When bacteria enters the pores the body attempts to combat this by bombarding the affected area with white blood cells, lymph and sebum to kill the bacteria and wash it out of the system. Acne lesions will occur if the pores block during any part of the process.
This is shown in the short video clip below:
What are the types of acne lesions?
The basic acne lesion is a non-inflamed and often mild skin blemish called the ‘comedo’, which is simply an enlarged/plugged hair follicle. There are two types of comedo:
1. Open Comedo (Blackhead) - Mild
A comedo that reaches the surface of the skin and breaks through is called an open comedo. Due to its black discolouration on the skin’s surface it is also known as a ‘blackhead’, which is a result of the buildup of cells and sebum reacting with oxygen. It is not darkly coloured from dirt.
2. Closed Comedo (Whitehead) - Mild/Moderate
If the plugged follicle, or comedo, stays beneath the skin, it is called a closed comedo. The appearance is a white bump called a ‘whitehead’ because it is unopened to the surface and the buildup of cells and sebum trapped inside are not exposed to the air.
Other troublesome acne lesions can develop, which are inflamed pus-filled lesions that can range in severity:
3. Papule - Moderate/Severe
The follicle can no longer contain the contents that are building up and have nowhere to go. There is a local immune reaction which causes an inflamed lesion that appears as small pink bumps on the skin surface and can be tender to the touch.
4. Pustule - Severe
The blockage of the papule increases to such an extent, causing the follicle to burst and leak the contents into the surrounding area. This further increases inflammation and encourages a large collection of white blood cells and growth of bacteria, which combine to produce a yellow pus-filled lesion.
5. Nodule - Severe/Very Severe
More severely, a papule or pustule can completely collapse or explode, severely inflaming the surrounding skin and may engulf neighbouring follicles, causing deeper inflammation.
An improper healing process can lead to a nodule, a large red, painful and solid lesion that is lodged deep in the skin
6. Cyst - Very Severe
A deep, painful, walled-off pus-filled lesion that has an increased risk of scarring. Sometimes pitted scars persist after the lesion heals.
Whilst this is a good explanation of the development and types of acne, it does not provide any insight into its cause.
What causes acne?
A dermatologist once described acne to me as a disease. She was convinced that acne was simply something which sufferers had to accept and live with. She truly believed that some of us would live with acne for the majority of our lives, until it ‘burned out’ of its own accord.
Unfortunately, her belief is one that is shared by many conventional dermatologists and as such, this view has been accepted as fact by society. This attitude suggests that we are powerless to find the root cause of our skin conditions. Treatments prescribed by the majority of dermatologists reflect this - they are, in most part, designed to suppress rather than cure.
The conventional approach: hormones and the sebaceous glands
Other than the palms of the hands and the soles of the feet, the entire body is covered with sebaceous glands, which secrete sebum into the hair follicles. Sebum works like an oil and lubricates the hair and the skin, giving the hair flexibility and vitality, and providing for the elasticity of the skin. Sebum also has several anti-bacterial properties that work to kill infections absorbed through hair follicles and skin.
It is commonly believed that during puberty, the sebaceous glands in some people become over active, and begin to secrete excessive amounts of sebum into the hair follicles.
As already discussed, it is then supposed that the excessive amounts of sebum excreted from the glands will clog the pore, trapping the infection underneath. Once this occurs, the body bombards the infection with lymph and white blood cells, forming a white head.
This has led to the accepted belief that increased sebum production causes acne, which is reflected by the common treatments that are prescribed by dermatologists.
Conventional treatments: reducing sebum production
Several prescribed drugs, such as Accutane and other external creams actually target the production of sebum, and prevent or lower its production in an attempt to control acne.
I have had personal experience with this type of medication, having been prescribed three courses over a period of two years. The months in which I was taking the drugs was the worst period of my life. The side effects were horrendous.
My skin dried out so much that I would experience frequent burning sensations. My lips and the corners of my mouth dried out and cracked severely enough to cause bleeding. My eyes were permanently dry and uncomfortable. I would experience regular nosebleeds. The skin over my knuckles and elbows would crack open whenever I made a large physical movement.
At this stage, my acne became extremely severe and looking back, I feel the Accutane and these side effects contributed to my psychological problems. I have several friends that have used the same medication. All have had much the same experience. None have been cured of acne.
But if acne is caused by hormones, what about acne in adults?
The common view that acne is a ‘teenage problem’ dictated by hormones fails to explain why:
- There has been a significant increase of acne sufferers in the last half century.
- The largest rise is among adults.
- Millions of adults who escaped acne during adolescence are experiencing acne for the first time.
It also fails to explain why in my late twenties I suffered with my worst bout of severe acne:
The Natural Dermatology approach: body toxins, the liver and the gut
I believe that acne is the result of two deficiencies in the operation of the body.
1. Inefficiently operating filtration system (A poorly functioning liver).
2. Inefficiently operating digestive system (A poorly functioning gut).
Aspects of a person’s lifestyle lie at the root of these deficiencies.
- The body being overloaded with toxins (Poor dietary choices).
- The body being overworked and receiving a lack of maintenance (Stress).
Acne can be monitored and contained by addressing each of these areas.
If that’s true, why is acne linked to adolescence and more common during puberty?
Adolescence is a period of significant physical change during which the manifestation of acne generally worsens. Unfortunately this is also the time in life when people are most concerned about their appearance, so a condition such as acne can have serious emotional and social effects. The emotional stress caused by psychological issues can further worsen the acne that the teenager already suffers.
As puberty begins, blood pressure, resting heart rate and respiration all raise to assist the body with its development and growth. These changes will all reduce towards the end of puberty, however whilst they are in a heightened state the body is constantly under a higher level of internal stress than it has ever faced. The most immediate effect of this is that the digestive system will begin to operate in a less efficient manner.
Since the body is developing at such a rapid rate, the required food intake increases. As the child consumes greater quantities of food, more toxins will be absorbed. Further, the complicated process of building and developing the body produces waste products that need to be eliminated. These processes increase stress within the body, and require more input from the filtration system. If the filtration system is not performing optimally, the body will eventually begin to excrete toxins through the skin.
Puberty causes an increased toxic burden
Despite it being commonly believed that acne is caused by the sebaceous glands being over active, during the onset of puberty, the body realizes it is susceptible to an increase of internal stress levels, and develops at a heightened rate thus, increasing the toxic burden on the body.
As a result, any increase in activity by the sebaceous glands is the body’s way of flushing out the toxins.
Contaminated sebum, not excessive sebum
The problem occurs when the sebum itself becomes contaminated with toxins, body fats and dead skin cells, which will cause it to thicken, so much so that it cannot exit the hair follicle. When this occurs, the follicle will block, resulting in the common pimple. The elements contaminating the sebum, rather than the sebum itself, are what result in the formation of pimples.