Anatomy of a Lesion
ln order to begin to treat acne, we must first learn some simple anatomy of the skin. Let`s begin at the surface, called the stratum corneum. lt is made tip of dead, protein-rich cells known as keratin, which acts as a protective barrier lor the underlying cells.
Just below the stratum corneum exists a layer of living cells, called the spinny layer because when these cells are viewed under the microscope,they appear to contain a series of little bridges. As we continue moving down through the epidermis (the outermost layer of the skin), we come to a layer known as the basal cells. The basal cells are constantly dividing and migrating toward the skin`s surface and are the precursors to all of the layers we have just described. Simply stated, basal cells grow and divide. And as they move toward the surface of the skin they mature, eventually becoming the dead layer known as the stratum corneum. This maturation process of basal cells into the stratum corneum is called keratinization.
To understand the physical changes that cause acne, it is important to understand the microscopic processes that produce it. We all know that our skin has pores. Dermatologists refer to these pores as follicles. Many of us think of a follicle as a small hair (since we usually hear it being referred to as a hair follicle); however, the follicle could either contain a hair or it could be empty. Imagine the follicle as a tube, extending from the surface of the skin down into the dermis, or the skin layer beneath the epidermis.
This deeper layer of skin - the derrnis - is made up of collagen and elastin, which support the surface of the skin and provide a home for blood vessels, nerves, and other cells. Directly beneath the dermis is a layer of fat that cushions and insulates the skin and contributes to the rounded look of a youthful lace. The follicle (or pore) originates from the dermis as a tube. From this tube branch glands that resemble little clusters of grapes. These are the sebaceous (or oil) glands that produce an oily substance dermatologists call sebum. The sebum flows to the top of the tube (follicle), eventually to be secreted onto the skin`s surface. (I should mention here that there is some debate among scientists as to whether sebum does or does not Iubricate skin, but that is not important to our story.)
Now that we understand some ol-the basic anatomy of the skin, let`s look at what actually causes acne. Most scientists believe that the primary cause of an acne lesion (commonly called a pimple) is something called retention hyperkeratosis. In reality the primary event is inflammation which then causes the retention hyperkeratosis. As we discussed. the surface of the skin, the top layer of the epidermis is called the stratum corneum. The dead cells of the stratum corneum, which contain a large amount of the protein keratin, are supposed to fall off the skin in a natural process called exfoliation or desquamation. This stratum corneum also lines the inside of the follicle [tube]. Scientists believe that if the inside of the follicle doesn’t exfoliate properly, the keratin mixes with sebum, making it viscous and sticky, clogging the follicle.
Why doesn`t acne make its first appearance before puberty? The answer to that is hormones. When we enter puberty, our body begins to produce testosterone. Testosterone breaks down into a substance called dihydrotestosteron (DHT) that stimulates the sebaceous gland to produce more sebum. For many reasons, this sebum begins the process of retention hyperkeratosis, or insufficient exfoliation within the follicle lining.
For a moment, pretend we could look down into that Follicle. There we would see that the dead stratum corneum cells are not being carried away by the flow of oil from the sebaceous glands, due to the insufficient exfoliation. Instead, they remain inside the follicle where they form a sticky mass. Within a short time a bacterium, Propionibacterium acnes, begins to multiply rapidly, creating Further inflammation within the follicle and surrounding skin. If new stratum corneum cells continue to be generated, but the dead ones are not exfoliating, the resulting condition is known as retention hyperkeratosis. The term "retention hyperkeratosis" simply means that the pore is retaining the stratum corneum cells, resulting in a clogged pore.
The dermatologieal term for this plug is comedo (plural “comedones"). When the comedo is initially formed beneath the epidermis, it is too small to be seen with the naked eye. At this point such a lesion is called a microcomedo. As it enlarges, it looks like a tiny white bump just below the surface of the skin. If you slide your finger over your skin you can often feel these small, hard bumps. As these lesions enlarge they... jump page here: The Acne Prescription: The Perricone Program for Clear and Healthy Skin at Every Age
With knowing the causes of acne and the process , the treatment will undergo easier and the mental preparation will give good effects from psychological side and mostly help them to get rid of adult and stubborn acne.
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