Acne is a skin disease consisting of blemishes that can occur on your face, neck, chest, shoulders and back. Acne is very common during the teen years but it can affect you during adulthood as well.
Pimples Under The Skin
If we look very closely at the skin surface we can see thousands of tiny openings called pores. These pores are the openings of follicles which are under the skin surface.
To keep your hair and skin well lubricated, your body depends on sebaceous glands which sit just under your skin. These glands secrete an oily substance called sebum which coats your skin and hair to prevent them from drying out.
Sebum travels up hair follicles and out through your pores onto the surface of your skin. Tiny glands continuously pump oil also known as sebum into the follicles, the oil travels up and onto the skin. The follicle is aligned with cells which produce a material called keratin, this keratin joins the oil that is flowing through the follicle.
Your hair follicles routinely shed dead skin cells, which sebum carries out of your body. When your body produces extra sebum and dead skin cells they can stick together and clog your pores resulting in skin blemishes.
Bacteria can also be found in the follicles, every hour of every day this mixture flows out of the pore openings as long as the pores remain open. Bacteria that normally exists in small amounts on your skin can flourish in the sebum in the clogged pore, leading to inflammation.
Unfortunately, pores can become clogged and start the acne process. Depending on where the clog is located and if you have inflammation, acne may appear as whiteheads which are clogged follicles closed off from the air.
Blackheads which are clogged follicles that turn a darker colour when the clog is exposed to air. Pustules commonly called pimples which are inflamed follicles clogged with pus or cysts which are larger painful pus-filled lumps going deep under the skin.
Creams or makeup may block them but most importantly the pores can become clogged by touching or rubbing with the hands. This can push dead skin cells down into the pore or cause a layer of skin to cover the poor. When pores are blocked the oil and keratin that are being pumped into the follicle can't get out. Pressure builds up and makes the follicle expand like a balloon being filled with water.
As the follicle gets larger and larger this stretches the follicle walls, tiny holes can form through which bacteria and other contents in the follicle can leak out. This attracts cells of inflammation which try to fix the problem. The cells lining the canal start to produce more keratin to shield themselves from the increasing stretch.
Unfortunately, this additional keratin adds even more material to the canal.
As more and more oil and keratin build-up, the follicle can actually burst causing much more inflammation. This is the point where we see red bumps and pimples on the skin
Inflamed Pimple Under Skin
Hormonal changes particularly a rise in testosterone can lead to sebum overproduction which is why acne often occurs during the teen years. However it can occur at any age, other factors contributing to the development of acne are bacteria, certain medications and genetics.
If you have a mild case of acne your doctor may recommend an over-the-counter lotion with one of several active ingredients. Benzoyl peroxide kills bacteria dries excess oil and removes dead skin cells clogging pores salicylic acid slows the loss of skin cells to prevent clogged pores. It may also break down whiteheads and blackheads the hydroxy acids such as lactic acid help remove dead skin cells, reduce inflammation and stimulate the growth of new smoother skin.
Sulfur removes dead skin cells and dries excess oil these are strong chemicals that may irritate your skin follow the directions for use exactly.
If over-the-counter products are not effective your dermatologist may prescribe stronger prescription lotions such as vitamin A which reduces the build-up of dead skin cells in your pores. Topical antibiotics which kill bacteria on your skin, or a combination of benzoyl peroxide and topical antibiotics. For moderate to severe cases, your dermatologist may prescribe an oral medication alone or in combination with a topical treatment.
These medications include oral antibiotics which kill bacteria and reduce inflammation and isotretinoin, which is used only for the most severe cases. A corticosteroid injection may be given to relieve your pain and help clear up a particularly large lesion.
For women, birth control pills containing estrogen may be prescribed to minimize the effects of testosterone regardless of the treatment your doctor recommends good skincare is essential. For example, wash problem areas twice daily with a mild soap and wash gently without scrubbing. If you have dry or peeling skin use an oil-free water-based moisturizer.
When choosing any product to put on your skin look for an oil-free or non-comedogenic label which means it won't clog your pores. Avoid picking or squeezing blemishes as these actions may lead to infection or scarring and avoid touching your face, with your hands, your hair or any object such as a cell phone.