
A healthy follicle
Our body produces sebum(oil) in order to protect and moisturise our skin. Sebum is produced in sebaceous glands (small glands attached to our hair follicles) and travels along the follicle to our skin surface. Along the way, sebum picks up dirt, dead skin cells and bacteria, bringing them out of the skin. Sometimes dirt and dead skin cells accumulate and forms a clot that blocks up our pores. As this happens, our sebaceous glands are still producing sebum, which gets trapped beneath the skin, causing further blockage.
Acne occurs when our pores get blocked. When sebum gets trapped beneath the skin surface along with dirt and dead skin cells, it creates an excellent environment for the Propionibacterium acnes bacteria. This bacteria feeds on fatty acids present in sebum and is a part of our skin makeup, While this is not usually a problem, when pores are blocked, excess sebum builds up and creates an excellent feeding ground for Propionibacterium to thrive. To combat this bacterial buildup, our immune system starts sending white blood cells to defend against the infection,a process which causes an inflammation that is commonly known as a pimple. There are different stages of acne, from non-inflammatory whiteheads and blackheads, to inflammatory acne like papules, pustules, nodules and cysts.
Non-Inflammatory Acne: Whiteheads and blackheads

Whitehead
Whiteheads (closed comedo) are formed when sebum and bacteria are trapped beneath skin. They can sometimes be so small that they can’t be seen by the naked eye.

Blackhead
Whiteheads become Blackheads (open comedo) when the pores open to the surface and the trapped sebum oxidises, turning a darker color.
When blackheads and whiteheads are removed, the passage in the follicle is cleared and normal sebum secretion resumes.
Inflammatory Acne
Sometimes the trapped skin and sebum extends the follicle so much that the follicle wall ruptures, attracting the attention of the immune system and causing the red, inflamed bumps we know as acne. These vary in severity, and come in the form of papules, pustules, nodules and cysts.

Papule
A papule occurs when the follicular wall ruptures. White blood cells are sent to stop the infection, causing red raised bumped on our skin.

Pustule
A pustule happens several days after a papule is formed. White blood cells rise to the surface, forming a pus-filled lesion that we commonly call a pimple.
In more serious occurrences, an inflamed lesion can collapse, spreading infection to the surrounding follicles. This will cause large painful bumps known as nodules or cysts.












