Acne 101

Acne is definitely a four-letter word for people who suffer with it. It is an inherited disorder of the pores – pores that want to sludge up with dead skin cells much like a clogged drain in your sink. Normal pores shed about one layer of dead skin cells per day inside the pore. The acne-prone pore sheds up to five layers of dead skin cells per day and the body just can’t keep up. This forms congestion under the skin which are non-inflamed acne lesions (blackheads and/or whiteheads; and if bacteria are present (which just loves to feed on the dead skin cells and oil), you will get inflamed pimples, pustules and/or cysts.

There are two main types of acne as we see it: non-inflamed acne and inflamed acne. Most people have a combination of the two.

What is Non-inflamed Acne?

Dead skin cells and oil (plus other debris) form a plug inside the pore. If this plug does not become inflamed, it can become a whitehead — a non-inflamed lesion under the skin, also called a “closed comedone”. This is also called “maturation arrest” acne, as it has not “matured” into a blackhead yet.

This is another non-inflamed acne lesion called a blackhead, where the pore remains open, also known as an “open comedone.” In the case of a blackhead, the tip of the plug darkens as it is exposed to oxygen in the environment.

What is Inflamed Acne?

As the oil and the dead skin cells build up, they put pressure on the cells surrounding the pore. With enough pressure, the sides of the pore rupture and the contents of the pore leak into the surrounding skin.  Because this material contains a lot of P. acnes bacteria, the surrounding skin now becomes infected, creating a red bump that we know as a pimple. The medical term for this red bump is an inflammatory papule.

This is a pustule which is different from a pimple only in that it contains white blood cells. When the immune system fights off the P. acnes infection, white blood cells, which are soldiers of the immune system — pile up, creating pus in the pore.

A nodule is a solid dome-shaped lesion that extends below the surface, deep into the layers of the skin. Scarring is common with nodules and  can sometimes leave an impaction behind, which can flare again and again.

When a group of pustules cluster together under the skin, they form a cyst. An acne cyst can appear similar to a nodule, but is pus-filled, and can have a diameter of 5mm or more across. They are usually very painful and scarring is common with cysts.

Acne is a mysterious disorder, but one thing IS for sure – it can be controlled with the right combination of products used in the correct way. Just as in a clogged drain, the pore must be treated with products that unclog it, keep it unclogged and kill the acne bacteria.

© Face Reality Acne Clinic