Skin Series:
In this skin series, discover why pimples occur, the differences between inflammatory, non-inflammatory lesions, and how acne forms.
To map out a successful recovery path, we first drop beneath the surface to differentiate non-inflammatory patterns from deeper inflammatory cycles.
"Understanding the precise breakdown of how breakouts develop is the first step to choosing the correct cellular skin support."
Breakout Classifications
Non-inflammatory
In general we see this as blackheads and whiteheads and the occasional non inflamed ‘spot’.
These are non-inflamed lesions where sebum and dead cells are collected near the surface of the follicle. The blackhead is black head because of the exposed oxidised pigment in the sebum whilst the whitehead is closed under the skin and not exposed.
Inflammatory Papules & Pustules
Pustules have a whitish or yellow ‘pus’ top and can feel hot and look red. Papules are firmer, are inflamed and do not have a pus top.
Inflammatory Cysts & Nodules
Cysts are deep, may be softer and filled with pus which don’t come to head. A nodule is deep, firm, hard.
How an inflammatory lesion forms
Our pilosebaceous unit consists of the hair follicle, hair shaft and sebaceous (oil) glands. The sebaceous glands attached to the hair follicle produce sebum and this sebum travels up the follicle to the surface of the skin to keep it healthy and protected. When the skin produces too much sebum due to trigger factors like hormones for example, there is an increase of oil. It’s worth noting that in an acne skin, the quality of sebum is also sticky and thicker due to deficiencies and alterations in it’s make up.
Your skin cells also play a part. A good functioning healthy skin naturally desquamates approximately every 28 days, whereby old cells are sloughed off and new cells replace them. However, sometimes, the cells that line the hair follicle may not be functioning as they should and don’t shed as effectively. Combine sticky oil with these irregular cells causes blockages at the mouth of the follicle opening.
Our sebaceous (oil) glands keep producing sebum because that is their function. When the oil can’t get up the follicle and out onto the surface of the skin, they start to adhere and mix with dead cells to block deeper in the follicle.
This compaction is now ready for the next stage… with the oil glands still producing oil, the follicle starts to swell, and you start to feel the sore red spots.
There’s a fourth factor that plays a part, our c.acnes (cutibacterium acnes). These bacteria live on/in the skin and are dominant housemates inside the sebaceous follicle. This bacteria has pro inflammatory potential to affect the balance in this environment and the by-products it produces irritates the follicle (like an out-of-control party) creating inflammation, resulting in a messy infected pustule (a pimple with pus) or papule (pimple without pus).
The walls of the follicle are not unbreakable and when they are over filled with this ‘mess’, engorge, expand and stretch, breaking the follicle walls, expelling either onto the surface of the skin which can take a week or two to heal or unfortunately breaking inwards which may take several weeks to heal. Healing takes place by our skin systems texturing clean tissue back over the structural damage.