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Acne is a disease of the Sebaceous glands. Sebaceous glands get their name from the oily substance they produce called Sebum. Under normal circumstances, sebum travels up the hair follicle and out onto the skin's surface. However, in acne, sebum is trapped within the follicle. Acne develops on those areas of skin where sebaceous glands are most numerous: the face, scalp, neck, chest, back, upper arms and shoulders. The acne lesions we know as blackheads and whiteheads are called Comedomes. Red, swollen pus-filled lesions are called Pustules.
Four basic factors work together for the development of comedones and acne:
1/ Hormones (Androgens)
2/ Increased Sebum (oil) production
3/ Follicle Blockage
Acne usually begins when the body starts to produce hormones called androgens. When androgen production goes into high gear, about age 11-14 years, acne also goes into high gear. Androgens cause the sebaceous glands to enlarge, and this is normal. People who develop acne have sebaceous glands that are over-stimulated by androgens. Young women tend to have acne flare-ups that coincide with the hormonal changes associated with their menstrual cycle. These changes affect the sensitivity of their sebaceous glands to androgens.
After the sebaceous gland is stimulated by androgens, it produces more sebum. The oily sebum accumulates in the follicle and travels up the hair shaft to the surface of the skin. As it travels up the hair shaft it mixes with normal skin bacteria and dead skin cells that shed from the lining of the follicle.
The greater the sebum production, the greater the likelihood that the hair follicle will become clogged and result in comedones.
As androgen production increases and sebaceous glands enlarge, the inner lining of the skin in the hair follicle also changes. Normally, dead cells inside the follicle shed gradually and get expelled onto the surface. However, at various times, including puberty, these cells are shed more rapidly and tend to stick and clump together. When they mix with sebum, they can clog the follicle – the cells and sebum form a plug in the follicle.
The clogged follicle becomes a breeding ground for bacteria. One type of bacteria specifically involved is Propionibacterium acnes (P.acnes). This bacteria ingests sebum and is a normal inhabitant of the skin, even in people who don’t have acne. However, when the sebaceous gland gets clogged and sebum builds up inside the follicle, P.acnes multiplies rapidly. Chemicals then produced by the bacteria can cause inflammation in the follicle and surrounding skin.
1. Non-Inflamed - Comedones (whiteheads, blackheads)
2. Inflamed – Pustules (pimples), Cysts and Nodules
While virtually everyone gets acne to some degree, some people are born with a predisposition to acne. There seem to be similarities in acne among family members regarding patterns of acne lesions, duration of acne and severity. Acne occurs in all races, but there are ethnic variations that suggest genetic influences. From a scientific standpoint, not much is known yet about the specific genetics involved in acne, but there seems to be a connection.
If a teenager’s parents or older siblings have had severe acne, that teenager is likely to have severe acne also. It is all the more critical for such teenagers to see a doctor experienced in skin care before the acne becomes severe.
Acne may also be due to (or aggravated by) contact with a large variety of comedogenic substances. For example, the airborne grease in a fast-food take-away can be comedogenic, as can motor-oil, which someone may be exposed to regularly at work. In fact, anything that can irritate acne-prone areas of the skin may make acne worse, including rubbing the skin, friction from clothing or hair, sporting equipment and so on.
The goal of acne therapy is to get rid of existing lesions and prevent the formation of new ones. Most treatments resolve existing acne lesions and with continuous use, discourage new ones from forming.
Here at the Melbourne Cosmetic Group we use a combination of treatments to successfully treat acne. These may include cosmeceuticals, prescription creams and tablets, LED Photorejuvenation, microdermabrasion and peels.
Regardless of the treatment you use, the following general guidelines should be followed:
1. Do NOT pop, squeeze or pick at acne. This will make it worse by spreading infection and toxic chemicals.
2. Gently cleanse the area once daily and pat dry. Exfoliating gently once daily can also be helpful as long as you do not irritate the skin.
3. Use “non-comedogenic” cosmetics and toiletries.
4. Avoid aggravating factors such as oils, grease, irritating clothing or sporting equipment and so on.
5. Give the acne products enough time to do their job.
6. Some acne products can increase the skin’s sensitivity to sunlight and UV light from tanning solariums. Use protective clothing and sunscreens and avoid tanning.