Acne is not caused by dirt clogging the pores or by eating oily food. Even if you wash your face, your super clean face can still be prone to pimples.
Adults can get acne lesions for a number of reasons, such as using acne-causing or comedogenic cosmetics and products, an increase in oil production mediated by hormonal stimulation (from the menstrual period, emotions or stress), and the use of certain drugs.
The causes of acne are multi-factorial, or a combination of many factors. The sex hormones, especially during the teen years, cause an increase in sebum production by the sebaceous glands. You can also inherit oily skin and the tendency to have severe acne. There may be a hereditary tendency for the cells lining the passageway of the sebaceous glands to become sticky and to clump together. There are bacteria that are naturally found in pilosebaceous unity. Called the Propionibacterium acnes, these bacteria feed on the sebum. These bacteria break down the sebum into fatty acids that can cause irritation and inflammation of the skin.
Depending on severity, the lesions of acne can be non-inflamed, or inflamed. The comedones, which are non-inflamed lesions, are plugs formed by sebum, sticky skin cells and P. acnes bacteria. A blackhead (open comedone) has an opening to the skin surface. It is “black” because of pigment deposition, and not because of dirt.
A whitehead is also a plug but it differs from the blackhead because the opening to the skin surface is closed, so that the plug does not protrude out of it.
Inflamed lesions are small or large red pimples, pustules (filled with pus), cysts, and nodules. Squeezing non-inflamed whiteheads and blackheads can cause the plug to rupture into the skin, and can result in an inflammatory reaction. Inflamed lesions can cause scarring.
You will note that nowhere in this article have discussed that acne is caused by dirt clogging the pores. This concept, which has long been perpetuated in write-ups and ads, is simply a myth. Even if you wash and wash and wash your face, your super clean face can still be prone to pimples.
There are no specific studies that prove the relationship between food and acne. The secretion of the sebaceous glands is under the influence of the nervous system, which in turn is dictated by the hormones. Eating oily foods will not make the sebaceous glands produce more oil or sebum. Some people have flares of acne when eating specific foods such as chocolates, nuts or seafoods, or even drinking soft drinks. If you associate certain foods with your acne, it is best to avoid them.
To help you clear acne, you have to be on a regimen tuned in to the kind of lesions that you have. Treatment will depend on whether your acne is non-inflammatory or inflammatory. Bear in mind that acne is not a kind of skin disease that is cured in one topical application or one intake of an oral medication. Usually, it takes three to four months before control is obtained, and often there must be some kind of maintenance program. Also, with many topical medications, there is some worsening in the first two or three weeks as the medicines at this stage would be a mistake because this “worsening” is an expected part of the treatment.
Oral antibiotics are given, but acne is not an infection coming from bacteria in the environment. The P. acnes bacteria are already in the skin and act by breaking down the sebum to cause irritating fatty acids. Other than controlling P. acnes population, antibiotics can also decrease the sebum production. It is not uncommon to be prescribed antibiotics for several months when the lesions are very severe. When you stop your prescribed treatment, the lesion will recur.
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