Why do I have acne?
Acne usually starts at around 12-15 years for boys and 11-12 years for girls, but sometimes as early as 8-9 years.
The hormones produced during puberty, by girls as much as by boys, stimulate the sebaceous glands: they produce excess sebum, rendering the skin oily and shiny. These sebaceous glands are more abundant on the face and torso.
Meanwhile the bacteria mainly responsible for acne - P.acnes - feeds on the excess sebum and spreads. This bacteria plays a central role in acne because it stimulates:
- sebum production. The two phenomenons go hand in hand.
- keratinocyte multiplication (skin cells). The orifice of certain sebaceous glands become blocked. Sebum is no longer able to flow on the skin's surface. This results in whiteheads (mycrocysts or closed comedones) and blackheads (or open comedones).
- As a part of the skin's natural defense mechanism, the comedones become inflamed. Red spots, sometimes painful, appear; as well as whiteheads with pus inside, or even big cysts, with significant abscess.
The P.acnes bacteria is particularly difficult to beat because it has developed an amazing resistance mechanism: it produces a glue-like substance called biofilm that acts as a protective shield. This shield allows the bacteria to resist the skin's natural defenses as well as certain treatments.
This is why acne tends to settle in.
What are the different types of spots?
Microcysts, closed comedones (2 to 3 mm)
These are known as whiteheads. They are caused by an accumulation of sebum, P. acnes bacteria, keratin and skin cell protein. These microcysts may open up and become open comedones. They may also become inflamed and form papules and pustules.
Open comedones (1 to 3 mm)
These are known as blackheads. Their color comes from sebum oxidization. Comedones can burst spontaneously. They rarely become inflamed, except when they are touched.
Papules: inflamed red spots (< 5 mm)
Spots characterized by their size and redness. They are painful and hot when touched. They can resorb or evolve into pustules.
Pustules: inflamed yellow spots (> 5 mm)
Spots with purulent content. They can be emptied and resorbed, but they tend to reappear.
Nodules are seen with the worst cases of acne. They are big, inflamed round spots, that can be felt on or under the skin. They can grow into an abscess; burst and leave residual marks.
How do I know which type of acne I have?
Early acne, also called retentional acne
Hyperseborrhea + comedones + microcysts
Spots appear on the nose, cheeks, forehead and sometimes on the shoulder and the pinna (external ear). Microcysts can sometimes be inflamed.
- Papulopustular acne
hyperseborrhea + comedones + microcysts + papules + pustules
This is the most common form of acne. It is found on the face, the chest and the shoulders. Its degree of gravity depends on its extent. There is a risk of scarring.
- Nodular acne
Comedones + microcysts + cysts + papules + pustules + nodules
This form of acne is more rare, and progressively extends to the neck, to the torso and to the buttocks. Nodules tend to fester. Spots can leave many marks.
The earlier a treatment is started, the better the results will be, and the lower the risk of scarring. Consult your pharmacist or dermatologist for advice. They will know how to guide you and direct you to the best treatment for your type of acne.
Which discovery will revolutionize acne treatment?
Recently, new research has shown that P. acnes has the ability to form into a biofilm. The biofilm is a type of protective shield formed by P. acnes colonies. It acts as a glue that helps bacteria to proliferate, while resisting the organism's natural defense mechanism. This also explains why the P. acnes is able to resist certain treatments. It is therefore particularly important to destroy this biofilm and limit its formation, which would help eliminate acne.
For the skin
All conditions require the help of a health professional for diagnosis and treatment