In the last two months I have had many new clients come in to Desiree’s Skin Care. The number one source of frustration, concerns, and questions is acne. Doesn’t matter age or occupation, it is the clear leader for problem skin, it is what brings most of you into my office.
I wrote a quick blog post about acne a month or so ago, but it’s obvious I need to spend more time on the subject. So, let’s take a more detailed look at acne – in a series of three articles, I will go into more detail about what acne is, why is it on the rise, and what we can do about it. I will end with clear treatment options that involve both facial appointments and at-home routines that will over time make a considerable positive difference for the acne prone.
So what is acne – other than really annoying?
Dermatologists and skin therapists alike have studied acne and its causes for years. They have looked at everything from diet to skin type to stress, and everything in between. And while science has found many things that make acne worse, there are four main factors that directly contribute to acne. These four main causes are also interrelated – they are like building blocks that work together to destroy your otherwise healthy complexion. They are the Sebaceous glands and sebum production, cell proliferation, bacteria, and the follicle type.
Despite what type of acne you have, sebum production, or oil, is the catalyst for the series of events that lead to acne, or skin breakouts. Excess oiliness can be caused by many things. The production of sebum is often linked to hormone levels in the body, and when those hormone levels get out of balance, or there is a shift in hormone production, the skin can generate more sebum, which will cause breakouts. This is the main reason why acne is prominent in teens. Other contributors to excess oil production are enlarged pores and follicles that are prone to congestion (skin not well cared for).
The second known cause is cell proliferation, or dead skin cells. In normal skin dead skin cells are sloughed from the epidermal canal and deposited on the surface of the skin where they are washed away. When this process doesn’t work properly for any reason, the dead skin cells can be stuck to the bacteria on the skin with the excess sebum or oil. The combining of the sebum and the dead cells can cause an impaction in a follicle, which then provides an ideal environment for bacteria to grow. This process has the very unpronounceable name retention hyperkeratosis. This is also a major cause of acne.
If you haven’t figured it out already, the third direct cause is bacteria. You remember all that oil generation we discussed – and the dead skin cells? Sebum is food for bacteria, and the waste product generated is a free fatty acid the is an irritant to the lining of the follicle. These fatty acids reacting on the follicle can cause inflammation, or may induce a non-inflammatory response such as a whitehead and eventually a blackhead. Oil combined with dead cells blocks follicles, providing the perfect place for bacteria to grow, inflaming the follicle even more.
Finally, the follicle itself plays a role. When the above three causes are occurring in your skin and the follicle is close to the surface of your skin, the result is a pustule. If the follicle is deep in your skin, a nodule forms. In some cases a membrane traps the infection and a cyst develops. Regardless of the follicle your body produces an enzyme to try to repair the damaged follicle while white blood cells accumulate to fight the infection, all causing more inflammation to the area.
So that’s the basics of acne, scientifically speaking. If you are coming to see me for an acne concern, I am looking at these four basic functions of the skin and where things aren’t functioning correctly. My treatments are put together – often completely custom for you – to address what combination of the four causes you have, and how to best correct the issues. This is also why treatment often takes time, because there is no one-shot miracle to fix any of the above causes. I will recommend products based on what I see in your skin, products that used in the long term will correct the issues your skin is having. I may tell you that you should come back to see me several more times at specific intervals, in order to continue correcting your skin issues. I will talk more later about treatment plans and options, but products need to be used in the prescribed manner, for the time recommended, in order to fully correct the issues.
In my next article I will talk to why it seems that acne is a growing problem – what are the external factors that influence acne, and what can you do about those factors. Follow my website, or on Facebook to catch all the information and happenings at Desiree’s Skincare!