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Beauty, Science

All about Acne: the microscopic war that never ends

You may have seen my last post all about skin where I mentioned how the skin will always pump out sebum in response to anything, everything and just because it can, and that this can occasionally blocks pores and cause some damage. I figured to dedicate a separate post to acne so we can have some real talk about that thing that ruined many a life in high school, and left many more of us crying in the bathroom about how unfair our face is  – no, not bullying or the sad scene when Troy had to choose singing or basketball in Highschool Musical, I’m talking about acne.

PIMPLES

Literally me*

If you haven’t seen the last post explaining the fundamentals of skin then I’ll quickly sum it up:

  • Pores work as the message carrier between your internal body and your skin
  • You have 5 million pores on your body!
  • Some sweat and some get oily with sebum (the fancy term for face-oil)
  • Sebum comes from the sebaceous glands, and is often to blame for acne
  • Sebum also creates a protective barrier on your skin, locking in moisture, keeping the skin waterproof and keeping bacteria out
sebum

As per our friends at Daily Health Post

WHY, SEBUM? WHY?

In case you were still grovelling, shrieking ‘Why me?!’ into your bathroom mirror, calm down, acne is not your fault.  Turns out you CAN blame your hormones, as an over production of sebum is prone to teenager’s skin going through physiological changes or anyone under stress. Remember when I said your skin is an organ? If you’re stressed, your body stresses, and your organs stress.  Stress affects everybody’s body differently, it can be caused by illness, bad food types, and even external stressors like work, family or other commitments. Think about it this way, if your heart rate can go up, and your appetite decreases or goes into overdrive when you’re stressed, why would your skin NOT freak out too?

stress
While your life is falling apart, you’re sick, or just growing some changes, your skin will produce extra sebum in an attempt to ‘help’, because sebum is just ‘such a nice guy’ that way. To make a long scientific story short, excessive stress and fatigue can lead to dryness and epithelial breakdown; to combat this, the body sends out signals for the skin to protect itself and re-hydrate the skin, this results in an over production of sebum and excessive amounts of oil. Most people are aware that the skin contains good and bad bacteria; specifically there is a particular bad bacteria: Propionibacterium acnes, a slow growing, gram-negative bacteria which lives on the skin surface and thrives on sebum. When I say thrives, I mean it – in fact the more oil your pores produce the stronger and bigger this bacteria gets. This battle of bacteria versus sebum results in reddened areas of skin which we would traditionally identify as the start of a pimple and, in a total panic, the pores create even more sebum in an attempt to ‘flush’ the bad bacteria away. This creates a vicious cycle that is essentially, a super small microscopic warzone all across the face, and the battle wounds result in red bumpy pimples and densely packed blackheads.

The good news, is eventually the pores will stop releasing sebum (once they stop panicking), the bad news is sebum slows down slowly- and anyone who suffers from hormonal acne especially during ovulation can vouch: it hits hard and then takes its sweet sweet time leaving! The glacial pace sebum stops coming has positive consequences though; the present sebum starts to get ‘stale’ allowing the older, leftover sebum to break down into natural fatty acids which the P.Acnes guys hate! These fatty acid chains chase down and cling to P.Acnes bacteria and stop them in their tracks, imprisoning them  – burying them alive into your pores instead, so instead of being washed away, they tighten and block the epidermis glands creating a mini bacteria graveyard…all over your face. 
It looks just like a giant, very obvious pimple that will appear two days before an important event.
Once your pores start locking up ugly bacteria in an attempt to destroy them, sebum production slows down to a complete stop as it is no longer needed to fight the good fight and retreats; this is why acne is always worse before it gets better. 

tombstone

…and not a single tear was shed

BEAUTY TIP: The more oil, the more food for those little suckers! Try aim for a mattifying toner or micellar water as part of your skin regime! Try Garnier’s Combo-Oily skin Micellar Water or splash some cash on Clinique’s Toner 3 for reducing pores and oils

At a battlefront, you can imagine how this would look: the sebum was beginning to admit defeat, slow down and retreat – the bacteria was winning; but before the bad guy generals in this microscopic war could celebrate, the sebum called in specialised reinforcements to destroy their enemy once and for all! Obviously, the surviving P.Acnes guys are mad, their buddies are locked in ugly bacteria filled jail cells, and they now plan to get even! As payback they will charge themselves to mimic the fatty acid chains by releasing chemicals that trick your skin cells into no longer recognising them as a threat, instead your pores will welcome them with open arms (with all your pores chanting “One of us! One of us!”) and give them full reign of the surround area (cluster acne anyone?).

SKINCELLS

See, some of your skin cells make you glow, some give you your skin tone, some block bad bacteria from entering the body, and some are in charge of making sure your skin stays hydrated. Others have more important jobs like identifying potential surface invaders like bacteria and viral infections, and destroying them before they penetrate the epidermis. However, the dermis family as a whole is a shifty one and despite usually being dedicated to the job, these skin cells happily take bribes and are easily tricked by the P.Acnes family to look the other way, no longer seeing them, or any other bacteria, as a threat. By dropping its guard the skin can no longer protect itself, allowing P.Acnes to hop from pore-to-pore, inflaming the skin and spreading the contagion. 
This is why some untimely acne breakouts can be worse than others: your skin just doesn’t want to come to the party, has run out of resources for battle, or  the guys manning the gate are asleep on the job. Either way, there isn’t much of a win.

WHY YOU SHOULD NOT POP PIMPLES

I know everyone seems OBSESSED with pimple popping (please, can someone explain why this is a thing?), but it is one of the worst things to do for your skin. Remember we talked about the tiny graveyard? Each white head, black head and nodule represents a little gravestone of each trapped P.Acnes fighter. Simply put:

ACNE IS A SIGN YOUR SKIN IS DOING ITS JOB! LET IT DO ITS JOB!fliptable

*ahem* I digress.

Once the P.Acnes guys have managed to trick your skin cells into letting them through, they start trying to bring more to the party. They will riot to get out of their prisons, creating inflamed and red topped pimples. If they are really pissed off about their teeny-tiny prison, they will produce a whitehead in their effort to break free. This takes a lot of energy and time for the bacteria to do, and they are totally cut off from their food source while in prison. The whitehead encases them, suffocating them, and slowly withers them away. Once a pimple does burst of its own accord, the bacteria will escape, albeit very tired and weary after rioting in its cell, and try find a new available pore to live in that requires little effort; this is when they are at their weakest and usually do not get very far as they are too weak to feed off or fight sebum, and instead stay crippled in the shadows until they can rise up for the next cycle  of acne breakout,  revolution.

BEAUTY TIP: Using drying agents or pore strips will squash the P.Acne resistance after they escape from pore-prison! Remember they busted the walls of their cell pretty well, so they are tired and won’t put up much of a fight. By using drying agents you remove any new sebum for them to go to, and without the strength to re-enter good skin cells or sebum to boost their spirits – they will starve painfully and shrivel up dead

How is this different to you popping a pimple, I hear you ask? When you squeeze a pimple before its prime, you essentially let the prisoners escape early. They haven’t had a chance to tire themselves out. They are mad as hell, are hungry, and have have been contained for so long they are itching for battle, and by ‘smooshing them’ on such a microscopic level, they can get pushed into the fresh skin cells; usually ones they could never conquer without your help! By entering the bacteria into fresh skin cells,  your immune system goes into overdrive (remember they had turned a blind eye before and were packing up to go home, and all of a sudden there are bad guys everywhere!) so they call in white cells to fight them off but it’s too late: and before you know it, you’re at a risk for cystic acne, chronic acne, and long term scarring.

scarface

When googling ‘scarred face’ be specific

It is hard to stop the P.Acnes gang, and don’t be fooled, they are always around no matter how much you wash your face. The trick with most acne treatments is to reduce the production of sebum WITHOUT damaging good skin cells, which, if you’ve ever tried a lot of acne treatments you will know some help and some just don’t: and that is because because not all skin is made equal and a solution that works for one person, will not work for  another.

Sometimes there is excessive sebum production no matter what you do: maybe your body is loving you so hard it wants beautifully hydrated skin and doesn’t know when to stop, maybe it is really worried  about this bacteria and kicks more ass than it needs to; who knows! But it isn’t wrong – remember, it is doing it’s job! 
You  can’t stop your organs from working, so you cannot stop your skin from doing its job.
But you CAN reduce the amount of available bacteria in many different ways. It is not uncommon for those with an overproduction of facial or body acne (particularly on the back and shoulders) to be commenced on antibiotics to help reduce the bacteria growth. If you’re concerned about excessive acne do see your local doctor or consult a professional who specialise in face stuff and skin to really get a good handle on your options or treatment possibilities. 

 ACNE SCARRING

Let the record show: scarring can occur naturally without you having to pop your pimples too.
It’s the end result of too much good stuff trying to fight bad stuff – it is the remnants of war.  The skin cells abandon the damaged sites of prison cells busted open too many times, creating a no-man’s-land, abandoning all potential of replacing the collagen or elastin lost in the ‘war on acne’. It is pretty tempting to pop whiteheads (I personally struggle too, but never pop them) and for some that is what works best to reduce and remove, and for others they simply don’t want a glaring whitehead greeting strangers for three days (and that is okay too, no judgement here!). Scarring becomes a greater concern for some the older the body gets as it becomes more noticeable once the skin begins to lose collagen. I personally see it as a mark of achievement: measuring how much ass your face kicked in the foremost years of your youth. However if you are concerned about it, here are some handy tips to consider:

  • See a specialist, you may be in two minds about it but it may be the best thing to do; remember, specialists are very qualified in their field (more than me!) so if you want some genuine, tailored advice, seek out someone who can give it! 
  • Be careful what you use; some store bought and home acne remedies can remove good skin cells and reduce natural healing mechanisms in the skin, opt for gentle scrubs or pH neautral treatments if possible
  • Consider benzoyl peroxide at low doses for drying acne spots overnight (providing it is safe to do so)
  • Look for exfoliates with glycolic or salicylic acid to brighten and shrink scarred areas 
  • Always seek professional advice before commencing treatment on your face especially if you suffer from excessive, hormonal acne or rosetta
  • Excessive oil production and acne means your face is too busy fighting to carve in any fine lines or wrinkles; so when you’re pushing to a ripe age your face will probably look 20 years younger (so when you met your high school bullies at your 40th graduation anniversary, you can smuggle sit back and know you look so much better than they do) 
  • REALLY IMPORTANT: Love yourself and the skin you’re in, it is beautiful: it is simply just doing it;s job, and that is pretty damn clever

So there you have it: a brief, simplified story of the good, the bad and the bold parts of acne and why it exists! I hope you found this post informative and useful, if you feel anything here is incorrect or could be explained better please do get in touch in the comments below! How do you manage acne scars? I’d love to hear it! 

Thanks for reading, stay shiney!

REFERENCES

(I also got a lot of back up information from previous references in the ‘what is skin?’ article)

American Academy of Dermatology (2017). Acne [webpage], from the AAD database

Alam, M., & Dover, J. S. (2006). Treatment of acne scarring. Skin Therapy Lett11(10), 7-9.

Jacques, R. (2013). How to prevent and get rid of acne scars for good, Huffington Post. Retrieved from the Huffington Post ONLINE database

Jackson-Cannady, A. (2011). Guide to treating acne scars and skin damage, [webpage] from WebMD database

Lewis, V. (2014). The immune system and the skin. Retrieved from thenetdoctor database

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