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Diseases and Conditions |
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Much Ado About Acne
Acne is not due to a single event but the result of multiple steps going “wrong”. Acne is a disorder of keratinization, meaning the formation of the cells that line the gland beneath the skin’s surface is dysfunctional.
Under normal circumstances the epithelial cells lining the neck of the sebaceous gland should invisibly exfoliate under normal conditions onto the skin’s surface through the pore. But these cells have a sticky surface, causing them to form a plug and preventing spontaneous exfoliation within the gland.
At the same time the plug has formed, the androgens have stimulated the sebaceous glands to enlarge and make extra oil.
The P. acnes bacteria that live within these glands are essentially served a feast of oil. They proliferate.
The gland is plugged, the oils continue to form whether or not they are able to reach the skin’s surface, more bacteria form and inflammation occurs.
This cycle continues until the gland can no longer contain itself, expanding under pressure until it pops beneath the skin’s surface. These are the events that contribute to the formation of inflammatory or cystic acne.
Acne therapy is aimed at intervening with various steps in this chain of events to clear and prevent recurrences.
Hormonal intervention of acne is aimed at preventing androgens from stimulating sebaceous gland activity; reducing sebum formation and can help minimize pore visibility.
Did I say pore size? Believe it or not, fluctuating levels of progesterone during our menstrual cycle is directly associated with changing pore size throughout the month.
Progesterone causes fluid retention and tissue swelling. We are all familiar with premenstrual “bloating”. You can thank progesterone for that monthly puffiness. As the levels of progesterone rise and the skin swells, the pores are effectively compressed shut. This has 2 effects; by day 26, your pores never looked so minimized. However, this tourniquet effect causes sebum to build up beneath the skin’s surface contributing to the formation of extra monthly blemishes.
An interesting multicenter study (JAAD 2001;45:957-60) showed that almost half of all women do experience a premenstrual flare of acne. But it’s women ages 33 and up who are most often affected.
Dr Kunin board certified dermatologist
DERMAdoctor.com |
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Bio
Dr. Kunin is a board certified dermatologist in Kansas City, Missouri. She
received her dermatology training at the Medical College of Virginia. She has
been featured on several local television and radio news and talk shows for her
expertise in her field. She also holds a position as Associate Clinical
Instructor at the University of Kansas Medical School Department of Dermatology.
In addition to general dermatology, her interests in cosmetic dermatology
include non-surgical approaches to skin rejuvenation, including chemical peels,
Botox, Isolagen, skin care products and sclerotherapy.
A leading source of doctor recommended skin care products and information!
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