The physiology behind pimple production:
Despite how it may look, your skin actually has millions and millions of microscopic pores. These pores are the openings of the sebaceous glands found in every human. These glands produce a yellowish substance called sebum which is responsible for keeping your skin healthy and hydrated. It is the maintenance of this essential water balance that keeps your skin soft and your hair shiny. It also acts as an antimicrobial agent, controlling the growth of certain kinds of bacteria and fungi and protecting your body from infection.
So what causes acne?
There are four processes involved in the production of acne:
-An excess shedding of skin cells
-An increased production of sebum
-Bacterial growth
-Inflammation
While it should be kept in mind that sebum production is a normal and healthy physiological process, there are certain factors which may induce an increased production. The most important of these is a group of hormones known as androgens (such as testosterone). They shift the physiological balance and cause an excessive production of sebum. The areas most affected -due to a presence of large sebaceous glands, in greater numbers- are the arms, the back and most noticeably, the face.
Another normal process that occurs every second of every day is the shedding of dead skin cells in huge numbers. Unlike snakes, where the skin is shed in cycles, in human beings it is a continuous and ongoing process. Up to 400 million dead cells are shed each day keeping our skin fresh, soft and clean. The factors affecting the shedding of skin are both innumerable and diverse. Various agents such as heat, UV radiation, hydration, abrasions and of course hormones affect the rate at which we shed our cells.
In normal conditions, our body is able to keep these factors in check. However, sometimes that rigid balance is unsettled. The hormonal imbalances during periods of puberty, menstruation or times of intense stress are the most common instances of this. Due to an increased production of androgens, the sebaceous glands start working in overdrive, producing excessive quantities of sebum. This sebum production, coupled with the increased loss of skin cells, blocks the pores of the skin leading to their accumulation in the deeper layers of the dermis. Aggravating this situation is the presence of certain bacteria such as Propionibacterium acnes (P.acnes). These bacteria are anaerobic in nature (meaning they do not require oxygen) and when the pores of the skin get blocked, it creates the perfect environment for them to reproduce.
When our body senses the presence of this infective bolus, it acts to extrude it as soon as possible. White blood cells aggregate in the area and a milieu of chemical reactions take place resulting in a confined pustule (the pimple), which is then broken apart over time. It is this inflammatory reaction which causes the pimple to appear red in color. So you see, acne is actually one of the many ways your body controls the spread of bacterial infection.
Something important to keep in mind is that as repulsive as acne may seem to you, it shouldn't be thought of as an abnormal blight on your skin, but just as a normal biological process running amok.
So how can you control it?
The four most effective tools in your war against acne are as follows:
1) Stop worrying about it: The most important step in your fight against acne is to accept it. It is important to keep in mind that acne - especially pubertal acne- is a normal part of growing up, and some degree of tolerance is required. Take solace in the fact that it is just a temporary phase which will soon pass. Apart from making you feel better about yourself, this will actually help reduce the occurrence of acne. Continuously stressing about the marks on your face will increase the level of androgens in your body which will in turn lead to the proliferation of these blemishes.
2) Visit a dermatologist: While it is advisable to visit a licensed dermatologist at least once (i.e. one that has an M.D. in Dermatology), anyone who has a sufficient experience in cosmetology will suffice. Take care to avoid quack doctors and ask your friends to guide you in finding an effective practitioner. It is important to identify the type of acne you're suffering from (Acne rosacea, Acne vulgaris... ) as well as the true severity of your condition. When it comes to our own appearance, we tend to turn small aberrations into scenarios of life and death.
Another important reason to visit a dermatologist is to verify that you are actually suffering from acne. For example, some people just have large openings of the sebaceous ducts (known as sebaceous filaments) which greatly resemble blackheads, but the treatment for each condition is different and it is important to identify exactly what you are suffering from before starting your treatment.
3) Keep your skin clear: Most people will tell you to wash your face repeatedly and use exfoliating scrubs. While hygiene is definitely important, excessive use of these products will just end up irritating your skin and will probably worsen the problem. Washing your face to prevent acne is less about cleaning your skin and more about keeping your pores clear. Washing your face with water or a mild soap two to three times a day should be more than enough. Try to time these washes so that you rinse your face every time you sweat up a storm while exercising or spend too much time in the sun.
4) Know your medicine: There are numerous over the counter and prescription drugs for acne. Despite what the promotional campaigns may tell you, there is definitely no "best" medication against acne. Most medications contain the same active ingredients and have only small variations in their compositions. So the efficacies of these vary greatly from person to person. If you find one that is useful for you, stick to it. If you find that your current medication is ineffective, try a different composition. But be patient and realistic. This problem is not going to solve itself overnight.
The most important step in choosing your medication is examining the active ingredients. A good acne medication should contain Benzoyl peroxidase, Salicylic acid or both. That is unless your dermatologist has prescribed something else. Then give that a try first; it's probably something specific to your condition. Once you've found a medication that works, remember not to overdo it. Excessive use of these products will just irritate your skin leading to excess shedding of cells, and once again - more acne.
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