Understanding Your Skin

The layers of your skin perform a complex number of functions to shield the body from injury, and maintain and regulate internal conditions.

The skin is broken down into distinct layers, the outer most being the epidermis consisting of the stratum corneum.  New skin cells develop in the lower portion of the epidermis and gradually rise upward to the stratum corneum where they are sloughed off and replaced by new cells rising from below.

Below the epidermis is the much thicker dermis, which contains sweat glands, oil and sebaceous glands along with blood and lymphatic vessels.  This layer is the area where the signs and symptoms relating to acne can begin.

Acne is a multifactoral problem

There is not one simple, identifiable cause for acne.  Over the years researchers have identified four key events or stages that seem to interact in the development of acne;

STAGE 1: Over production of sebum (secretion of the sebaceous gland)

STAGE 2: Abnormal desquamation (shedding of the skin)

STAGE 3: Proliferation of propionibacterium acnes (p.acnes-anaerobic bacteria)

STAGE 4: Inflammation (tissue reaction to infection)

Different grades of acne

The following represents a common method for classifying or grading acne:

GRADE I OR NON-INFLAMMATORY ACNE - is characterized by the presernce of open and closed comedones (blackheads).

GRADE II ACNE - the presence of comedones in combination with in-flammatory lesions; superficial pustules (skin elevation containing pus) and pustules and papules.

GRADE III ACNE  - is characterized by more severe inflammation and widely distributed pustules and papules.

GRADE IV ACNE - is the most severe and is usually referred to as severe recalcitrant cystic acne.