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About acne

How Acne Generates and Spreads - Stage 1

About Acne »

Your skin replaces itself almost completely, depending on your age, every 28 to 45 days. That is its highly effective way of avoiding the build-up of the damage done to it day in and day out by ultraviolet light, pollution, and general wear and tear. In this process, dead keratinocytes on your skin's surface-that is, the stratum corneum - are sloughed off, and new cells from the base of the epidermis work their way up to replace them.

When this process works correctly, the old cells on the surface of the stratum corneum fall off uniformly, and new flattened cells are added from below at the same rate. However, sometimes (for a variety of reasons we will discuss shortly) your body suddenly produces an excess of sebum. Since the sebum is oily and somewhat sticky, it may combine with some of the loose cells at the surface of the stratum corneum so that instead of sloughing off, they produce a paste-like material. This paste may then wedge itself into an open hair follicle (pore) and there set, compact and harden into a solid, hard-to-remove wad that partially plugs up the mouth of the pore.

At the same time, there appears to be a change in the constitution of the cells that line the hair follicle canal, and this may be an even greater problem than the surface plugs. Apparently, through a series of hormonal events that scientists do not fully understand, some or all of these internal cells become sticky. Normally, as they dry, the cells lining the follicle are swept out by the emerging sebum. But once they become sticky as a result of those hormonal or other changes, the sebum can no longer rinse them out. Instead, they adhere to the sides of the canal, adding to the partial blockage.

These partial blockages are called microcomedones. The first impact of these microcomedones is that they force the canal to dilate, which enlarges the pores at the skin's surface, a condition typical of acne sufferers. Apart from their looking unattractive, these enlarged pores are something of a mixed blessing. On the one hand, they allow more of the sebum to emerge, thus delaying or reducing the amount of internal sebum build-up. On the other hand, the larger mouths of the pores are more likely to gather plugs from the cell-and-sebum mixture on the surface of the stratum corneum.

As more sebum builds up inside the pore, if the partial blockage is generated from the external 'paste' of cells and sebum, and is therefore near the surface, you start to see blackheads. The dark colour of blackheads comes from a pigment in the sebum, not from dirt. Nevertheless, they look 'dirty' and are unsightly.

If the blockage is generated by sticky internal cells and is therefore further down the canal, you will see only a slight reddening and a bump. An acne spot is sure to erupt eventually, but so far it is still too far down to be visible. In profusion, these deep down microcomedones give rise to the bumpy feel of the skin even when the acne has not yet broken out.

Next, sweat penetrates past the partial blockage into the stagnant sebum and, through a series of chemical and physical reactions, turns it into a waxy, 'cheesy' consistency. This is what you see emerging if you (unwisely) squeeze your acne spots. The water in the sweat also causes the canal walls to swell, much as the skin on your fingers swells if you keep them too long in water. Generally, this mild swelling is desirable, as it keeps the skin healthily moisturized. However, in this special case, the moisture tends to further occlude the pores, thus wedging in the wads and blocking the pores even tighter.

Before long -between the internal 'sticky' cells of the canal, the external cell-and-sebum 'cement' and the water-swollen canal itself a complete blockage occurs. This so-called comedone may appear either as a firm white pustule or whitehead (called a closed comedone) or as an expanded blackhead (called an open comedone). In either case, the plug is now so firmly in place that no sebum can escape at all. And your skin is ready for the next, really nasty stage of acne.

• Stage Two
• Stage Three
• Stage Four

If you are interested in booking a FREE consultation for advice on the best treatments and products for your acne or acne scarring, please call us today on 01132 823 300 or complete an enquiry form.