Acne begins beneath the skin long before it shows up on the skin and most people experience the breakout of acne at some point in their life. It is not the result of uncleanliness. There are certain changes in the body that can trigger acne including hormone levels that increase the production of oily substance in the skin called sebum. Sebum normally flows out of sebaceous glands which are attached to the hair follicale. In some cases excess sebum (oil) can get stuck and clog the follicle so sebum can’t excrete to the skin surface.
Normal P-Acne bacteria and dead skin cells further plug up the follicles. An overgrowth of bacteria irritates and reddens the skin. P-Acne thrives and proliferates in the oxygen free environment that consumes the trapped sebum (oil in the follicle) causing release of the toxic enzymes that eventually break down the cellular wall. This process can start a chain reaction of painful inflammation and infection under the skin. When this inflammation spreads and breaks through the skin, it is called acne. Acne can range from mile to severe and it can start from a whitehead or blackhead (comedones) that can inflame to pimples and can progress to a nodule, cyst or abscess. Whiteheads are closed comedones that are white because the sebum (oil) has not been exposed to the air. Blackheads are open comedones and they are enlarged plugs in pores that appear black because they are pushed through the surface of the skin. The sebum darkens when exposed to air.
AN APPROACH TO ACNE TREATMENT
- Use of a mild non-detergent cleanser to clean the face in the morning, evening and after heavy exercise
- Do not scrub your face or use drying products as they can hurt the surface of the skin and make it more vulnerable to acne
- Do not pinch, pick, squeeze or rub acne as these actions can also hurt the skin surface and cause scarring
- Cosmetics used should be “non-comedogenic” as these do not promote formation of closed pores that lead to acne
- Moisturizers can relive dry or irritated skin, should be oil-free
- It is important to avoid the sun when possible and if exposed use a sunscreen
Benzoyl Peroxide is a treatment for acne secondary to its effect on killing the P-acnes bacteria that causes the acne. It also reduces inflammation and opens plugged hair follicles by increasing the turnover of the skin cells. It slows the formation of whiteheads and blackheads. It is important to realize that improvement in acne is usually seen by the 3rd week and maximal improvement in 8-12 weeks of treatment.