Acne - How Does It Start?
The surprising thing is even in this modern era - men on the moon, library of congress on a pinhead and whatnot - no one really knows. It's a mystery why the same amount of oiliness and bacteria can coexist peacefully on one person's skin, while on another's... see picture at left.
So granted, we may not know the How of it, or specifically the Why of it, but we know the Where of it. The pore, or the pilosebaceous duct as it’s affectionately called, is acne’s ground zero. People with acne have skin cells that are, for whatever reason, especially sticky, and they mix with the skin’s oil (aka sebum) which tends to be more solid for acne sufferers – think of oil used in the kitchen, it can be runny, like vegetable oil, or solid, like Crisco - with acne sufferers it’s Crisco. This unappetizing mixture forms a cork in the pore.
Once this cork is in place, the pore is blocked from oxygen and while the oxygen's away, the bacteria thrive, feasting on sebum, and excreting all sorts of irritating byproducts. The irritation brings inflammation, which as any skincare professional will tell you, is a double-edged sword. This call-to-arms kills off the bacteria, but it comes at the price of redness, puss, and swelling that may seal shut surrounding pores and start a cascade of acne.
So cast a wary eye at anyone who claims there is a cure for acne. There isn’t one, at least not yet. It’s a matter of understanding the skin’s genetic response, both when it comes to the production of sebum and it’s reactivity to the bacteria in the pores.
That's why doctors often refer to 'managing' acne since we’re left treating the symptoms, not the cause. In the next article we'll discuss one of these treatment programs - the ubiquitous Proactiv Solution System, touted as “The Answer for Acne”…. (Acne’s question must have been: how do I make two dermatologists obscenely wealthy?)
