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Acne is common and is usually treatable. You may need treatment for several months to clear spots. Inflamed acne needs to be treated early to prevent scarring. Once the spots are gone, you may need maintenance treatment for several years to keep the spots away.
MILD-TO-MODERATE ACNE - BLACKHEADS, WHITEHEADS AND SMALL PIMPLES:
Some pores become blocked (plugged). This is due to the skin at the top of the pores becoming thicker, combined with dead skin cells that are shed into the pores.
You can see the plugs that block the top of the pores as tiny spots known as blackheads and whiteheads (comedones).
Note: the black of the blackheads is due to skin pigment and is not dirt as some people think. In many cases, acne does not progress beyond this mild stage.
Some sebum may collect under blocked pores. You can see this as small spots called pimples or papules. In some cases, acne does not progress beyond this mild-to-moderate stage when you can see a number of small pimples, blackheads and whiteheads.
MODERATE-TO-SEVERE ACNE - LARGER SPOTS AND INFLAMMATION:
Trapped sebum is ideal for a germ (bacterium) called Propionibacterium acnes to live and multiply. Small numbers of this bacterium normally live on the skin and do no harm.
However, if a large number develop in the trapped sebum, the immune system may react and cause inflammation. If inflammation develops, it causes the surrounding skin to become red and the spots become larger and filled with pus (pustules).
In some cases the pustules become even larger and form into small nodules and cysts.
Each inflamed spot will heal eventually. In some cases, the area of skin that was inflamed remains discoloured for several months after the inflammation has gone (post-inflammatory hyperpigmentation).
This is often more noticeable in darker-skinned people. Also, a small pitted scar is commonly left on the skin where there was an inflamed spot.
These small scars often do not fade fully and are a marker in older people that they once had inflamed acne spots.
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