Acne Education Archives – Advanced Skin Clinic

How Does Acne Form

Dr Bhavesh — Mon, 12 Apr 2021 06:18:08 +0000

How Does Acne Form

Even though acne is such a common disease, we still don’t know precisely how it forms. Traditionally, researchers believed that acne was caused by male hormones that are present in both males and females. The view was that increased male hormones led to more skin oil production and clogged pores. Inside these clogged pores, skin oil would build up, and acne bacteria would thrive on the trapped skin oil, ultimately causing inflammation in the skin and acne lesions. Recent research, however, has found that inflammation is present right from the start. Because of this new knowledge, researchers now classify acne as a chronic inflammatory disease, and not just a hormonal and bacterial affliction.

STEPS IN ACNE FORMATION

Steps 1 - Triggering of Inflamation

The main type of skin cell in our skin (called keratinocytes) constantly produce inflammatory molecules at low levels that act as a “surveillance system” to detect bacteria or something else that requires an immediate immune response. When triggered by something, this surveillance system will then increase its production of inflammatory molecules and cause inflammation. This inflammation can then induce changes in the tiny hair follicles that cover our skin (often called pores), leading to acne.

factor(s) might trigger inflammation?

Acne bacteria (C. acnes)
Changes in skin oil (sebum) composition
Stress

But other factors, or a combination of factors, may be at play.

Step 2: Hair Follicle (Pore) Changes

Once inflammation is present in a hair follicle, it begins to stimulate an overproduction of the sticky skin protein, keratin. Changes in sebum composition also become evident at this point.

The overproduction of keratin and different composition of sebum may then stimulate even more inflammatory molecules and the formation of a clogged pore (comedone).

Step 3: Formation of a Clogged Pore (Comedone)

The clogged pore traps sebum and excess keratin, which begins to build up. This provides the perfect breeding ground for C. acnes bacteria. C.acnes can lead to increased production of the inflammatory molecule that leads to additional stimulation of keratin production. This further clogs the pore, and as sebum and keratin continues to build up inside the pore, a comedone (whitehead or blackhead) is formed

Step 4: Rupture of the Clogged Pore (Comedone)

Eventually, the buildup of keratin, sebum, and, usually, C. acnes, puts pressure on the pore wall. The pressure becomes too high and causes the wall to rupture, releasing the pore’s contents into the surrounding skin.

The body’s immune system reacts to the contents of the pore as a “foreign invader” and reacts with much more inflammation, which leads to the production of red and sore inflammatory acne lesions, such as a pustule

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Adult Acne – Everything You Need to Know

Dr Bhavesh — Sat, 10 Apr 2021 08:11:15 +0000

Adult Acne - Everything You Need to Know

Adult acne is usually defined as acne that affects people over the age of 25.

In about 1/2 of cases, acne ends after adolescence (around 18 – 20). For the other 1/2, it continues into adulthood. For a minority of people, particularly women, acne can subside after adolescence and then make a resurgence in adulthood.

Adult Acne in Men: Exactly why acne continues in men is not fully understood, but normally it is as simple as “it hasn’t gone away yet.” That means, just like what caused acne in the first place, it is a potential combination of:

Hormones: Higher levels of testosterone and other male hormones, and/or higher sensitivity to these hormones lead to more acne.
Genetics: If your father or mother also had adult acne, your chances go up.
Physical irritation of the skin: Wearing a face mask for a sport or frequently wearing a baseball hat are two examples of physically irritating the skin that could keep a man in a cycle of acne. Even constantly touching the skin can aggravate acne.
Stress, smoking: Medical evidence at this point shows us that when the body is chronically attacked with stress or with harmful substances, It has a harder time keeping its organs in top shape. The skin is the body’s largest organ, so while the evidence regarding stress, smoking, and acne is not yet overwhelming, replicated, and completely understood, it makes common sense that chronic negative assaults to the body could lead to more acne.

Treatment of Adult Men: Treating acne with a proper benzoyl peroxide regimen can keep the vast majority of men clear. However, in some cases of severe, widespread (particularly if on large areas of the body), and scarring acne, isotretinoin is an option that can be carefully and soberly considered.

Adult Acne in Women: While girls as a whole have less acne than boys, this balance flips in adulthood, with more women struggling with adult acne after the age of 25. This is thought to be because of the fluctuating hormones during the menstrual cycle, but may also be due to:

Genetics: If your mother or father also had adult acne, you are also more likely to struggle with it.
Physical irritation of the skin: Wearing a face mask for a sport or wearing a lot of makeup, particularly if you apply it or remove it roughly, are 2 examples of physically irritating the skin that make it much harder for a woman to stay clear. Even constantly touching the skin with your hands or hair, especially when you are using potentially pore-clogging hair products, can aggravate acne.
Stress, smoking: Medical evidence at this point shows us that when anyone’s body is chronically attacked with stress or with harmful substances, it has a harder time keeping its organs in top shape. Based on the research that has been produced so far, when it comes to the body’s largest organ–the skin–and when we look at acne in particular, women may be more susceptible to both stress and smoking when compared to men.

Treatment of Adult Women: Treating acne with a proper benzoyl peroxide regimen can keep the vast majority of women clear, even through the hormonal roller coaster a menstrual cycle entails. However, when blood tests show a hormonal imbalance, particularly when levels of androgens (male hormones) are overly elevated, hormonal treatment, including oral contraceptives (the birth control pill) and/or anti-androgens, can be the treatment of choice. In some cases of very severe and scarring acne, a last resort option is isotretinoin (Accutane^®), an oral medication that comes with many side effects–some of which can be lifelong–but can clear acne in extreme cases.

Isotretinoin is the #1 birth defect-causing medication on the market. Consider it only if under the supervision of an experienced physician, and if it is taken, always use at least two (2) forms of responsible and dependable birth control. And as with any medication that permanently changes the body, have your eyes open to potentially long-term side effects.

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What Is Acne?

Dr Bhavesh — Sat, 29 Aug 2020 04:58:59 +0000

What Is Acne?

Acne is a chronic inflammatory skin disease that starts after the onset of puberty when hormones increase. These hormones initiate to the production of skin oil, which is necessary for acne to form.

Acne can occur on any part of the body that has pores, which are tiny hair follicles. All parts of the body except the palms of the hands and soles of the feet have pores. However, we see acne mostly on the face and upper body (back, chest, back of the neck, shoulders) because these areas contain many pores, and the pores in these areas produce the most skin oil.

Acne lesions start when inflammation, increased skin oil production, and an overgrowth of skin cells causes pores to become clogged. This traps skin oil inside the pore where acne bacteria thrive and reproduce.

Inflammation plays a major and central role in acne development and is present from the very start of a clogged pore all the way until an acne lesion is completely healed. While all acne is inflammatory in nature, it is helpful to use the terms “non-inflammatory” to refer to acne that is not red and sore and “inflammatory” to refer to acne that is red and sore.

Non Inflammatory Acne

The very first phase of a clogged pore is called a microcomedone, which cannot be seen with the naked eye. Microcomedones form when an overproduction of skin cells narrows the opening of the pore and leads to a clog. Skin oil that normally drains to the surface gets trapped inside, and acne bacteria, which thrives in skin oil, reproduces rapidly.

The trapped skin oil and bacteria build up until they become visible to the naked eye, and the lesion is then called a comedone. There are two types of comedone:

Whiteheads
Blackheads

Inflammatory Acne

Inflammatory acne develops when so much pressure builds up inside a clogged pore that is breaks the wall of the pore, allowing the pore’s contents to leak into the surrounding skin.

The body’s immune system sees these contents as “foreign invaders” and activates inflammatory cells, most notably white blood cells, to fight the infection. The influx of inflammatory cells causes the acne lesion to become red and sore.

There are four types of inflammatory acne lesions:

Papules
Pustules
Nodules (severe)
Cysts (severe)

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Acne Cause

Dr Bhavesh — Wed, 26 Aug 2020 07:36:29 +0000

What Causes Acne?

Scientists still do not know exactly what causes acne, But known as a multifactorial disease, which means several factors likely lead to its development . Acne Is Likely Caused by Multiple Factors, Including

Hormones – For Sure

One thing we do know for sure is that acne is in part a hormonal disease. We know this because acne symptoms start only after the body begins producing hormones during puberty. Also, we know that acne symptoms usually increase when male hormones that are present in both males and females, called androgens, are elevated. Increased levels of growth hormones may also affect acne. The most likely explanation why these hormones increase acne is because they increase the amount of skin oil that the skin produces, and more skin oil is strongly linked to more acne.

Inflammation – For Sure

Acne pimples are often red and sore, clear indicators of inflammation. As scientists continue exploring the skin, they are becoming more convinced that acne is at its core an inflammatory disease, and are finding inflammatory molecules at every step of acne development, from the very first stages of a clogged pore. We see clear signs of the inflammatory component of acne when we treat it as well. Most acne medications and treatments have specific anti-inflammatory properties that are thought to be part of their anti-acne action.

Evolutionary Biology – For Sure

Acne is a genetic disease. If one or both of your parents had acne, chances are heightened that you will as well. Why would evolution select for this trait? That is still unknown.

Stress – Very Likely

The mind and the body are connected. This is not Eastern philosophy, it is undisputable physical reality. Emotional stress affects our endocrine (hormone) system and immune system, which may leave the skin less able to stay clear. Physical stress, such as over-taxing the body through an overly demanding exercise schedule or not getting enough sleep, may also adversely affect our body’s endocrine and immune systems.

Vitamin Deficiency – Perhaps

Inadequate levels of vitamins in the skin may prevent the skin from fighting inflammation effectively. When it comes to acne, research is zeroing in on antioxidants in particular, such as vitamins A, C, and E. Antioxidants are the always-viligant troops the body uses to combat inflammation. Many of us also have inadequate levels of vitamin D in our bodies and skin as well. Whether this leads to more acne is a subject of ongoing interest.

Diet – Perhaps

The impact of diet on any disease is notoriously difficult to study, and acne is no exception. Because of a lack of robust, long-term studies, we do not know whether diet and acne are related, and if so, to what degree. However, it is not yet time to discount the effect of diet on acne, and the admittedly imperfect research that we have thus far points toward the possibility that a high-glycemic diet, as well as low levels of omega-3 fats, antioxidants, and zinc in the diet might contribute to acne. When it comes to dairy, it is too soon to say either way.

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