What causes Acne?
Some people think that acne is a result of poor hygiene but they are wrong. The cause of acne is an over production of oil (sebum) from the sebaceous glands. Sebaceous glands are attached to our hair follicles and regulate the release of sebum into the skin tissues for softness. Acne occurs as a result of excessive sebum (oil) mixing with keratinized (dead) cells in the hair follicle. This creates a micro plug called a comedone. Comedones are blackheads and pimples appearing most frequently on the face but can also appear on other parts of the body.
The micro comedone plug prohibits oxygen from entering the hair follicle which sets up a breeding ground for Propionibaterium (P. acnes) to proliferate. It’s normal for Propionibaterium to be present in the skin and it usually works to break down sebum creating a balance of oil but the clogged follicle prevents oxygen from entering and the P. acnes multiplies creating swelling, irritation and a pimple producing infection.
The over production of sebum may be due to the excessive release of androgen, estrogen or testosterone hormones. So it’s understandable that more women suffer from acne than men since women are prone to hormonal imbalance during menstruation, pregnancy and menopause. However men are subject to hormonal changes too especially during puberty. Oily acneic skin is the most frustrating condition because of the potential physical and emotional scars. And don’t think it’s just that way for teens. Adult acne is very challenging because it can be caused by several things in both men and women, one of which is mental stress that can trigger a release of hormones from the adrenal glands causing the body to increase the skin’s secretion of oil from the sebaceous glands. Studies have shown that adult acne has been rising and in the past decade it has come to be acknowledged as a common skin disorder and not just a teen skin problem.
Classifications for Acne Types
Acne inflammation presents a variety of lesions; comedones, pustules, papules, cysts and nodules on the face, chest and back. These lesions are classified as Acne Grades l, ll, lll and lV to identify their type as mild moderate or sever for appropriate treatment.
Acne Grade I
Presents as a worm like mass of keratinized cells called blackheads on the face but can appear on others parts of the body. Blackheads maybe accompanied by occasional pimples. The small pore closed comedone is the precursor of inflammatory acne papules, pustules, and cysts. The treatment for Acne Grade l blackheads with an occasional breakout of pimples is to stimulate follicular cell shedding with a simple Glycolic and or Salicylic Acid solution applied twice daily to control oil preventing the accumulation of dead cells that create the blockage at the mouth of the pore opening. Untreated this condition could lead to a serious acne condition potentially requiring a more aggressive intervention.
Acne Grade II and III
Is a chronic disorder of the sebaceous glands and presents a variety of very serious lesions; comedones, pustules, papules, cysts and nodules on the face, chest and back. P. acnes bacteria is sensitive to topical and oral medications and if properly treated pustules and cysts will heal without scarring. The topical treatment for Acne Grades ll & lll blackheads with chronic breakout of pimples, pustules and cysts is to stimulate follicular cell shedding and control oil production with a combination of Glycolic Acid and Salicylic Acid solutions. Benzoyl Peroxide or its herbal alternative Totarol is applied to suppress the bacterium that causes the inflammation. Much more aggressive treatment is needed for Acne Grades ll and lll to prevent permanent depressed scar tissue formation.
Acne Grade lV
Exhibits all of the above including advanced stages of cystic acne, scarring, and painful inflammation creating potential skin disfigurement, physical and emotional problems.