Your skin’s surface is constantly replenishing itself shedding dead skin cells and replacing them with new ones. Essential oil (known as sebum) needed to lubricate your skin and prevent it losing moisture is produced by the sebaceous glands and is secreted via the hair follicle ducts (tubes) to the skin’s surface. If dead skin cells build up, then they can form a plug and block the opening to the duct. But why does this happen? Here is the science behind spots…
The science behind spots
During teenage years, into our twenties and at numerous other stages in life, time of the month and increasingly later in life etc. our skin becomes sensitised to hormones. These hormones are there all the time and it is actually a myth that you produce more hormones when you get acne. It is a fact that hormone levels are the same, before, during and after the acne episode in 100% of men and about 75% of women. The 25% are those with polycystic ovary syndrome.
One particular hormone which is produced by the conversion of testosterone is dihydrotestosterone (DHT) is always present in the body, including in the skin but your skin normally ‘ignores’ it. The skin becomes aware of DHT and becomes sensitive to it. This causes the skin structure and the oil made in the sebaceous glands to lose natural chemicals called fatty acids, particularly one called linoleic acid, one of the ‘famous’ omega essential fatty acids we keep hearing about. I.e. our skin becomes lipid deficient. The loss of linoleic acid etc causes the skins barrier properties and ability to retain moisture to be compromised.
If the skin is losing too much water it then compensates by producing more oil and also the rate at which we make new skin cells accelerates, producing more skin cells meaning the skin surface thickens. At the same time, the production of keratin (the substance that hardens our nails), increases in skin cells causing more thickening of the skin. As the skin surface also lines the neck of the hair follicle duct, oil produced in the associated sebaceous glands comes out onto the skin surface. Then the thickening leads to a narrowing of the hair follicle duct and it can become blocked.
So you have more oil trying to get out of a narrowing tube being blocked from the surface by thickening skin and lots of dead skin cells. It’s not surprising you get a blockage. This can lead to a pimple but on its own is not an ‘angry’ spot.
Increased oil without increased dead skin cells tends to cause oily skin. But then increased oil, skin thickening and more dead skin cells lead to blockages in the hair follicle tube that the oil comes out of, causing a pimple. However, when this blockage occurs and oil builds up under the plug, it creates a great breeding ground for a type of bacteria which likes to live in areas of the skin where little oxygen can get in. They grow in this oxygen deficient environment under the plug and group together as they feed on a part of sebum known as triglycerides. They then break these down into glycerol, which they absorb as food. The resulting free fatty acids left from this enzyme breakdown of triglycerides trigger the body’s immune response and this starts the inflammatory process. This combination of clogged pores, bacteria growth, trapped oil and inflammation, causes a spot to form and appear on the skin’s surface.
The bacteria often seen in acne is called p.acnes and it has an interesting defence mechanism when it is threatened by immune activity or antibiotics. Like many anaerobes, p.acnes produce what is called a biofilm which is secreted by the bacteria and is a thick slimy barrier of sugars and proteins. The biofilm barrier protects the bacteria from external threats. If a biofilm is broken or dissolved then the bacteria can form a new one in less than 24 hours. This is a major reason why antibiotics don’t work or take a long time to work. Benzoyl peroxide can rupture the biofilm but the released planktonic (individual) bacteria quickly group together to form a new biofilm. This is also a reason why combinations of benzoyl peroxide and antibiotics like clindamycin often struggle to control acne.
GT peptide also slows down the release of inflammatory chemicals and so has an anti-inflammatory action.
What is a BioFilm made up off?
1- EPS (Extracellular Polymeric Substances): a gel consisting of water, polymers of uronic acids or teichoic acids, proteins and salts. The EPS can represent up to 80% by weight of the biofilm. Due to its high water content, the matrix can contribute to resistance to antibiotics preventing the diffusion of these substances through the biofilm, probably by binding these molecules.
2- Planktonic bacteria represent the remaining part of the biofilm.
To properly sort acne you need to work this process backwards
◆The Inflammation to reduce reddening and scarring risk
◆Acne Bacteria without attacking your skins healthy bacteria
◆The Oil Production by the glands, not just oil already on the surface
Skin Thickening without making the skin angry
◆Restore Linoleic acid levels in the skin to restore barrier functions
◆The amount of DHT in the skin, but only in problem areas of the skin and not in the rest of the body.
Do these six things and you will have a great chance of having and keeping great skin! When hormone levels normalise again then our skin usually loses its sensitivity to DHT and skin returns to normal in most cases.
So there it is, the science behind spots. For the help you may need or the treatments you want, we recommend you visit a skin specialist at your nearest Accredited Treatment Centre.
This website is supported by an educational grant by SkinMed