What’s Going On Down There?
‘Plugging’ In To What Happens Next
So sometimes, sometimes… the pore becomes clogged at the surface and traps the oil underneath. How does this happen? The sebaceous gland duct in the pore becomes clogged because of surface dirt or because the pH balance of the acid mantle is disturbed and is damaged in some way. Most often it’s because the sebaceous glands are overactive and the amount of sebum and keratin trying to exit is just too much for this tiny system to handle. This can be caused by numerous reasons including diet and hormones.
The use of typical topical drying agents such as salicylic acid or benzoic peroxide, only encourage the sebaceous glands to produce more oil and a vicious cycle occurs. The other thing that could factor into the vicious cycle is the use of exfoliants, scrubs, or masks. These will all be discussed further in the Chapter entitled “Why Me?”
During the teen years the whole body goes through profound changes, the skin is no exception. In fact, the skin cells that line the opening of the hair follicle undergo significant structural changes during puberty and add to the problem of clogging pores. The body is literally toughening up for the pressures and demands of adulthood.
Most people grow out of acne after adolescence as their systems normalize. But not everybody… One of THE most common skin disorders around is oily seborrhea, simply the skin is working a little too efficiently and producing too much oil. And of course it’s most common where there are an abundance of sebaceous glands.
Acne most often appears on the face, but can be found on the chest, breasts, back legs or other areas of the body. It can occur anywhere there is a hair follicle or pore. And hair follicles cover 95% of the skin’s surface. Ever get a pimple on your behind and wonder how that happened? It’s the same basic skin system that’s working on your face or anywhere else for that matter. You are more prone to get acne on your face, scalp, chest or back however, because the oil glands there are larger and more active. On the face breakouts usually concentrate along the “T” zone – forehead, nose and chin, although other types of acne appears on the cheeks, jawline, neck or behind the ears.
‘Plugging’ In To What Happens Next – Blackheads
When excess sebum is trapped in the skin it is simply called a pimple or comedo (comedone acne). At the earliest stages of development it is called a microcomedo that is so small it can only be seen by a microscope.
This pimple ‘plug’ does not allow additional sebum or dead skin cells out until the body realizes what’s going on and does something about it. Sometimes the body dilates the pore so the plug will have a chance to get out. In the case when the pore is open to the air, the trapped sebum (lipids, keratin and even some melanin) turns dark from exposure to oxygen, making it officially a ‘blackhead’ or an open comedo.
Blackheads can hang out on your face for days, weeks, or even years sometimes – if left alone. Often however, if bacteria infects the blackhead or if the pore continues to pump out sebum, the pores distends or distorts its shape and the body senses an imbalance. It alerts the system to release enzymes that cause inflammation to occur. The bacteria that invades the gland is called Propionibacterium acnes (P. acnes). This is where the term acne comes from. This bacteria is a anaerobic diphtheroid and normally resides on the skin with the purpose of eating up excess surface oils. Bacteria can be a good thing you see – it’s good to have them sweeping off your doorstep, just don’t let ‘em inside!
‘Plugging’ In To What Happens Next – Whiteheads
When the pore opening remains closed, bacteria begins to accumulate and multiply by feeding on the skin’s lipids (oil). The bacteria’s byproducts (free fatty acids) irritate the skin and the gland become infected and inflamed. The byproducts also attract other ‘chemical scavengers’ to the area that can do damage to the pore’s follicular wall. The body’s defense system sends white blood cells (leukocytes) to the rescue and a whitehead (also known as a closed comedo) forms (acne pustulosa). This is nature’s miniature battlefield.
If left alone, the white blood cells attack the bacteria by secreting enzymes which break down the bacteria and ‘push’ the leftovers out to a yellowish point on the whitehead called a pustule which ultimately dries up as eventually the swelling and the whitehead dissipates. But if you’re like me (and you must be if you’re reading this book) you’ve rarely or never seen that happen, because you’ve never waited that long for your own body to do its work.
The common combination of all of these skin breakouts: blackheads, whiteheads, etc. are referred to as acne vulgaris (an ‘ugly’ latin simply meaning common). It can also be called papulopustular acne.