Treatment of Acne
June/July -07- newsletter
Acne starts as an inflammation in the
follicles of the sebaceous (oil) gland on the skin. It is
usually related to sudden hormonal changes at the onset of puberty or later on
due to other factors like stress, increases of P. acnes bacteria on the
surface of the skin, and or very active oil glands. The
skin is the largest organ of the body and most exposed to the elements and the
outside environment. Just like our internal organs the skin
has some very special functions. We will review these since it’s important for
a better understanding of acne treatments, and to better find an acne solution
that will meet your needs. About 70 % of individuals with acne do not follow
up on their treatments and give up for lack of satisfaction with their home or
prescribed treatments.
The following are the six primary
functions of the skin and how they relate to the onset of an acne skin
condition.
Heat regulation-The skin regulates body temperature and going from one
temperature into another does affect how natural oils released affect the skin. Excess oils on top of the surface could plug follicles. For example, you could be outside in the sun one minute and later in an air conditioned room. During a cold winter day you may walk into a heated room and a few seconds later be out in the snow. These daily stressors over time do contribute to natural skin changes, and surface irregularities. Even with perfect skin eventually a preventive skin care treatment program may be needed.
Absorption-The skin limits the amounts of substances entering or leaving the
outer layer (epidermis), so excess oils on the surface could block the skin’s
ability to release or absorb moisture or new oils.
Secretion-Sweat glands and oil follicles need to excrete natural oils and
moisture that when mixed as in outer sebum it forms part of the acid mantle of
the skin and its acidic ph. preventing bacteria from multiplying. The skin is the
first line of defense in the body against disease. So too much drying or too
much washing of the skin without balanced ph skin care products could
aggravate acne and lead to other skin conditions.
Protection-The epidermis and dermis and the subcutaneous fatty layer provide
insulation and protection against trauma. The skin also protects itself from the harmful effects of the sun by melanocytes producing Melanin at the basal layer under the epidermis that helps absorb UV radiation and serving as a shield to protect the body. Too much heat and over stimulation with harsh cleansers could trick the skin to sense trauma and release extra pigment and lead to hyper-pigmentation and discolorations. Ethnic skin and acne skin conditions are more sensitive to developing some forms of discoloration such as red or dark spots.
Excretion-Perspiration is the process by which the sweat glands excrete waste
materials and also helps cool the body. Hard or thick oils could also block perspiration and contribute to extra bacteria on the surface of the skin leading to an acne condition or the spread of acne across the surface.
Sensation-Irritation or painful inflammation is what prompts many to seek
relief and care for the newly forming acne problem.
If we review closely the above functions and their roles on our daily lives we
see that there are factors that could be avoided or corrected with some
preventive skin care.
The 4 major pathological features of acne that could be corrected or addressed
are:
a)
Hyperkeratinization-extra cell build up on top, or cells not
exfoliating soon enough blocking the follicle or the pores. A topical therapy
such as with a cleanser that is ph. balanced and that has some alpha-hydroxy
acids that are hydrating and yet help increase cell turn over such as lactic
and citric acid infused with aloe, cucumber or other botanical to make it
gentler on the skin. Excess cells block the pore and make the oils trapped
harder creating comedones.
b)
Sebum production-excess oils that are not cleared continue to block
other follicles thus spreading the acne across the skin. Over stimulation of
cleansing acne skin with high alkaline but oil drying soaps exacerbate and
increase instead of decrease oil production. The skin sensor
nerve endings get a false temporary reading of dryness and stimulate the oils
glands to produce even more oil. This creates a vicious circle and frustration
and one of the reasons many get frustrated and abandon their treatments.
Skin can be oily and still be dehydrated.
c)
Bacterial proliferation-Excess bacteria and in particular P. acnes
release irritating by-products such as free-fatty acids and bacterial proteins
that cause inflammation in the follicle. P. acnes will not
survive near oxygen and a cleanser or cream with benzoyl peroxide functions
similarly to hydrogen peroxide bubbling oxygen on the skin. The formula may be
blended with a botanical such as aloe or cucumber extract so that is milder. The FDA is conducting more studies for benzoyl peroxide since its irritating and seems to promote tumor growth factors when it was applied to mice and studies with laboratory animals. However, this involved mostly cream application that rested on top of the surface for a longer period of time. The research done with Physicians Choice would only use Benzoyl peroxide 5% only as a Cleanser so that is not resting on the skin but only rinsing off right after the wash. It still has enough time to do its job and is available to be purchased separetely. We do not include this in our acne kit and specially since this particular cleanser may be best used only once or twice a week for those with a more aggravated condition. In our kit the acne gel is what we use as an anti-bacterial agent and not the benzoyl peroxide. Please note that many studies did show it reduced P.acnes and it was used effectively for about 20 years.
The benzoyl portion of the compound is what brings the oxygen down into the bottom of
the follicle where P. acnes tend to reside and it does not survive. Ethnic skin also benefits from the cleanser type since the irritation by a cream in addition to possible sun exposure could stimulate the melanocytes to produce melanin and cause hyper pigmentation. The regular acne cleanser in our system without benzoyl will perform its job and then rinse off nicely without residue. The skin will then be ready for the application of a toner that has lactic and citric acid infused with aloe to help gently exfoliate and keep the cells from building up and occluding the follicles. An acne gel is our preferred method of a stay on the skin acne treatment. It absorbs nicely and won’t interfere with daily make up or cosmetic application. Many gel formulations to include the one we carry have an anti-inflammatory such as salicylic Acid and natural antibacterial agents such as Azelaic Acid. Azelaic acid is also a natural skin brightener that helps reduce some of the discoloration or redness associated with acne. For a moisturizer an oil free formula that leaves a nice matte finish works great
and ours has magnesium ascorbyl phosphate a stable fat soluble type of vitamin
C that stimulates skin repair and protects the cell membrane.
d)
Inflammation-This is the leading cause of acne scarring if cystic acne is not
drained properly and if a rupture occurs inside of the follicle. P. acnes is the leading cause of inflammation and it’s by products that get released deep inside the follicle. Antibacterial and anti-inflammatory ingredients help fight, supress and reduce the amount of bacteria that cause inflammation.
In summary Acne is a complex but manageable skin condition and a positive
outlook and a daily at home care with periodic professional visits ensures
success. In section 2 we will cover different types of acne and other
interesting information. The acne kit we have is effective for all types and we have a special license to carry these professional formulated products. Article by Theresa@airtanbeachstore.com
Licensed Esthetician.