While all this is happening, your sebaceous gland, near the bottom of the follicular canal (or pore), is still in full swing, unaffected by the existence of a plug closer to or at the canal's exit. Consequently, with nowhere to go, the sebum starts to build up and expand the canal. Eventually, it forms a small internal balloon. This is what you feel when those red spots swell and become sore to the touch. The sorer they are, the larger the sebum balloon and the more certain you are that a nasty zit is on the way.
There are several occasions when the body may produce more sebum than usual. The most important is when the sudden generation of testosterone, a condition that all males and females experience during puberty, activates the sebaceous glands. We don't fully understand how testosterone -produced by the testes in men and by the adrenal glands (situated just above the kidneys) in women - sensitises the sebaceous glands to produce more sebum. However, we do know that it is not the amount of testosterone that determines how much acne forms. Rather, any new spurt of testosterone production stimulates the production of excess sebum.
If the amount of testosterone were determinant, men would obviously suffer far more from acne than women, and acne sufferers would have larger amounts of testosterone in their systems than non-sufferers. Moreover, one noted side effect of men who are placed on a testosterone supplement regime - a somewhat controversial therapy that some doctors prescribe to improve muscle tone, bone density and libido -would be the appearance of acne. None of this is true. Thus, acne is certainly not a hormonal disease.
Another frequent trigger of acne in both men and women is stress. We are not certain exactly how stress causes the production of more sebum, although there are several plausible theories. But no doubt there is a connection. Indeed, a not infrequent phenomenon is the appearance of acne in brides just before the wedding date - at precisely the moment they least want their faces to break out! This is stress-induced acne. And of course the acne adds to the stress and thus tends to perpetuate itself.
In women, a third important influence on acne is the hormonal changes associated with the menstrual cycle, during which testosterone and other hormones experience significant variations not only in quantity but also in the way they affect various bodily functions and feelings. Similarly, acne is often influenced by the onset of pregnancy or birth. A newly pregnant woman may paradoxically find that her acne suddenly clears up completely or suddenly reappears after years of absence. Then, when she has had her baby, she may again experience an onset or a cessation of her acne. Even more annoying, there is no guarantee that the problem always goes in opposite directions. Quite possibly, it could get worse both at the onset and at the completion of pregnancy. No one ever said having babies is easy!
The first symptom of an over stimulated sebaceous gland is unusually oily skin. Teenage boys, in particular, seem to suffer from this condition. Among other symptoms, this gives rise to the lank, oily hair that has become almost a trademark of teenage idols. Contrary to many a parent's incorrect belief, the condition has little to do with poor personal hygiene.
Oily skin is not in itself unhealthy. On the contrary, at a time when teenage boys' hair follicle growth is in full swing -and the skin's pores therefore open and the stratum corneum still relatively thin -the extra oil ma y provide valuable protection. Moreover, extra oil in adults tends to fight all sorts of the ageing effects, including the formation of wrinkles and the development of dry, grey skin that we associate with either poor health or advancing age. However, excess oil production (especially among teenagers) carries with it the disadvantage that, combined with the rapidly shedding skin cells, it is available to form the plugs that can easily clog open pores.
• Stage One
• Stage Two
• Stage Three
• Stage Four
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