Youthful Skin 101

Causes of Acne

Where Acne Begins.

Acne occurs within a "PiloSebaceous Unit" which is comprised of a Hair Follicle (often called a pore), a Sebaceous Gland and a fine hair. The Sebaceous Gland produces an oily substance called "Sebum". The oil secrets to the outer layer of skin through an open follicle pore and moisturizes the skin and hair. The PiloSebaceous Units are most numerous on the face, neck, upper back and the chest. When this natural process performs normally, healthy skin will generally be acne-free. If the system performs abnormally, skin becomes "acne-prone".

Normal Pilosebaceous Unit

Acne Prone Skin.

Androgen, which is a male hormone is a primary culprit. Although acne problems are most common among teenagers, adults can also be prone to acne. It is estimated that 20% of adults between the ages of 25 and 40 will experience some degree of acne problem. Increased levels of Androgen during puberty causes the sebaceous glands to enlarge and produce an over abundance of Sebum. After teenage years, hormones become more balanced resulting in a decrease in the size of the sebaceous glands and a reduction in oil production. With adult women, Androgen levels can increase due to monthly periods, pregnancy or starting and stopping birth control pills.

Cells called keratinocytes line the walls of the follicle. The body sheds dead skin cells continuously and many of these dead cells make their way into the follicles. The combination of sticky Sebum, keratinocytes and dead skin cells fill the narrow follicle pores creating a "soft plug" which prevents the oil from reaching the surface of the skin. The soft plug also entraps bacteria initiating infection and inflammation which sets the beginning stages of acne.

What is Acne?

Bacteria summons white blood cells to the area to fight infection resulting in swelling and redness which signals the body's reaction to inflammation. The initial signs of acne are basic lesions of "whiteheads" and "blackheads" called comedones which are enlarged and plugged hair follicles.When the plugged follicle stays under the skin, it produces a "white bump" (whitehead). If the comedo reaches the skin's surface, it is called a "blackhead". The black discoloration occurs when the Sebum is exposed to air. When the plug breaks, all of its components spill onto the skin leading to "pimples" otherwise known as acne lesions.

Whitehead Blackhead

Escalation To More Serious Acne.

Even though acne is not considered a serious health threat, if ignored and left untreated, simple whitehead and blackhead lesions can progress to painful forms of acne with severe lesions which can cause permanent scarring. At minimum, pimples can become unsightly and a source of emotional distress.

Levels of Advanced Acne Lesions.

  • Inflamed lesions. Small bumps that appear pink on the skin's surface.
  • Pimples with white or yellow tops of pus. Red at the base.
  • Large, solid lesions under the skin. Very painful.
  • Very deep, very painful lesions. Can cause scarring.

Approach To Acne Treatment.

Licensed estheticians are generally qualified to treat minor to moderate acme problems with acne facial treatments using professional cosmeceutical products. They will analyze unique skin conditions and customize treatments. They will also recommend a regimen of at-home skin care. The services of an esthetician are generally much more affordable than those of dermatologists and wellness medical centers.

For more serious, painful and potentially scarring acne lesions, the medical attention of a dermatologist should be considered. As medical doctors, they are more qualified to perform more invasive procedures and can prescribe medications that contain more potent ratios of active ingredients.

Estheticians and dermatologists will likely use and recommend products that contain Salicylic Acid which is an exfoliate cleanser, and Benzoyl Peroxide which kills bacteria. Regardless of whether you use a dermatologist or esthetician to treat your acne condition, it is crucial to follow his or her recommended at-home skin care regimen. See this suggested Acne Control Regimen.