What Causes Acne Lesions?

By | April 6, 2018

In order to properly treat acne, we first need to learn some simple anatomy of the skin. A good place to begin is at the surface, it’s called the stratum corneum. It’s composed of dead skin cells known as keratin, which acts as a protective layer for the underlying living cells.

These living cells are in what is called the spiny layer. It was given this name because when viewed under a microscope they appear to contain a series of little bridges. As we continue moving deeper through the epidermal layers (the outer layers of your skin) we come to the second layer – referred to as the basal cells.

These cells are constantly dividing and moving closer to the skin’s surface. All these cells are known to do is grow and divide. On their way to the surface they mature and eventually become part of the dead outer layer known as the stratum corneum. This maturing process isknown as keratinization.

To understand the physical changes causing acne, we need to look at the microscopic processes that produce it. We all know that our skin has pores, dermatologists call them follicles. Imagine the follicle as an empty tube (they may or may not contain small hairs) extending from the top layer of skin down deeper into the dermis.

This deeper layer of skin, the dermis, is comprised of collagen and elastin, which support the surface layer of the skin and provide a home for the blood vessels, nerves and other cells. Just under the dermal layer is a layer of fat that cushions and insulates the skin and contributes to the rounded look of a youthful face. The pore (or follicle) originates from the dermis as a tube. The sebaceous glands branch off of these tubes like little clusters of grapes. They are responsible for producing an oily substance called sebum.

Now that we understand this let’s look at what causes acne. Many dermatologista believe that the primary cause of acne is something called retention hyperkeratosis. This occurs when the dead skin cells on the top layers of skin, and also within the follicle, do not exfoliate naturally. When this occurs, the keratin (dead cells) mixes with sebum making it viscous and sticky, clogging the follicle to become what is known as a comedo.

These comedos come in two types: closed comedo (whitehead) and open comedo (blackhead). If the lesion is able to drain to the surface it will eventually heal. If it can’t it may develop into a papule and then finally into a pustule which is commonly known as a pimple. The inflammation may progress further and cause the lesion to grow further through the dermis resulting in a cyst or nodule.

This is due to bacteria infiltrating the comedo. It breaks down sebum into fatty acids resulting in a condition known as oxidative stress in the surrounding cells. Oxidative stress is caused when free radicals overwhelm the anti-oxidants, which are the natural defense system of the cell. This results in changes to the redux status, which is responsible for maintaining the balance of the cell by controlling the balance between free radicals and antioxidants.

Under oxidative stress a chemical chain reaction takes place that causes a gene to be turned on which leads to inflammation chemicals called cytokines to be produced at the cellular level. This process leads to stickiness within the follicle, which results in the beginning of the comedo.

David writes about health and wellness issues on various websites. His website Acne Scar Removal explains the latest on quick, safe and effective acne treatments. His site also lists many great home remedies for acne.

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