The Blemish Battle

By Dixie Medford, P.C.C.D

Those who are unhappy with their skin often just sigh and suffer.  Why, at 35, do they have incessant blackheads and breakouts that won’t go away no matter what they do?

Why haven’t they outgrown the blemishes and oily skin that has plagued them since the age of 14?  Women who hate their hair get a haircut, women who want to physically look better join a gym, but suddenly at the age of 48 they still have blemishes.  Why?

Acne occurs when oil glands within the skin becomes plugged.  The most active sebaceous glands, which are most acne-prone, are located on the face, chest and back areas.  Sebaceous glands are attached to every hair follicle on the body.   These glands produce sebum or what we refer to as oil.   Normally sebum flows continuous out of the sebaceous glands up through the follicle and out of a pore to the skin surface. There the sebum melts on the skin’s surface, moisturizing and smoothing the face and body in the most natural, pure, and compatible way possible.   Acne occurs when the path gets blocked and sebum cannot reach the skins surface.  The main contributor to blockages is strictly follicle skin scales and a thickened sebum. 

When the body produces too much sebum, and dead skin cells or hair debris aren’t shed normally, they can block the exit from a pore.  All this excess solidifies as a soft, white substance.  This plug then blocks the pore, causing the walls of the sebaceous duct to bulge and the surface to swell.  If the surface of the pore is covered by skin, it is called a whitehead or milia. If the pore is open with no skin covering it will become dark, and is known as a blackhead or comedones.

Milias or comedones become pimples when the plug grows too large, and the wall of the duct ruptures.  A bacterium called P Acne or Propionibacterium acne lives inside the pore.  It ruptures and along with the excess sebum, dead skin cells, and hair debris causes infection.  If the rupture takes place deep inside the pore instead of near the surface of the skin, it forms cystic acne; which is a boil like infection.

What truly causes breakouts?  There is no question that hormone activity is responsible for oily skin and breakouts.  Breaking out is definitely most prevalent in adolescence.  Statistics show that three out of four teenagers have various forms of acne or problems with breakouts.  Adolescence is a time of tremendous hormonal changes that stimulate sebaceous glands and increase oil production.  It is also noted that one in five adults between the ages of 25 and 45 experience acne, and nearly half of all adult women experience mild to moderate acne.  Anything that raises hormone levels such as stress, menstrual cycle, pregnancy, birth control pills or certain medications can produce blemishes.  Progesterone and androgens, male sex hormones that can also be found in females tend to create acne problems. 

However, hormones alone are not enough to create these skin problems.  Something unknown goes wrong in the sebaceous gland, which is activated and made worse by the hormones.  These unknown reasons are thought to be related to genetic predisposition, creating a defective gland, impaired skin or sebaceous gland lining that does not shed properly, or the abnormal sebum is too thick or irritating to the skin.

There is little evidence that diet affects acne.  However, food allergies can certainly be a problem.  Likewise, alcohol consumption, caffeine, smoking cigarettes, lack of vitamins, and poor eating habits affects everyone’s skin.  If certain foods such as shell fish, milk products, or wheat seem to worsen acne it is best to avoid them one by one to see if that makes a difference.  Hair products can cause breakouts around the hairline, and fluoride in toothpaste has been known to be a problem around the mouth.

Teenagers as well as adults often seek relief from their breakouts by going to the drug store or cosmetic counters where acne products are shelved.  Many products promise clear skin by stopping breakouts, drying up blemishes, and slowing down the production of oil.  Many of these products are irritants and can actually worsen the problems for sensitive skin. Ingredients that show up repeatedly include; alcohol, salicylic acid (a peeling agent), benzoyl peroxide (a disinfectant), sulfur (a mild antiseptic), boric acid (a toxic antiseptic), camphor, menthol, clove oil, and eucalyptus.  By contacting a skin care professional these individuals have access to the latest advancements in skin care technology.  They have an arsenal of effective methods and products to reduce sebum production, create healthy skin-cell turnover, and fight bacterial infection.  Blemish treatments work by reducing sebum production, speeding up skin cell turnover, and fighting bacterial infection.  Products lines such as MD Forte, Obagi and Skin Ceuticals are formulated with pharmaceutical grade ingredients and are known to be best at combating challenges with acne.  Prescription treatments such as Retin-A, Differin, Azelaic Acid, and topical antibiotics have proven to be extremely effective, and are only available through doctors. 

It is best to leave extractions to a skin care specialist.  Dermatologists and estheticians are trained professionals and know the best treatments for your skin.  Many procedures are now available from Microdermabrasion, Foto Facial to Chemical Peels.  Glycolic is a well-known acid that exfoliates surface skin cells to smooth and refine skin. Microdermabrasion is another option for combating blemishes.  The gentle abrasive action of the crystals and the suction combine to remove the dead outer layer of your skin, while bringing newer, fresher skin to the surface.   

No one will argue acne isn’t disruptive or emotionally upsetting.  Whether your 14 or 45 skin care specialists agree your best defense against the blemish battle is to watch your diet, drink lots of water, avoid known irritants to the skin, commit to a good skin care regimen and continue with the supervision of a skin care professional.