Acne is always a skin problem that everyone suffers at least once in their lifetime. You may start taking care of your skin carefully, paying more attention to the products and your diet probably because of acne.
In this post, I want to break down the biology, different types of acne, factors contributing to its formation, and skincare ingredients to target acnes.
CAUSES OF ACNE
First, we can’t deny the root causes of acne is hormones, family history, medication, age, diet, stress, pollution, etc. These factors contribute to the formation of acne, which is directly related to the disorder of sebaceous glands.
Now let’s come back to the basis; Sebaceous (oil) glands are attached to the hair follicle and can be found everywhere on our body except for the palms of the hands and soles of the feet. Sebaceous follicles are the target sites for acne. Everything acne-related is from this place!!
The inflammation of sebaceous glands is caused by the interplay of 4 key factors:
- Follicular keratinization
- Excessive sebum secretion
- Overpopulation of Cutibacterium acne
- Inflammation
You will see how these factors contribute to the acne breakout.
HOW DO ACNE FORM?
Sebaceous gland produces sebum which keeps the skin and hair moisturized. Our skin cells (corneocytes) are being shed off constantly and renewed in desquamation process. This process occurs not only on the skin surface but also inside the pores. If the sebum starts to spread over the skin as well as the corneocytes are being shed off normally, our skin remains moisturized and healthy. Well, this is true when the process works correctly, unfortunately, it’s not that simple ☹.
Next, let’s get to different types of acne.
Microcomedone (early acne)
Microcomedone is formed when the sebum and corneocyte get stick together due to the excess sebum secretion and increased keratin production. They get trapped in the narrow opening of the pores.
It’s called “micro” as it looks invisible from outside, but inside the pores the materials are building up. Cutibacterium acnes or C. acnes is the culprit that resides in the materials. *
*You might be wondering as the acne-causing bacteria was Propionibacterium acnes (P. acnes). Well, studies and research has changed the name because C. acnes belongs to the P. acnes family (which is very diverse), so it’s more accurate to called it C. acnes.
Comedone
Open comedone (blackhead) and closed comedone (whitehead)
The accumulated sebum and corneocyte trapped in the pores form an open plug called open comedo or blackhead, or form a closed plug called closed comedo or whitehead.
Comedone can be infected or not infected depending on the C. acnes can spread and infect the cells around the pores.
Papule/ Pustule (pimple)
In this case, the pores’ sides rupture, a lot of C. acnes leaks into the surrounding skin cells causing infection. This initiates a mild immune response from our body, in which the white blood cells (part of the immune system) create a pus inside the pores. We call it pustule.
and papule or pimple (if it is a red bump without pus).
Nodule/Cyst
If the spreading of C. acnes is wider and deeper causing more severe infection, our immune system responses with stronger signals. Cysts or nodules are formed. They are very painful and may leave scars.
HOW TO FIGHT AGAINST ACNE?
I hope the above information is not too much to cause you any confusion.
I know acne makes us feel uncomfortable and much more…; we want to try different ways to stop the angry breakouts and can’t wait for them to disappear (to the point we keep picking our pimples ☹).
Since acne treatment is beyond the scope of this post, and for more complex- inflammatory acne types, you should always consult dermatologists for better treatments.
Below is a list of ingredients that target acnes:
–Vitamin A and its derivatives are the proven ingredients in fighting acnes. Read more here.
Tretinoin, adapalene, and isotretinoin are prescribed drug that are best options.
Adapalene 0.1% is available as an OTC in USA.
–Salicylic acid is a chemical exfoliant suitable for oily, acne-prone skin. It can penetrate and exfoliate to the pore level. Salicylic acid alone can’t be enough though.
–Benzoyl peroxide is another acne fighter, kill bacteria and may decrease the sebum production; not allowed in cosmetics in EU, UK, but available in the US. as OTC and a cosmetic product.
–Azelaic acid: clear pores and reduce inflammation. And this is also not a sole ingredient to defeat acne.
The bottom line:
Acne formation is more than the bacteria trapped in the pores. There are many factors leading to the development of acne.
It takes time to fight those breakouts, so first start to take care of your skin more carefully.
Clean your skin gently. Avoid rubbing and touching your face. No squeezing or picking pimples. Use sunscreen and soothing moisturizer.
Consult dermatologists for topical and oral treatments.
I hope you find this helpful!
Reference:
Saurat JH. Strategic targets in acne: the comedone switch in question. Dermatology. 2015;231(2):105-111. doi:10.1159/000382031
Dréno B. What is new in the pathophysiology of acne, an overview. J Eur Acad Dermatol Venereol. 2017;31(Suppl. 5):8-12. doi:10.1111/jdv.14374
