What is acne?

According to the National Institute of Health, Acne is a skin disease of the pilosebaceous units which consists of a sebaceous gland connected to a canal, called a follicle, that contains a fine hair. Sebaceous gland are glands in the dermis skin layer producing an oily, waxy substance called sebum. If the canal gets blocked in anyway there is a risk of developing acne.

During puberty, the body’s production of sex hormones increases, which in turn increases the production of sebum from the sebaceous glands. If the sebaceous glands produce more sebum than the gland is capable of transporting out through the pores of the skin the risk of acne, pimples and blackheads increases. Acne is a relatively complicated skin disease but there are solutions that provide permanent improvements which you can read more about the Cure My Acne Program.

Healthy skin
Healthy skin and well functioning sebaceous glands will produce the correct amount of sebum in order to keep the skin balanced. The pores will not be blocked nor will bacteria grow.

 

Microcomedone
All acne will start as a microcomedone which is a blocking of the follicle. The plug prevents sebum from reaching the surface of the skin through a pore. The mixture of sebum and dead cells allows the bacteria Propionibacterium acnes (P. acnes) that normally live on the skin to grow in the plugged follicles. Acne is categorized as either non-inflammatory or inflammatory.

 

NON-INFLAMMATORY ACNE
In non-inflammatory acne so called comedones (blackheads or whiteheads) are formed. These are enlarged and blocked hair follicles filled with sebum, bacteria and dead skin cells. There are two variants of non-inflammatory acne:

Whitehead
Comedones that are closed means that the stratum corneum (the uppermost part of the epidermis also called the horn layer), forms a thin membrane which allows bacteria and sebum to be “trapped” under the skin, which in turn leads to small, white bumps called whiteheads. Usually whiteheads that become inflamed are called pimples.

Blackhead
Open comedones, means that comedones reaches the surface and opens up so that the sebum is being exposed to air and is hence being oxidized (it reacts with oxygen: O2). This in turn means that a small black plug of sebum, bacteria, and dead skin cells is formed, also known as blackheads. It is not dirt and can not be washed away. Blackheads rarely turns into inflamed pimples.

Both a whitehead and a blackhead can heal by itself by releasing its content of bacteria, sebum and dead skin cells. The healing process of a blackhead is however usually very lenghty.

 

INFLAMMATORY ACNE
The bacteria Propionibacterium acnes (P. acnes) produce chemicals and enzymes that breaks down the follicle wall and if the whitehead will not heal there is a risk of rupture instead.  White blood cells will be attracted and that cause inflammation. There are two types of inflammed acne.

Papule
When the follicle wall has been broken down by the chemicals produced by the Propionibacterium acnes, the immune defense system will send white blood cells to the area which will produce inflammation. The whitehead often grows and become red, a so called papule is formed.

Pustule
If the white blood cells make their way to the  the stratum corneum, ie the upper part of the epidermis, then the papule will be topped by white, yellow pus-filled lesion with a red inflammed base. This is called a pimple.

Inflammatory acne can grow and then collapse downwards when the follicle breaks along the bottom. This can lead to large and solid lesions deep within the skin. These are called nodules and are painful. A cyste is also a deep but pus-filled lesion that risk causing permanent scarring. Cystes can also be very painful. When touching or picking the skin the risk of inflammation is increased.

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