhs.uk/conditions/acne/causes/. Last access date 6-2024
  2. Acne – NHS. Available at https://www.nhs.uk/conditions/acne/. Last access date 3-2024.