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Acne: A plumbing issue

Acne: A plumbing issue

This will be the first (of probably many) posts about acne.

So, what is acne? Acne is simply a defect in the oil drainage system of the skin. Each pore contains a hair follicle and an oil gland. People with normal skin produce oil (sebum) from the oil (sebaceous) glands of the skin and it comes out of the pore and lubricates the skin in a regulated manner. With acne- there is a mismatch between the amount that drains and the amount of oil produced. The oil glands tend to produce too much oil, often at a rate where there is some backlog into the pore. On top of this- the top layer of the skin is a bit damaged or sluggish and the pore tends to be blocked with dead skin. If the oil cannot drain out of the skin properly- it back logs. Anything in the body that is stagnant is at risk of developing infection. This collection of oil (sebum) becomes infected and inflamed and depending on the top layer of skin you end up with any of the following:

Blackheads: These are simply excess sebum below the skin that has started to oxidise (i.e. change its chemical composition) and as a result it changes colour and becomes black.

Whiteheads: Whiteheads are a result of when the sebum that has collected together in a plug so it tends to look yellowish/whitish below the skin. Blackheads and whiteheads tend to be painless.

A pustule is the sebum that has trapped but has become infected- part of it leaks to the top layer of the skin and the skin around it tends to be inflamed. It often has an angry red border and can be quite painful.

A cyst contains infected sebum that is trapped but much deeper below the skin, often near the oil gland itself. The oil gland and the trapped sebum becomes inflamed and the depth of the infection is why cysts tend to be the most painful type of acne. Cystic acne is also the most serious type of acne- because it sits closer to the deeper layer of skin it can cause irreversible scarring.

The acne that teenagers typically get is quite different from adult acne. Teenage acne tends to be due to the changes in hormones and the body that occurs during adolescence. Teenage acne is characterised by excessively oily skin. Adult acne tends to be more hormonal and often skin can be oily, dry, patchy and sensitive- seemingly all at the same time.

However- the mainstay of treatment with both types of acne is essentially clearing the drainage between the oil gland at the surface of the skin. The treatments differ because adult and teenage skin tends to be different, but the aim of the treatments is essentially unchanged- reducing oil, clearing dead skin and fighting infection. The treatments should also be targeted at the type of acne you are prone to. The treatment for largely comedonal (blocked pores) acne will be quite different from those with cystic (deeper, painful) acne.