It starts when greasy secretions from the skin's sebaceous glands (oil glands) plug the tiny openings for hair follicles (plugged pores). If the openings are large, the clogs take the form of blackheads: small, flat spots with dark centers. If the openings stay small, the clogs take the form of whiteheads: small, flesh-colored bumps. Both types of plugged pores can develop into swollen, tender inflammations or pimples or deeper lumps or nodules. Nodules associated with severe cases of acne (cystic acne) are firm swellings below the skin's surface that become inflamed, tender, and sometimes infected.
Although acne remains largely a curse of adolescence, about 20% of all cases occur in adults. Acne commonly starts during puberty between the ages of 10 and 13 and tends to be worse in people with oily skin. Teenage acne usually lasts for five to 10 years, normally going away during the early 20s. It occurs in both sexes, although teenage boys tend to have the most severe cases. Women are more likely than men to have mild to moderate forms into their 30s and beyond.
Acne lesions are most common on the face, but they can also occur on the neck, chest, back, shoulders, and upper arms.
Contrary to popular belief, acne isn't caused by a harmful diet, poor hygiene, or an uncontrolled sex drive. The simple truth is that heredity and hormones are behind most forms of acne. Swearing off chocolate or scrubbing your face 10 times a day won't change your predisposition to this unsightly, sometimes painful, and often embarrassing skin problem.
Thank you WebMD! ;)
Let's go a little bit deeper into what is acne: (Danke Acne.org!)
Human skin, especially on the face, neck, back, and chest is covered in hundreds of thousands of microscopic hair follicles, often called pores.
For reasons no one completely understands, these follicles sometimes overproduce cells and become blocked. Sebum (oil) which normally drains to the surface gets trapped and bacteria begins to grow.2-11
All acne lesions start out as a microcomedone.1,12-13
Normal follicle
Microcomedone
There are two main types of acne
1. Non-inflammatory acne
Microcomedones can spontaneously become unplugged and heal or they become
non-inflamed skin blemishes called comedones--either a whitehead or a blackhead:12-13
non-inflamed skin blemishes called comedones--either a whitehead or a blackhead:12-13
Whitehead
When the trapped sebum and bacteria stay below the skin surface,
a whitehead is formed. Whiteheads may show up as tiny white spots,
or they may be so small that they are invisible to the naked eye.1,13
Blackhead
A blackhead occurs when the pore opens to the surface,
and the sebum, which contains the skin pigment melanin, oxidizes and
turns a brown/black color. It is not dirt and can not be washed away.
Blackheads can last for a long time because the contents very slowly drain to the surface.1,13
2. Inflammatory acne
A blackhead or whitehead can release its contents to the surface and heal.
Or, the follicle wall can rupture and inflammatory acne can ensue.
This rupture can be caused by random occurrence or by picking or touching the skin.
This is why it is important to leave acne prone skin relatively untouched.1,12-13
Or, the follicle wall can rupture and inflammatory acne can ensue.
This rupture can be caused by random occurrence or by picking or touching the skin.
This is why it is important to leave acne prone skin relatively untouched.1,12-13
Papule
A papule occurs when there is a break in the follicular wall.
White blood cells rush in and the pore becomes inflamed.13
Pustule
A pustule forms several days later when white blood cells
make their way to the surface of the skin.
This is what people usually refer to as a "zit" or a "pimple."13
A papule or pustule can completely collapse or explode,
severely inflaming the surrounding skin, and may engulf neighboring follicles.
These lesions are called cysts or nodules:1,13
severely inflaming the surrounding skin, and may engulf neighboring follicles.
These lesions are called cysts or nodules:1,13
Cyst
Sometimes a severe inflammatory reaction can result in very large pus filled lesions.1,13
Nodule
When a follicle breaks along the bottom, total collapse can occur,
causing a large, inflamed bump that can be sore to the touch.13
The Myths of Acne: (Acne.org again).
There is a staggering amount of misinformation out there when it comes to acne. Read through this page to get the real bottom line on the most misunderstood concepts in acne.
Myth Washing or scrubbing your face will help clear up acne
Reality Facial blemishes are not caused by dirt.1 Contrary to what you may have seen in commercials, pores do not get blocked from the top down due to "impurities." Rather, the walls of a pore stick together deep within the skin, starting acne formation. Far from preventing acne, frequent washing actually irritates pores, which can cause them to become clogged. A washcloth or any other cleansing device can add even more irritation. The best bet is to wash very gently with bare hands, and only wash twice a day.2
Myth Stress causes acne
Reality Stress can affect hormones and can theoretically promote acne. However, an effective acne treatment regimen is more powerful than a bout of stress any day. Some psychiatric medications, notably lithium which is often prescribed for bipolar disorder, may have acne as a side effect, but stress itself is no big deal.3 Your time is better spent determining the right course of acne treatment rather than feeling guilt about stress.1,4
Myth Masturbation or sex causes acne
Reality This antiquated notion, originating as early as the 17th century to discourage young people from having premarital sex, is not based on scientific evidence.
Myth The sun will help get rid of acne
Reality 10-20 minutes per day of sun exposure for people with lighter skin and 20-30 minutes per day for people with darker skin may prove beneficial for acne symptoms, especially body acne. However, overly exposing your skin to the sun creates skin damage, which leaves the skin irritated. This irritation can result in more acne in the weeks following over exposure as the skin heals itself. If you notice a break out "out of the blue," ask yourself if you got sunburnt about two weeks ago. That may be the cause.1-2,5 Don’t be afraid of the sun, but try not to get burnt.
Myth Diet and acne are related
Reality Available scientific evidence does not yet support a compelling case for a diet and acne connection. The bottom line is we need more research. We do know that people in some hunter/gatherer societies do not experience acne whatsoever across the entire population. This is in stark contrast to the widespread presence of acne throughout all modern society. It leaves us to ponder whether the indigenous people's unprocessed diet contributes to their acne-free skin or whether their clear skin is a result of genetics or some other factor. Discovering a dietary way of preventing acne may be a future reality, however, we may live so differently from our ancestors that it has become close to impossible to replicate our ancestral diet.1-2,6-8. Note: If you feel that you have cleared your acne using a particular diet, or if you are planning on attempting a diet of some kind, please post your method on the Nutrition & holistic health forum. Keep in mind that almost any diet will appear to work in the short term because as your body loses weight, insulin and other hormones react and acne tends to recede. Then, as body weight levels out or increases, acne symptoms tend to return. Any legitimately effective anti-acne diet should continue working after the initial weight loss period.
Myth Only teens get acne
Reality So many adults now experience acne that some dermatologists refer to it as an “adult acne epidemic.” Exactly why this occurs is unknown, but 50% of adult men and 25% of adult women now experience adult acne at some point.9,10,11. The good news is that it is treated the same way in an adult as in a teen.
Myth There is no cure for acne
Reality Reality Accutane (isotretinoin) provides long-term remission of acne symptoms in approximately 2/3 of people who take an adequate dosage (1mg/kg).12,13,14,15. Since “cure” is defined as “a complete or permanent solution or remedy,” a strong case can be made that isotretinoin provides a cure for many people. However, since isotretinoin comes with such severe side effects, it is essential that anyone considering the drug enter into a careful decision-making process alongside a trusted physician.
Myth You should never pop a pimple
Reality If you search online, the vast majority of medical sources specifically warn against popping a pimple. However, this advice is never referenced or based on scientific evidence. While it is commonly agreed that attempting to pop pimples which are not yet ready and do not have a white or yellow center can cause the pimple to become more severe and potentially scar more severely, popping a zit which is ready and does in fact have a white or yellow center can actually eliminate the infection and initiate healing. Popping must be performed correctly to achieve the best result. Also, it is vital that popping never be combined with picking of the skin. Countless plastic surgeons who specialize in acne scar correction will tell you that picking the skin causes as much or more scarring than the initial acne lesion itself.
Myth Dermatologists know everything there is to know about acne
Reality Even though acne is the #1 reason people see dermatologists, this does not mean that a dermatologist is a specialist in acne unless she specifically decided to focus her practice on this area. Becoming a dermatologist requires a person to study and understand a huge list of skin diseases, and acne is simply one of many. It is important that an acne sufferer be his own advocate when it comes to acne and learn everything he can about available treatments before speaking with a dermatologist to prevent a revolving door of prescriptions which very often do not provide adequate clearing of the skin.
Okay, so know you now some stuff about acne and you're like, so how the hell do I treat this crappy condition? Let's help you with that. :)
So the most recommended treatments for acne are topical gels, antibiotics and accutane. Let's learn about these treatments.
PRESCRIBED:
Here are the most common prescribed (ie given by a doctor/ derma) treatments. You can see (from my last post) that I'm using 4 of these: clindamycin, benzoyl peroxide, adapalene (differin gel) and an oral antibiotic (amoxicillin). TOPICAL GELS:
~These gels are normally used to kill acne bacteria.
~Benzoyl peroxide is the only known substance which can bring oxygen under the skin surface. Since bacteria cannot survive in the presence of oxygen, when used in an adequate dosage, benzoyl peroxide eradicates 99.9% of these bacteria almost immediately. It also exerts a mild drying and peeling effect which is thought to help prevent breakouts. Benzoyl peroxide also helps lessen inflammation.
~It also can help with inflammatory responses.
~Tretinoin: It is thought to help unplug follicles and keep pores clear. It also increases the speed at which surface skin cells are replaced and helps reduce inflammation.
~Adapalene: Acne is thought to be caused by the skin cells inside the follicle shedding too fast and clogging pores. Differin gel slows down the accumulation of skin cells inside the follicle that plug the pores.
ANTIBIOTICS:
Oral antibiotics help stop the growth of P. Acnes (acne bacteria), from the inside out. Antibiotics also have an anti-inflammatory effect.
ACCUTANE aka ISOTRETINOIN:
Originally under the brand name "Accutane" but now available only in generic form, isotretinoin is a derivative of vitamin A taken in pill form for 15-20 weeks. Doctors normally prescribe it for people with "severe nodular acne" that does not respond to other treatments. Nodules are inflammatory lesions with a diameter of 5mm or more. A single course of 15-20 weeks has been shown to result in complete clearing and long-term remission of acne in many people. *Sometimes 24 weeks or more is done*
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What it does:
Reduces the amount of oil produced by the oil glands.
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Exactly how Accutane works on a cellular level is unknown, but we do know that it affects all four ways that acne develops.
- It dramatically reduces the size of the skin's oil glands (35%-58%) and even more dramatically reduces the amount of oil these glands produce (around 80%).
- Acne bacteria (P. acnes) live in skin oil. Since oil is dramatically reduced, so is the amount of acne bacteria in the skin.
- It slows down how fast the skin produces skin cells inside the pore, which helps pores from becoming clogged in the first place.
- It has anti-inflammatory properties.
Accutane is a very serious drug though and can NEVER, EVER, EVER be taken by someone pregnant or planning to be pregnant and you MUST prove that you have two forms of birth control (women) (condoms for men)!!! There can be severe side-effects from accutane. Commonly it is just dryness and maybe some msucle ache but it can be as severe as depression and more.
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