Acne Basics

“Acne; a chronic inflammatory skin disorder of the sebaceous glands characterized by comedones and blemishes and is a hereditary trait which is also triggered by hormonal changes.”

What does that mean? You may have inherited acne, and adult hormones kick-start the onset. A rough start to being a grown-up! What now? All acne is composed of three factors including dead skin, bacteria and sebum (oil). Managing these factors is key to minimizing break-outs.

There are three types of acne; inflammatory (papules and pustules), non-inflammatory (comedones, commonly known as blackheads and whiteheads), and cystic or nodular acne. Severity ranges from Grade I minor acne, to Grade IV, the most severe cystic acne including papules, pustules, comedones and inflammation.

Causes of acne begin with clogged pores, oily or dirty skin, an overabundance of bacteria, “comedogenic” cosmetics and products, and triggers such as hormones, stress and certain foods. Clogged pores can be due to a hereditary condition called “retention hyperkeratosis” in which dead skin is not shed as it is on normal skin and continues to build up. Excessive oil production triggered by hormones combines with dead skin to cause comedones or sebaceous filaments (oil plugs in the pores). Make-up, hair and skin products can also cause cells to build up (comedogenic ingredients), or cause inflammation and irritation due to using ingredients that are inappropriate for your type of skin. The real bad guys in the formation of acne are bacteria. They thrive in an anaerobic (oxygen deprived environment) and can create a real “party in your pores” causing inflammation and pressure on the follicle wall. If the wall ruptures it causes infection (pustules and papules). Cysts are deep pockets of infection where the skin forms hardened tissue to stop the spread of bacteria. This type of acne results in permanent scarring to the skin.

Other variables that contribute to acne are hormonal fluctuations (usually testosterone). Stress, triggers more oil production and adrenalin as well as hormonal fluctuations. Foods affect bodily function and excessive iodides in salt, MSG, kelp, cheese, fast food, processed foods and shrimp and crab aggravate acne. Other common foods that contribute to acne are dairy, peanuts, caffeine, and “white foods” such as pasta, potatoes, sugar and rice. Considerations for dirty phones, pillows, make-up brushes, leaning on dirty hands, friction or exposure to dirt, sweat, oil, or other environmental factors should be noted.

Managing acne takes discipline and good habits. At a minimum, stay hydrated and practice stress reduction and good nutrition. Cleanse and protect your skin with products that are appropriate for your skin EVERY DAY. Exfoliate 3 times a week. Eliminate products that make acne worse or irritate your skin. Avoid environmental aggravators including dirt, grease, sun, humidity, and pollution. Schedule a facial with an esthetician that specializes in acne. An esthetician can help you create a home care routine with the right products. Balancing stress, hormonal fluctuations and inflammation can be helped by acupuncturists, nutritionists and exercise. Because smoking robs cells of oxygen, it contributes to acne directly. STOP smoking. For more severe types of acne, a doctor should be consulted to prevent permanent scarring to the skin.


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1 P. 96, Milady’s Standard Fundamentals for Estheticians, 9th Edition, 2004


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