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Acne
What is Acne?
Acne is the most common of all skin diseases. Statistics
show that eighty-five percent of all people between
the ages of twelve and twenty-five have some type of
acne. It is a combined disorder of the oil glands and
the hair follicle in the skin. Contrary to some conventional
conceptions, it is a problem suffered not exclusively
by teenagers. Some people are plagued their whole lives
by constant outbreaks of acne.
How do Acne and Scars Develop?
Each follicle, or pore, in our skin contains a tiny
hair and is connected with multi-lobed oil glands called
sebaceous glands. These glands produce sebum, an oily
substance that lubricates our hair and skin. At the
same time, skin cells inside the follicle are shed gradually
and both the dead cells and sebum are expelled onto
the skin surface.
Most of the time the glands produce the right amount
of sebum and the pores are fine. However, in acne, too
much sebum is produced by the over-stimulated sebaceous
glands. When excess sebum is mixed with the dead skin
cells, a plug is formed in the follicle. The sebum and
dead skin cells are prevented from leaving the clogged
up pore, while the excretion of sebum and the shedding
of skin cells continue to take place. The accumulated
sebum in turn causes a build-up of bacteria that live
on it. This leads to swelling around the pore and acne
is the result. This could happen to anybody, young and
old.
However, a few eruptions every now and then are not
what concern us. We acne sufferers are concerned with
those numerous and serious pimples that dotted our face
and neck and never seem to go away.
Another problem that concerns us is scarring. The accumulation
of bacteria in acne could trigger our body's defense
mechanism. The white blood cell antibodies would enter
the clogged up follicle and kill off the bacteria. Only
that in the process of destroying the bacteria, the
antibodies may severely affect other skin organisms
and cells. This is how scars develop. Many unsightly
marks would remain on our skin even after the acne is
long gone.
4 Stages of the Common Acne.
0 Under normal conditions, sebum produced by the sebaceous
glands and dead skin cells around the hair follicle
are shed onto the skin surface.
1 Whiteheads
When the sebaceous glands are over-stimulated, they
enlarge and produce more sebum. The follicle is plugged
from the inside by the mixture of excess sebum and the
dead skin cells. As the mixture continues to accumulate
in the follicle, it eventually forms a whitehead (closed
comedo). Whiteheads are small collections of pus around
the follicle and the sebaceous glands. They usually
appear on the skin surface as small, whitish bumps.
2 Blackheads
Sometimes, the mixture of excess sebum and dead skin
cells serves only to block the pore partially, restricting
but not completely sealing off the flow of oil onto
the skin surface. This results in solidification of
the sebum that fills the hair duct. The dried sebum
and the shedded skin cells reach the skin surface at
the pore opening and are discolored on exposure to air,
forming a blackhead (open comedo). The dark color of
blackheads is not due to dirt but is from a pigment,
called melanin, of the shedded skin cells.
Both the whiteheads and the blackheads are non-inflamed
lesions.
3 Pustules and Nodules
As we mentioned earlier, the accumulated sebum in a
clogged follicle could cause a build-up of bacteria
because some bacteria live on sebum. One type of bacteria
specifically involved is Propionibacterium acnes, or
P. acnes for short. P. acnes ingests sebum and is a
normal resident on skin even in people who don't have
acne. However, when the hair follicle gets clogged and
sebum builds up inside the follicle, P. acnes multiplies
rapidly. In addition, it produces an enzyme that breaks
down sebum into a substance called 'free fatty acid.'
It is this substance that causes inflammation, redness
and swelling around the pus-formed area of the skin.
These inflamed and generally more serious acne lesions
are called pustules (pus-filled yellowish bumps) and
nodules (firm, red, painful lumps just under the skin.)
This can be treated with a series of blue light treatments
as well as laser genesis
4 Cysts
If the inflammation is deep and severe, or if the spot
is manipulated or squeezed, the pus can burst deep into
the skin tissues rather than onto the skin surface.
Swelling and pain take place as the body's activated
defense mechanism sends bacteria-fighting white cells
to the area. This deep-rooted inflammation and infection
result in cyst formation. Cystic acne is the most severe
and stubborn of all types of acne, and carries the biggest
threat of scarring. The white blood cell antibodies
that are to fight bacteria could destroy other skin
organisms and cells, severely affecting the whole follicle.
Sometimes, after the acne is healed, permanent scars
remain on the skin.
What Causes Acne?
Most medical literature still maintains that the exact
cause of acne is unknown. Actually, from what we have
learned, we already know that acne is the result of
excess production of sebum by the over-stimulated sebaceous
glands and clogged follicles.
The causes of acne therefore can only come from two
fronts:
a) Whatever that drives sebaceous glands to work overtime,
and
b) Easily clogged pores.
Easily Clogged Hair Follicles
Let's look at the second front--easily clogged hair
follcles--first, as this is the cause of acne that is
rarely mentioned, Ingrown hairs or pseudofilliculitis
which is easily remedied with laser hair removal.
I have always wondered why my acne condition has been
so stubborn and long-lasting. While most people have
to bear with it for perhaps a few years, I suffered
for decades. One day, it dawned upon me that perhaps
I was born with an acne condition. Could it be that
my pore openings are smaller than the average?
We know that over-production of sebum occurs in the
teen years and, as a result, clogged pores and acne
breakouts happen to many during this period. What if
I were born with smaller pores? It would explain why
my acne continued to embarrass me even after I'd passed
my twenties. For people with smaller pores, even normal
sebum production could have the pores clogged easily,
from teen years on and thereafter.
In addition, my hair follicles may have an innate ability
to shed skin cells quicker and more often than normal.
It has been observed that during puberty, skin cells
are shed more rapidly and tend to stick together. This
makes plugging the follicle more likely when they mix
with sebum. In cases like mine, the shedding machine
may begin working overtime after puberty.
To long-term acne sufferers, it's possible that we are
born with smaller pore openings, or a higher rate of
shedding skin cells, or both. We may simply be equipped
with easily clogged pores. Blame it on heredity.
On top of it, our pores can also be blocked readily
by certain oil-based moisturizers and cosmetics that
contain synthetic chemicals and vegetable oils. If you
are often attacked by acne breakouts, change to a non
oil-based moisturizer and similar cosmetics. Test to
see if artificial make-up is the suspect to your acne
condition.
Over-production of Sebum by the Sebaceous Glands
What drives the sebaceous glands to work overtime is
a more complicated matter. It could be because of heredity.
It could also be a matter of many other factors.
Why heredity again? We know that when the sebaceous
glands are over-stimulated, they will enlarge and secrete
more sebum. Western medical researches have identified
a number of factors that could cause an over-stimulation
of the oil glands. These include:
• increased production of the male sex hormone
androgens at puberty;
• hormonal imbalance in women at menstruation;
• other factors that cause hormonal changes, such
as stress, not enough sleep, etc.
While these factors could lead to occasional outbreaks
of acne for many people, the long-term acne sufferers
may inherit these symptoms. There are people who are
born with over-sensitive oil glands that keep on producing
a higher level of sebum all the time, stimulated or
not. These are the people with oily complexions. They
are, therefore, more prone to having acne. Laser Genesis
shrinks back the sebaceous gland and cuts back on oil
production.
There are also people who are born with a hormonal imbalance,
an over-production of androgens, or inadequate estrogen.
My daughter is a case of the latter. They too, because
of heredity, are more likely to have acne breakouts
more seriously and for a longer period of time than
most people.
Acne in Puberty
For most people, acne usually begins during puberty
when the body starts to produce the male sex hormone
called androgens. This is the main cause of acne. The
sebaceous glands are very sensitive to androgens. They
cause the glands to enlarge and secrete a higher level
of sebum. During puberty, the skin cells are shed more
rapidly and they tend to mix with the abundant sebum
more easily. As a result, there is a greater likelihood
that the hair follicle will become clogged and form
acne.
Acne due to Hormonal Changes
Young women tend to have acne flare-ups that coincide
with their hormonal changes associated with their menstrual
cycle. Likewise, stress and insufficient sleep are situations
that can cause hormonal imbalance in our body as well
as acne breakouts.
Hormone is known to be the main culprit for acne.
Why Acne is so Aggravating?
Think about it for a minute. Should acne breakouts appear
only on some less noticeable places like the armpits,
or the ankles, would we still care? Well, perhaps somewhat,
if it's painful, but certainly not as nearly a big deal
as we make it today.
So, why does acne has to be on the face, the worst place
possible? It's because oil glands around the T-zone
on the face, the neck, the chest and the back are more
concentrated and more active. Sometimes, a pimple or
two may pop up in the armpit, or on the bottom, really.
But overall, they show up where it hurts. It's the genes.
Acne's Natural Cycles
Even if you do nothing to the acnes, most of them gradually
heal themselves. As each of these pimples heal, new
ones appear. The healing pimples usually fade to a pink
mark that generally disappears in time. However, some
pimples leave scars that look like small pits or bumps.
The full cycle of acne generally lasts about 8 weeks.
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