Try Our Battle Plans for Blemishes
By Paula Begoun, Prevention
Intro
There's no way around it: One of the most worrisome and prevalent skin care problems many women suffer through at some time in their lives is acne. Whether it's blackheads, whiteheads (white bumps that do not contain pus and are not swollen or red), papules (inflamed, red, raised bumps that do not contain pus), or pustules (inflamed, red, raised bumps that contain pus), blemishes are commonplace skin imperfections.
The language may not be pretty, but acne affects approximately 95 percent of the population at some point during their lifetime. This common disorder can range from mild to severe, can sometimes cause extensive scarring, and can occur anywhere between the ages of 11 and 50.
Regardless of your age, gender, skin color, or ethnicity, what causes acne is the same across the board. As a result, there are certain basics for fighting breakouts that are essential if you are going to have any chance of winning the battle. To create a plan of action—and it does take an organized plan of action—it is essential to let go of the inaccurate but persistent and pervasive information concerning blemishes and instead learn what really can help your skin. You can't choose wisely if you don't know what you're fighting against.If you don't understand all your options and don't focus on what can work and what can't, you will end up making the condition worse than it was to begin with, or find temporary relief, only to have the problem show up time and time again.
The Three Myths about Blemishes
First and foremost, you need to get over three myths about treating breakouts—because not only will they fail to prevent or eliminate a blemish, but they can also cause a whole range of additional skin problems.
The first myth is the notion that you can dry up a blemish.
Water is the only thing you can dry up and a blemish has nothing to do with being wet. Skin cells, however, do contain water, and when you dry up the skin you are really drying up the water in the skin cell. Drying up skin impairs the intercellular matrix (skin's protective barrier), which can increase the presence of bacteria in the pore and cause flaking and a tight, dry feeling. None of that stops breakouts but it can lead to irritation and add another predicament to your skin care woes. What's true is that blemishes can be aggravated by oil production, which needs to be reduced and/or absorbed. Absorbing oil on the skin or in the pore is a radically different process from drying up skin.
The second myth is that blemishes are caused by dirty skin.
Unfortunately, this mistaken belief causes harsh overcleaning of the face with soaps and strong detergent cleansers. That only increases the risk of irritation and dryness, and doesn't do anything to prevent blemishes. Not only that, the ingredients in bar cleansers and soaps that keep them in a hard bar form can clog pores and actually cause breakouts. The truth is that gentle cleansing and overall gentle skin care are critical to getting breakouts under control.
The third myth is that you can spot-treat blemishes.
Sadly, lots of products are based on this concept. However, once you see a blemish, you can't just zap it into oblivion. For most types of blemishes (other than those created by an immediate reaction to a cosmetic or some other topical irritant or sensitizing reaction), by the time it shows up on the surface of the skin, it has been at least 2 to 3 weeks in the making. The truth is, it takes time for conditions in the pore to create a blemish. If you don't understand and you don't learn how to deal with that somewhat lengthy process, you can't successfully tackle recurring breakouts. Dealing with only the blemishes you see means that the blemishes that are forming won't be stopped.
Remember, you can't dry up a blemish because it isn't wet, and irritating ingredients not only may make matters worse by creating more redness and swelling, but also hurt the skin's ability to heal. The best course of action is to work on the cause of the blemish, not the aftermath.
What Causes Blemishes?
What truly causes breakouts? There are four major factors and one minor one that contribute to the formation of blemishes.
1. Hormonal activity
2. Overproduction of oil by the oil gland
3. Irregular or excessive shedding of dead skin cells, both on the surface of skin and inside the pore
4. Buildup of bacteria in the pore
Less likely to cause problems but still a problem for some is:
5. Irritation or sensitizing reactions to cosmetics, specific foods (rarely), or medicines
Fundamentally, this is how a blemish occurs. Inside an oil gland a type of bacteria called Propionibacterium acnes (or P. acnes) finds a perfect environment for growth. Dead skin cells and excess oil in the oil gland provide just the kind of conditions that P. acnes needs to thrive. As P. acnes reproduces, irritation and inflammation occur, which is why most blemishes are red and swollen.Each hair follicle grows from a sebaceous (oil) gland that secretes an oily, firm wax called sebum. The structure that the oil gland and hair follicle share is called the pilosebaceous duct or unit, more popularly referred to as a pore.
When things are going well, the sebum smoothly leaves the pore and imperceptibly melts on the skin's surface, helping to keep the skin surface moist and smooth. When things aren't going well, as when the pore becomes plugged with sebum and dead skin cells and bacteria run amok, a blemish is the outcome.
Surplus sebum is generated primarily by hormonal activity. When too much oil is produced, it can become mixed with dead skin cells from the skin's surface, with poorly sloughed skin cells from the pore's lining, and with small pieces of hair debris from the follicle. This combination of sebum, dead skin cells, and small pieces of hair can clog the pathway out of the hair follicle/oil gland, creating quite a backup. Now you've got problems.
When your body produces too much oil, and dead skin cells on the surface of skin or inside the pore aren't shed normally, they can join together in blocking the exit from a pore. All this excess oil and dead skin cells solidify as a soft, white substance that plugs the pore. If the surface of the pore is covered by skin, it is called a whitehead (milia). If the pore is open, without any skin covering, the top of the plug is exposed to air and darkens, causing a blackhead.
Whiteheads and blackheads become pimples when P. acnes begins growing inside the plug, causing irritation and inflammation. This inflammation and excess oil causes the wall of the oil gland to rupture, spilling the contents (oil, cell debris, bacteria, and all) into the surrounding skin tissue. The body's immune system then responds, sending lymph to the inflamed area to help with repair (and causing swelling), and you now have a pimple.
There's no way around it: One of the most worrisome and prevalent skin care problems many women suffer through at some time in their lives is acne. Whether it's blackheads, whiteheads (white bumps that do not contain pus and are not swollen or red), papules (inflamed, red, raised bumps that do not contain pus), or pustules (inflamed, red, raised bumps that contain pus), blemishes are commonplace skin imperfections.
The language may not be pretty, but acne affects approximately 95 percent of the population at some point during their lifetime. This common disorder can range from mild to severe, can sometimes cause extensive scarring, and can occur anywhere between the ages of 11 and 50.
Regardless of your age, gender, skin color, or ethnicity, what causes acne is the same across the board. As a result, there are certain basics for fighting breakouts that are essential if you are going to have any chance of winning the battle. To create a plan of action—and it does take an organized plan of action—it is essential to let go of the inaccurate but persistent and pervasive information concerning blemishes and instead learn what really can help your skin. You can't choose wisely if you don't know what you're fighting against.If you don't understand all your options and don't focus on what can work and what can't, you will end up making the condition worse than it was to begin with, or find temporary relief, only to have the problem show up time and time again.
The Three Myths about Blemishes
First and foremost, you need to get over three myths about treating breakouts—because not only will they fail to prevent or eliminate a blemish, but they can also cause a whole range of additional skin problems.
The first myth is the notion that you can dry up a blemish.
Water is the only thing you can dry up and a blemish has nothing to do with being wet. Skin cells, however, do contain water, and when you dry up the skin you are really drying up the water in the skin cell. Drying up skin impairs the intercellular matrix (skin's protective barrier), which can increase the presence of bacteria in the pore and cause flaking and a tight, dry feeling. None of that stops breakouts but it can lead to irritation and add another predicament to your skin care woes. What's true is that blemishes can be aggravated by oil production, which needs to be reduced and/or absorbed. Absorbing oil on the skin or in the pore is a radically different process from drying up skin.
The second myth is that blemishes are caused by dirty skin.
Unfortunately, this mistaken belief causes harsh overcleaning of the face with soaps and strong detergent cleansers. That only increases the risk of irritation and dryness, and doesn't do anything to prevent blemishes. Not only that, the ingredients in bar cleansers and soaps that keep them in a hard bar form can clog pores and actually cause breakouts. The truth is that gentle cleansing and overall gentle skin care are critical to getting breakouts under control.
The third myth is that you can spot-treat blemishes.
Sadly, lots of products are based on this concept. However, once you see a blemish, you can't just zap it into oblivion. For most types of blemishes (other than those created by an immediate reaction to a cosmetic or some other topical irritant or sensitizing reaction), by the time it shows up on the surface of the skin, it has been at least 2 to 3 weeks in the making. The truth is, it takes time for conditions in the pore to create a blemish. If you don't understand and you don't learn how to deal with that somewhat lengthy process, you can't successfully tackle recurring breakouts. Dealing with only the blemishes you see means that the blemishes that are forming won't be stopped.
Remember, you can't dry up a blemish because it isn't wet, and irritating ingredients not only may make matters worse by creating more redness and swelling, but also hurt the skin's ability to heal. The best course of action is to work on the cause of the blemish, not the aftermath.
What Causes Blemishes?
What truly causes breakouts? There are four major factors and one minor one that contribute to the formation of blemishes.
1. Hormonal activity
2. Overproduction of oil by the oil gland
3. Irregular or excessive shedding of dead skin cells, both on the surface of skin and inside the pore
4. Buildup of bacteria in the pore
Less likely to cause problems but still a problem for some is:
5. Irritation or sensitizing reactions to cosmetics, specific foods (rarely), or medicines
Fundamentally, this is how a blemish occurs. Inside an oil gland a type of bacteria called Propionibacterium acnes (or P. acnes) finds a perfect environment for growth. Dead skin cells and excess oil in the oil gland provide just the kind of conditions that P. acnes needs to thrive. As P. acnes reproduces, irritation and inflammation occur, which is why most blemishes are red and swollen.Each hair follicle grows from a sebaceous (oil) gland that secretes an oily, firm wax called sebum. The structure that the oil gland and hair follicle share is called the pilosebaceous duct or unit, more popularly referred to as a pore.
When things are going well, the sebum smoothly leaves the pore and imperceptibly melts on the skin's surface, helping to keep the skin surface moist and smooth. When things aren't going well, as when the pore becomes plugged with sebum and dead skin cells and bacteria run amok, a blemish is the outcome.
Surplus sebum is generated primarily by hormonal activity. When too much oil is produced, it can become mixed with dead skin cells from the skin's surface, with poorly sloughed skin cells from the pore's lining, and with small pieces of hair debris from the follicle. This combination of sebum, dead skin cells, and small pieces of hair can clog the pathway out of the hair follicle/oil gland, creating quite a backup. Now you've got problems.
When your body produces too much oil, and dead skin cells on the surface of skin or inside the pore aren't shed normally, they can join together in blocking the exit from a pore. All this excess oil and dead skin cells solidify as a soft, white substance that plugs the pore. If the surface of the pore is covered by skin, it is called a whitehead (milia). If the pore is open, without any skin covering, the top of the plug is exposed to air and darkens, causing a blackhead.
Whiteheads and blackheads become pimples when P. acnes begins growing inside the plug, causing irritation and inflammation. This inflammation and excess oil causes the wall of the oil gland to rupture, spilling the contents (oil, cell debris, bacteria, and all) into the surrounding skin tissue. The body's immune system then responds, sending lymph to the inflamed area to help with repair (and causing swelling), and you now have a pimple.
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