So What Really is Acne?

Everybody can describe the big spots under the skin called macules, the spots with heads on called pustules, the oiliness, the bacteria, the scars!

But what really causes it?

We probably all know Hormones are part of it, but surprisingly for many your hormone levels don’t change. In fact in 100% of male acne cases and around 70% of female acne cases, hormone levels are the same before, during and after acne.(30% of women who do suffer from hormonal changes are due to poly Cystic Ovary issues).

The true start of acne are physiological changes which make our skin more sensitive to our hormones, particularly a form of the male (androgen) testosterone hormone called DHT (Di-hydro-testosterone). This sensitisation leads to a depletion in lipids and fatty acids in the skin which leak out of the skin and fall off with our dead skin cells. These ‘fats’ help to control the rate that water escapes from the skin. This is called trans epidermal water loss known as TEWL and its critically important in many skin conditions.

So it is true that acne is called by a hormonally triggered loss in the skins ability to control water loss.

If water is escaping too fast from the skin then the skin cells start to suffer and so the skin has to respond. So new cell production increases in the epidermis and this thickens the skin, which slows water loss. Also more keratin (the stuff that makes your nails hard) is deposited in the upper skin cells called keratinocytes and this also slows down water loss. So your ‘horny layer’ becomes hornier. So yes you can say acne sufferers are hornier. The other thing that happens is the skins sebaceous glands increase production of sebum (oil) which flows out of the hair follicle duct onto the skin. This liquid oil also slows down water loss.

The problem is although the skin is thickening upwards, the top layer of skin also lines the neck of the hair follicle duct. So this thickening, narrows the duct and can close it totally. This is exacerbated by the increased number of dead skin cells and oil all combining to help block the duct.

Right now, such a skin would not have acne, but it would have blackheads, whiteheads (closed and open comedones). ‘A congested skin’.

Many bacteria live on our skin and feed on the oil (sebum) we produce, one of these is known as p.acnes. It doesn’t particularly like living on our skin in a high oxygen environment as it prefers a low oxygen environment . However it survives on our skin in a semi dormant state, but it feeds on the oil by secreting enzymes onto the skin and breaking the oil down to glycerol, which is sucks back up as food. What’s left of the oil, as in free fatty acids, just fall off with our dead skin.

However once the hair follicle duct is shut, then food for the bacteria is cut off. So the bacteria migrates under the plug to find the oil and finds a lower oxygen environment and so rather be semi dormant, it starts to reproduce and many bacteria occupy the hair follicle duct, but now the free fatty acids produced from the bacterial enzyme breakdown build up under the plug and trigger the body’s immune response which leads to swelling. This can also lead to the breakdown of the hair follicle duct walls and the bacteria invade the surrounding area, which can result in scarring.

When the bacteria is attacked by antibiotics, other treatments and also by the body’s immune system; this causes the bacteria to group together in a colony where they share their protective coating and it becomes one shared coating with the bacteria inside it. This is called a biofilm and it protects the bacteria from immune attack and also from antibiotics which cannot penetrate the biofilm. This is why antibiotics can take so long if at all to work on acne. Benzoyl peroxide can be used to break open the biofilm which releases some of the bacteria which may then be attacked by the antibiotics and killed. However due to benzoyl peroxide only have a short term effect, the biofilm forms again and the antibiotic becomes in effective.

So what can be done?

Well if you don’t get the blockage you don’t get the spot.

However using exfoliating agents and benzoyl peroxide tends to thin the skin which accelerates water loss again and can make the situation worse. Using things like salicylic acid can help to soften and dislodge the plug but too much can again be exfoliating and using it on a twice daily basis again can lead to increased water loss and the skin thickening cycle gets worse. Also if the walls of the hair follicle duct have actually thickened to the point where they meet and the duct is blocked but there is no oily plug then we struggle to resolve this.

There are lots of other strategies and I have created a schematic for those who want to see it just click here.

If you can increase fixed ‘fats’ in the skin then cell production slows, keratin deposition reduces and oil production slows. SkinMed Aknicare® has a unique way of doing this.

Also by increasing these fixed fats actually makes the skin less sensitive to the DHT hormone.

So that’s one thing to help.

The other is to find a way to kill the bacteria in the biofilm. We have a fast and unique way of doing this and it does not use antibiotics, or benzoyl peroxide, or even retinols.
A product called Aknicare® has an ingredient that gets below the blockage where the bacteria are feeding and reproducing and the bacteria break this ingredient down instead of our oil. Their enzymes are preferentially drawn to it.

This means three things –
1. Intact sebum means no food for the bacteria
2. Free inflammatory fatty acids left from the enzyme breakdown of the sebum are reduced and so inflammation goes down.
3. Now the bacterial enzyme breaks down the Aknicare ingredient to release lots of citric acid, it makes the area very acidic and this kills the bacteria. However what about the biofilm?

Well it also contains another ingredient which opens up channels into the biofilm which allows the citric acid producing ingredient in. This means it kills 96% of the bacteria while in the biofilm. You can think of it as rather than being protective to the bacteria, the biofilm actually becomes their ‘coffin’.

There was a recent study comparing Aknicare® to Duac, the number one (cash) prescription treatment containing benzoyl peroxide and antibiotic, Aknicare was faster and better at reducing spots, both inflamed pustules and angry macules and also worked better on open comedones (black heads). This was statistically significant, the study can be read by Clicking here.

Aknicare® has been previously tested on hospital presenting acne in London Hospital group. These were patients who were failing on GP prescribed treatments. Aknicare® was highly effective and symptoms resolved in a matter of weeks, not months as with other treatments. Aknicare® slowed down oil production by an average of an amazing 53% . This study was carried out by the top acne Professor in the UK and head of the UK acne charity. This study was published in the British Journal Of Dermatology, which has the reputation of being the best dermatology academic journal in the world. You need a good professionally done trial to be accepted for publication. (click here to read the study)

These results have been supported by top specialists across Europe and it’s so good, it comes with a money back guarantee.

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