ACNE
What Causes Acne
At Just Josef we believe that Acne can be treated, controlled and even eradicated, by fully understanding exactly what causes the condition and following a system designed to deal with Acne where it starts; beneath the skin.
Acne is a chronic disorder of the sebaceous glands. While sometimes it seems pimples appear overnight, the development of an acne breakout is actually an extended process that begins at the cellular level. All pimples begin as a blockage of the hair follicle/pore. Gaining an understanding of why a blockage begins and how a pimple develops will ultimately help you in treating your acne.
The function of Skin Pores
Although we're not covered head to toe in a suit of fur, our skin is abundant with hair follicles, tiny shafts through which hair can grow and reach the skin.
"Follicles" and "pores" are sometimes used interchangeably, and other times referred to as two different things. In truth, the pore is simply the opening upon the skin of the hair follicle, which extends downward through several layers of skin. If a hair follicle were a tall chimney, the pore would be the opening at the top of the chimney. Instead of emitting smoke, the follicle emits a shaft of hair. Skin cells are constantly dying inside the follicle. Additionally, small sebaceous glands located inside the follicle (picture a cul-de-sac located off to the side of an otherwise straight road) produce oil called sebum. Sebum is a mixture of fats, proteins, cholesterol and inorganic salts. Sebum travels up the follicle and (in a perfect world) exits through the pore. It also carries those dead skin cells found within the follicle up to the skin's surface. What about sweat -- doesn't that come out of the same pores? No. Sweat is produced by separate sweat glands that also heavily populate your skin. While sweat emerges from the skin from a different source, it does affect your skin's appearance. Once that sweat reaches the surface, it dries but leaves salts behind that can block your pores, when the pore is occluded (blocked) and the materials trying to get out can't, resulting in breakout or acne.
The Skin
The Epidermis
The outermost section of the skin, the part you see every day, is called the epidermis. The epidermis consists of five layers. The deepest layer of the epidermis is the stratum germinativum. It is composed of a single layer of cells. Cell division, or mitosis, takes place in the stratum germinativum.
The new cells begin their journey up through epidermis to the skin's surface. First, they are pushed up through the stratum mucosum, then the stratum spinosum. These three layers (stratum germinativum, mucosum, and spinosum) together are called the basal layer.
As the skin cells travel further, they reach the stratum granulosum. In this layer, the cells begin dying and hardening, giving them a granular appearance. By the time the cells reach the stratum corneum, they are dead.
The stratum corneum is made up of these tightly packed dead skin cells, which are continuously falling off and being replaced. This process is called desquamation. It takes approximately 28 days, from cell birth to sloughing off, to occur.
The Dermis
The dermis is the deepest or inner section, of your skin and is made up of tough connective tissue. The dermis nourishes and supplies blood to the epidermis. It is also what gives the skin its elasticity. The dermis is much thicker than the epidermis but has just two distinct layers: the papillary layer and the reticular layer.
Within the dermis, you will find blood and lymph vessels, nerves, arrector pili muscles (the muscles that make your hair stand on end), sudoriferous (sweat) glands, sebaceous (oil) glands, hair follicles, and pores. It is within the hair follicle/pore and sebaceous glands that acne begins.
The Hair Follicle
The hair follicle is a small, tube-like opening in the skin through which hair and sebum reach the skin's surface. The follicle consists of the pore opening, hair root and bulb, sebaceous duct, and sebaceous gland. Although it is contained within the dermis, the epidermis lines the inside of the hair follicle. In a normal functioning follicle, the sebaceous glands secrete oil, or sebum, into the pore. Typically, sebum and dead cells shed from the stratum corneum and emerge at the skin's surface through the pore opening. In those with acne, however, this process goes awry. In acne-prone skin, sebum and dead skin cells easily become trapped within the follicle. This accumulation of cellular debris and sebaceous matter forms a hard plug that obstructs the pore opening. This obstruction is called a comedo. It manifests itself as non-inflamed bump or blackhead on the skin's surface. When a comedo blocks the pore opening, it creates an anaerobic environment or a lack of oxygen within the follicle. This anaerobic environment, along with excess sebum within the pore, creates a favorable environment where Propionibacteria Acne can thrive as the follicle becomes filled with sebum, dead cells, and bacteria, it begins to swell. The follicle wall ruptures and spills into the dermis. White blood cells rush in to fight the bacteria. Redness and swelling occur, and pus is created. A pimple has now formed. If the rupture in the follicle wall happens near the surface; a pimple is usually minor and heals quickly. It is when the break occurs deep within the dermis that more severe lesions, such as nodules and cysts, develop.
People with acne frequently have a variety of lesions. The basic acne lesion, comedo, is simply an enlarged hair follicle plugged with oil and bacteria. This lesion is often referred to as a microcomedo because it cannot be seen by the naked eye. If the plugged follicle, or comedo, stays beneath the skin, it is called a closed comedo or whitehead. Whiteheads usually appear on the skin surface as small, whitish bumps. A comedo that reaches the surface of the skin and opens up is called a blackhead because it looks black on the skin's surface. This black discoloration is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time. Other troublesome acne lesions can develop, including the following:
Papules--inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch.
Pustules (pimples)--inflamed, pus-filled lesions that can be red at the base.
Nodules--large, painful, solid lesions that are lodged deep within the skin.
Cysts--deep, inflamed pus-filled lesions that can cause pain and scarring.