http://www.healthyskinbydesign.com/acne.cfm

Very helpful article with great illustrations of the first stages of acne.

I Knew it! I knew all that bs about excess sebum was wrong! I always noticed this buildup of flakiness on my skin, and I'm not at all oily. I don't think oil is the problem but rather an exacerbating factor that contributes to the plug.

That's why sulfur helps I guess, it increases cell turnover so skin cells don't have enough time to get stuck.

well the stuff about sebum isn't wrong, if there wasn't seebum there wouldn't be acne. but abnormal keritinization is the main issue, and that is what retinoids correct.

That's not true. Acne can be a sterile skin condition. Bacteria, which feed on the oil, make it worse, but are not a requirement in the acne process. The bacteria come in after the acne process has started and take advantage of the new skin conditions created by acne. If bacteria caused acne, people of all ages would have it, and it would be contagious, neither of which is true of acne.

Its also the composition of the sebum that allows the skin cells to help klump together as well, so you may not be very oily, yet you still form plugs so it can be the quality not the quantity. But acne is always a combined result of skin cells and sebum, but some cases could be more one then the other.

The thing is my skin is very dry in that there's not much oil at all, so i always wondered why there was so much emphasis on over production of sebum when in my case it seemed more like too much flakiness is plugging my pores. I know no one's skin is 100% oil free, that would be a serious skin disease, and there has to be enough oil for the cells to stick together to cause acne, but I know I don't have excess sebum. My point being, all these threads trying to find cures by reducing oil production just wouldn't work for me, whereas, i think if the keritinization problem was addressed, most people's acne would be taken care of. Hence why vit A, retinols, accutane work..not by reducing oil, but by increasing cell turnover. So the emphasis needs to be more on cell turnover rather than on oil production. I've seen some oily people with no acne, I don't think oil is the problem.

i meant inflammatory acne. it is true.

Everyone's right here.

Oil contributes to inflammatory and comedonal acne but of course it is not the only factor in the genesis of acne. If the pores didn't get clogged up with dead skin cells and sebum there would be no acne. The viscosity of the sebum plays a great role, too, although a person with normal sebum and abnormal keratinization will likely also have acne. Both play a part.

The retinoids and AHA products do feel to me that they improve the viscosity of the sebum while also exfoliating the skin, normalizing keratinization, and thus keeping the acne at bay.

how come AHA products alone does not solve acne then?

I think the cell turnover problem has to be addressed from start to end, meaning you can't let it start and then try to remove it because you'll never be totally cleared. i don't think aha can really get into the pores very far if a plug is already there. And from what I've read, the plug becomes almost glue-like in that it's very difficult to dissolve once it's formed. You've got to make your skin keratinize properly from the start so no plug gets a chance to form in the first place. I read somewhere that the making of a pimple can be 5 months or more in the making, starting with the tiny almost invisible plug of cells, and it's all downhill from there. If your skin increases it's own cell turnover, those little plugs will be pushed out on their own naturally. AHA mostly just removes the dead skin cells that are already there, but if your cell turnover process isn't working right, it won't induce the proper cell turnover necessary to clear your skin.

My skin cleared 85% by using glycolic acid alone. I had primarily comedonal acne with an occasional flare of inflammatory acne. For ME, I said, the AHA product seems to change the viscosity of my sebum and it definitely exfoliates. I am now using BHA as well as Green Cream and the baby's hair brush method of exfoliation (for aging and the last bits of clearing of comedonal acne). It is working for me.

Well this has always kinda been the core of the problem I guess, but nothings ever been done about it. This is why I wish they could use stem cell research or something to create a treatment that corrects keratinization because, correct me if im wrong, if you dont have that problem, then all the millions of other shit that cause acne wouldn't really matter.

I agree, without the keratin problem being oily wouldn't do anything other than make you shiny. The oil by itself isn't thick enough to clog anything. You can attest to that yourself just by feeling the oil on your own face. In order it to be thick enough, it would have to literally be solid at body temperature, which it obviously isn't. It needs the piled up skin cells building up to create the plug. Without that, there's no way to block the pore.

retinoids do correct that, usually. that is how accutane works (besides reducing oil) but your right, most treatments just kill the bacteria.

Everyone is correct here especially the karatin problem. But I dont think keratin problem is the only culprit for the pathogenesis of acne. In some cases it can also have anything to do with food sensitivities, liver problems, digestive problems, stress, hormone imbalances... that's why some women develops acne (mostly on jawline only) during their "time of the month" only.

There is a keratinization problem BECAUSE of sebum. As you get older and into adolescence, sebum gets produced at a more constant pace. As more sebum is made and reaches the surface(even a little bit), it rehydrates dead skin cells not allowing them to flake off properly. This is what causes the more skin cells to build up clogging a pore.

And when the skin is stripped of its moisture by constant washing with detergents, it produces more oil. NOW WAIT. I'm not saying the skin will make extra oil. I am saying that when you take off more oil than you are supposed too, the pore is going to have to "fill up" all over again. When the skin is dried out like that, dead skin cells can get deeper in the pore. And when the glands are producing a lot of oil due to being stripped combines with the clogged pore, it can cause a pimple. The more dead skin cells, the worse the pimple.

That's wrong for a few reasons. 1: If that was true, everyone in the world would have acne, 2: oil doesn't hydrate skin cells, water does. 3: I have too little oil, very dry skin, and I have acne. 4: Plenty of people have oily skin with no acne, 5: the article says says Step 1, not Step 2.

Well I'm glad to see that this article has sparked a conversation. I always had a feeling that killing Propionibacterium doesn't stop the issue of how your pores are getting clogged in the first place. If careful consideration is taken into the shape of the pore, readers would understand that various forms of topical ex-foliation can not reach deep enough inside the pores to remove the keratin blockade. Common sense tells us that no brush-bristle or micro-bead in our cleansers are small enough to ex-foliate the lining of the pores as it would the surface of the skin. According to wiki Propionibacterium "When a pore is blocked this anaerobic bacteria overgrows and secretes chemicals that break down the wall of the pore, spilling bacteria such as Staphylococcus aureus into the skin, forming an acne lesion (folliculitis)", a pore must first be 'blocked' before Propionibacterium "secretes" chemicals that break down the follicular wall break which causes inflamed acne. This tells us that in order to stop inflammation, using Benzoyl Peroxide is a great way to kill Propionibacterium but it does nothing in unclogging the pore?



If the quote above is taken into thought, maybe diet has some measurable affect for certain people.

According to Wiki, "Benzoyl peroxide works as a peeling agent, increasing skin turnover and clearing pores, thus reducing the bacterial count there as well as directly as an antibacterial." Skin turnover only means an increased production in keratin, but what about that "normal intercellular cement that we all produce.... evolving into a glue that is nearly im­possible to breakdown"? Wiki doesn't go into details about how BP "clears pores", so I don't necessarily even believe that it does. If BP increases skin turnover, doesn't it then (for some people) make their acne worst by speeding up the blockades? Perhaps thats why: http://youtube.com/watch?v=Za3tM2Ruadw occurred?

According to Healthy Skin By Design, the recent advances in research for acne has shown that Retinoic Acid and Azelaic Acid is leading the way in prescription medication, but what about non-prescription medicine?



I want people to pause for a moment and note that AHA "glycolic acid appears to help in breaking down the 'glue-like substance' in the follicle that contributes to the formation of follicular blockage". What good is cell turnover if at each turnover that 'glue-like' substance Healthy Skin By Design mentions is part of the issue? Wouldn't it make sense that pure 'cell turnover' only means acne faster? Someone give it a good thought and explain to me what the implications of that may be if there is any, because I'm particularly concerned about these "thorny keratin glue-like formations".

Well for the last two months I've tried the all-natural regimens, and things started snowballing; recently I've been using 10% BP for two weeks and it seems like my acne has gotten worst since the all-natural regimen. My skin is soooo extremely bumpy, dry, and crusted, maybe that level of BP is doing more harm than good. I'm soon to get myself on a strictly AHA, BHA, and BP regimen (products by Paula's Choice - some forum members have reccomended). Perhaps taking a look at a microscopic zoom of human flesh can give you a better idea of how to care for your skin:





Sources:
http://en.wikipedia.org/wiki/Propionibacterium_acnes
http://en.wikipedia.org/wiki/Acne_vulgaris
http://en.wikipedia.org/wiki/Benzoyl_peroxide
http://www.healthyskinbydesign.com/acne.cfm
http://medspa.squarespace.com/display/Show...ategoryId=80491

LOL you should know better considering that you've been in this forum longer than others. Now give me some credible evidence/study that shows a pore will "fill up" because it's stripped by constant washing. lol I gotta see this.

Wow! our skin looks so weird under a microscope... lol. Interesting. Now I can see a clear picture why can't the products just "dive in" to the dermis layer easily.

Keep the researches comin'!