The Basics of Acne

The normal skin is composed of two parts. The upper part is called the epidermis and is composed of skin cells. These cells continually divide, grow, and mature. As they reach the surface of the skin they flatten, die and are then shed. The deeper part of the skin is called the dermis and is composed mainly of collagen, which supports the epidermis. Within the collagen are the nerves, blood vessels and other structures that comprise the skin.The whole surface of the skin, except for the palms and soles, is covered in small skin pores. Each pore is the entrance of a small, flexible tube that runs through into the dermis and represents the canal through which the hairs grow to the surface. Each hair canal is associated with a sebaceous gland, which produces an oily substance, called sebum. The sebum is pumped into the hair canal and from there onto the surface of the skin, where it lubricates the hair and protects the surface of the skin.

sa-diagramofskin-001A – Sebum production is stimulated and produced in hair follicles. Bacteria breeds in sebum. Infection occurs creating Comedones, Papules, Pustules, and Cysts.
B – Hormones stimulate rapid cell growth of skin cells and bacterial cells. Skin begins to get congested.
C – Stratum corneum builds up. Holds in infection and inhibits penetration of proper nourishment for healthy cell growth.

Acne Is A Skin Disease
Acne occurs in and around the pilosebaceous follicle, consisting of the hair canal, the tiny hair and the sebaceous gland. What causes acne is not fully understood, but many dermatologists believe acne is not a hormonal disease, even though it is related to the levels of the male hormone, testosterone. It is generally believed that acne occurs because the oil gland becomes overly sensitive to the male hormone present. With the increased sensitivity of the gland to the male hormone, more oil is produced in the follicle. Another cause may be due to a change in the constituents of the oil being produced by the sebaceous gland. Instead of floating off, dead cells become very sticky and adhere to the inside of the canal. Over the period of months and years these dead cells build up and cause a partial blockage in the hair canal, that leads to blackheads, whiteheads and then, eventually, inflammatory spots, papules, pustules and cysts of acne.In all hair canals, bacteria are present. These are normal residents within the hair canal and are present in everybody. As the oil accumulates in the follicle, these bacteria start to multiply and produce chemicals that will lead to inflammation. The whole area becomes inflamed and this leads to the first inflammatory spot of acne, which is red spot or papule. Acne can occur anywhere on the body apart from the palms of the hands and soles of the feet. The most common areas for acne are the face, neck, chest, back, upper arms and buttocks.

Acne Causes
Not every teenager with oily skin has acne. Not every adolescent whose mother and father had acne in their youth develops acne. The exact cause of acne is still not fully understood. So it is not always possible to answer the question “Why do I have acne and my brother, sister and friend do not?” Here are some factors may or may not related to acne.

Androgens
Androgens (male hormones) are the only hormones that directly stimulate oil glands to enlarge and product sebum. Both sexes produce androgens, male in the testes and adrenal glands, and females in the ovaries and adrenal glands. Researches find the most acne sufferers do not have abnormal amounts of hormones for their age and sex. It may be that the sebaceous glands of people who have acne react differently, perhaps excessively, to normal levels of the hormones.

Blockage of Follicles
Normally, skin cells in the follicles grow, mature, die, flake off and are carried to the surface of the skin by the flow of sebum. For acne patients, these cells instead carrying to the surface, block the inside of the follicle, trap oil and bacteria and form a comedone.

Bacteria
Acne is not an “infection” in the true sense of the word, but bacteria inside the follicles do contribute to acne inflammation. These bacteria combine with the fatty acid to attract white blood cells, produce chemicals that make holes in the walls of the follicle, then allow the contents of the follicle, the sebum, dead cells, and bacteria, to leak out into the adjacent skin, create a local inflammation. When the area of inflammation is large enough, papule, pustule, or acne cyst comes out. Reducing bacteria’s number through treatment can effectively improve if not eliminate the acne.

Genetic Factors
Acne tends to run in families – if you have one parent who had severe acne, your chances of developing bad acne are higher. Also if you have a parent who has had persistent acne, your chances of developing persistent acne are higher. It suggests that some trait or factor can be passed on from parent to child that, in the presence of other existing factors, promotes the development of acne.

Stress
Acne creates lots of emotional problems, like depression,anger and anxiety, for most of sufferers. Studies have shown severe stress also can induce acne for some people. Keeping relaxation and coping with stress will certainly help control and improve acne.

Oily Skin
Generally, people with acne have oilier skin than individuals who do not. Furthermore, the oilier your skin the worse your acne.
But oily skin is not the cause of acne. Studies show there are many acne sufferers who have normal or even dry skin, and some people with oily skin without a trace of acne.

Common Acne Treatments
Acne can and does cause enormous suffering for those who are affected by it, and needs to be treated as soon as possible. Early treatment should limit the severity of acne and prevent the physical and psychological scarring that can be caused by acne. Available treatments for acne today include medicated cleansers, exfoliants, benzoyl peroxide, Retin A, topical antibiotics, retinyl palmitate (vitamin A), physical treatments, oral antibiotics, intralesional corticosteroids, hormonal therapy, systemic corticosteroids, Accutane, and natural treatment formulas.

Benzoyl Peroxide
Benzoyl peroxide is often the first self-help treatment and one of the most common topical medications used to treat mild to moderate acne. It kill the acne bacteria inside the follicles and thus reduce the inflammation. It also functions as an exfoliant keeping the skin drying. The major side effect of benzoyl peroxide arises from its drying properties. Even at the lowest concentrations, many users experience excessive peeling and, sometimes, rashes. Discontinue immediately if redness, itching, or excessive drying and peeling develop, and consult with your family physicians for your treatment medications.

Salicylic & Glycolic Acids
Mild acid solutions, such as salicylic and glycolic acid, can be effective on acne. These encourage the peeling of the top layer of skin and the opening of plugged follicles, which helps reestablish the normal skin-cell replacement cycle. Salicylic acid helps unclog pores to resolve and prevent lesions. Like many other topical acne treatments, salicylic acid must be used continuously, even after the acne lesions have healed. Its effects stop when you stop using it, so your skin will return to its uneven shedding; pores become clogged, and acne returns.

Retin A
A derivative of vitamin A, and currently the most externally applied medication to rid the skin of comedones. Retin A  may eliminate existing blackheads and closed comedones, but it also prevents new ones from forming and thus alters the entire process that leads to the development of papules, pustules, and other inflammatory blemishes. Most users will suffer some degree of stinging, redness, and some peeling. Other derivatives of Vitamin A, including Retinyl Palmitate are available without prescription and are shown to be similarly effective with less irritation.

Topical Antibiotics
These kind of externally applied antibiotics are formulated as water-alcohol solutions, creamy lotion, gels, and ointment. They can be effective in surface treatment of mild-to-moderate acne and dry up pustules quickly. Alcohol content in the solution causes some users dryness, peeling and itching.

Oral Antibiotics
These are the usual treatment doctors prescribe for moderate-to-severe acne, and commonly prescribed for treating severe acne in which there are deep papules, large pustules, and cysts. Tetracycline is the first oral antibiotic to be used to treat acne, also the most popular one. But side effects from using are sometimes a problem, including gastrointestinal upset, stomach irritation, swallowing discomfort and sun sensitivity. Women may develop vaginal yeast infection.

Hormone Treatment
Androgens (male hormone) increase the size and oil production of the sebaceous glands, and contribute to the development of acne. Estrogens (female hormone) or antiandrogens block the action of androgens on the oil glands and thus help improve an acne condition. These medications always used in severe acne cases and can help acne, but simultaneously with multiple possible side effects, including nausea, weight gain, breast tenderness, mood change, spotting , and blood vessel problems.

Accutane
According to USA Today, several cases of suicide and of psychiatric problems associated with the use of Accutane have been reported to the FDA. Studies show a possible link between Accutane and an increased risk of colon cancer. Use Accutane only if you have severe acne with large papules and cysts that do not respond to other forms of treatment. This vitamin A derivative is very powerful anti-acne drugs and with it the most severe forms of acne can be controlled.

Acne Scars
If you suffer a serious acne, you may also develop a permanent physical acne scar, one of major side effects of this skin disease. Acne scarring generally is unpredictable, even a dermatologist can’t give you a definite yes or no answer. Acne scarring depends upon some major factors. The kind of acne you are experiencing is most important. Cysts and deep inflammatory papules are more likely to lead to scarring than are comedones, small papules, and superficial pustules. Your skin property also has a big role, skin’s response to treatment medication and skin’s tendency to scar from an injury. Sometimes acne scarring has already occurred before adequate treatment has been started; in other cases, acne scarring develops despite what seem like adequate measures to prevent it. Essentially, acne scarring can be classified as two types, pitted scarring and keloid scarring.

Pitted Scarring
Pitted scarring generally results from more severe and deeper acne. Most of this is due to deep inflammation which causes destruction of the collagen, which supports the skin, and either allows the skin to dimple into the hole or else the scar attaches to the epidermis and pulls it down into an sharp icepick-like scars. Scarring is due to loss of substance in the skin. Many people will develop a mark where a spot has been, it may be red or, in darker skins, very dark.
With pitted scarring, the scars may improve, or eventually settle with no treatment. Using collagen injection and some surgical treatments, like dermabrasion, laser-resurfacing or Chemical medication are available today. But always go to a dermatologist to get advice in advance.

Keloid Scars
Keloid are hypertrophic scars which can occur even after fairly trivial acne. They grow slowly and can reach 5 cm across. They are tender or itchy and very embarrassing. Keloid scars generally are treated by a dermatologist with injection of steroids.

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 Suggested Skin Authority products to treat and prevent acne breakouts:

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Acne & Oil Control                                       Vitamin A Cell Renewal

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 Calming Mask                                             Exfoliating Cleanser

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