Acne occurs when the oil produced by sebaceous glands does not reach the surface of the skin but is trapped in tiny pores or follicles. Keratinised skin may close off the pore causing the follicle wall to bulge, which creates a whitehead. If the pore stays open, the top surface of the oil may become oxidised creating a tough film or cap resulting in a blackhead. Given the correct environment and compromised immune function, a certain strain of the bacteria (P. acnes) feels right at home and begins to replicate in this trapped oil. When this viral strain of bacteria spreads from the follicle into the surrounding tissues, pimples are formed. Healthy skin is also a host to P.acnes but the strain is different from that in acneic skin.
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