During childhood, the sebaceous glands are small and virtually nonfunctioning. These glands are under endocrine control, especially by the androgens. During puberty, androgens stimulate the sebaceous glands, causing them to enlarge and secrete natural oil called sebum, which rises to the top of the hair follicle and flows out onto the skin surface. In adolescents who develop acne, androgenic stimulation produces a heightened response in the sebaceous glands so that acne occurs when accumulated sebum plugs the pilosebaceuos ducts. This accumulated material forms comedones.
Acne scar tissue is very common, and it can affect people with moderate acne problems as well as severe. Why is this? When your skin becomes inflamed during an acne breakout, the natural formation of the skin cells is disrupted. Once the infection is cleared away, the skin is often left wrinkled and pock marked, a clear sign of acne.
Pustules resemble papules because they are round, small lesions. However, pustules are inflamed and contain pus. At the base, they are red and have a whitish or yellowish center. In general, they don't contain a lot of bacteria, but they are irritated and inflamed because of interaction with sebum components.
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