We’ve all been there. One minute your skin is clear and bright and the next there is a volcano brewing just under the surface of your skin. It’s human nature to want to pick and try to get rid of the invader as soon as possible. This scenario leads you to a horrible red lesion that can lead to scarring and cause you to feel horrible about your appearance.
The big picture: 66 million Americans have active acne. Though there are many triggers and 4 different types, chances are that either you or someone you know may be suffering with this condition. Acne typically is a hereditary disease and can happen to a person whether there skin is oily or not. For someone with acne the skin on the epidermis sheds more slowly while new dead cells are being created much more rapidly in a process called retention hyperkeratosis. This process keeps the cells from shedding and mixes with sebum which creates a plug. The plug is what is commonly called a blackhead. A blackhead is also known as an open comedone. Congestion in the skin can also be characterized by a bumpy texture, but no opening in the pore. These bumps are called closed comedones. A good home care regimen and regular trips to your skin therapist for customized treatments and gentle extraction can prevent further progression of this condition.
Open and closed comedones combined with triggers like: Stress, cosmetics containing comedogenic ingredients, environmental factors like seasons or work environment as well as nutrition, medications, hormones, friction from synthetic fibers or repetitive rubbing against the skin can lead to enflamed papules and pustules if left untreated. One factor that can contribute to the development of these pustules is the presence of propionibacterium (p. acne bacteria) This bacteria loves life without oxygen which is why is thrives in pores that are congested. A bi-product of this bacteria loving life in our plugged pores is that it creates glycerol and fatty acids which lead to irritation in the pore walls.
At that point our body’s immune response kicks in and sends white blood cells to kill those bacteria. The introduction of white blood cells stretches the pore until it can hold anymore. At this point you will see a white or yellow tip on the top of your pore. The pore keeps swelling and can actually rupture into the dermis ( the live skin under the epidermis which contains important tissue, nerves and immune cells). Picking or squeezing the lesion could make the situation worse because the infection can inadvertently be pushed further down into the tissue as well. Bacteria under the fingernails can also be introduced. The white blood cells from your bodies immune response do a great job killing bacteria, but don’t know the difference between bacteria which are bad and good things like collagen and other beneficial tissue. The result can lead to red scarring from our pigment cells which is an immune response as well and pitting from the collagen and tissue breaking down.
So with all of this information what is the best way to handle an inflamed lesion you ask? The best thing to do is avoid picking and scratching. Probably easier said than done. What is the alternative? Using ingredients that bring down inflammation and kill bacteria. Salycilic acid is the best tool in this situation. It loves oil and can penetrate down into the poor and kill bacteria while being an anti-inflammatory ingredient. Benzoyl peroxide used sparingly will kill bacteria on an infected lesion. For sensitive skin try tea tree as it acts like Benzoyl Peroxide, but is much more gently. Oat extract, licorice and green tea are all great anti-inflammatory ingredients as well. You can also try icing a lesion 15 minutes at a time. A good rule of thumb is when you see red is to reach for one of those ingredients and try to calm your skin down before it gets out of control. Not sure where to start? A good resource is your skin therapist. They can guide you on what ingredients will work best on your skin and safely remove non-inflamed plugs before they cause a problem for you.