The processes going on in the skin of a person suffering from acne are explained here. You also find a survey of the factors causing acne and measures you can apply yourself to prevent, cure or alleviate acne.

Acne gives the combination of symptoms like greasy skin, white heads, black heads, pimples, inflammation and scar formation. Acne mostly affects young people in the age 14 - 25, but also sometimes older persons, like women in their menopause. Most teenagers experience outburst of acne, some only little, but for others acne may develop into a serious skin ailment with great cosmetic impact.

To understand the acne process, some knowledge about skin anatomy and physiology is essential:

The skin has there layers: The outer layer called epidermis consists of epithelial cells. Under this lies the dermis consisting of connective tissue. At the bottom there is a layer called the hypodermis consisting mostly of fat cells.

The skin has narrow pores extending from the surface down to the top of the sub-dermis, called hair follicles. A hair extend from a growth zone in the bottom of each hair follicle and out at the skin surface. Around the hair in the dermis, there are small glands called sebaceous glands. These glands produce a fatty substance, sebum, which empty through the follicle opening and lubricates the hair and the skin.

Acne starts by the glands in the hair follicles increasing their sebum production. This will in the beginning only cause greasy skin. Eventually the sebum in the entrance of the follicles mixes with dead epithelial cells. This mix reacts chemically to forms hard props, comedones that close the pore entrances. According to the color of the comedones, they are called black heads or white heads.

Then the closed hair follicle gets filled with sebum and swell. The swollen follicle then gets infected by bacteria. The bacteria and the accumulated sebum cause the follicle and the surrounding skin to get inflamed, forming a pimple. At last the inflamed follicle burst and empties its content. Eventually the affected area heals. Sometimes the inflammation reaches deep into the skin surrounding the follicle and destroys skin tissue. This will cause more or less distinct scars that may reside permanently. Typically an affected person will have follicles in all these stages of the process at any given time.

The increased hormone production in the puberty stimulates to increased sebum production. The male hormone, testosterone, seem to contribute most. Also girls begin to produce more testosterone in the puberty. Also in other periods, altered hormone production may give acne, for example by women in the menopause.

Since not all teens get acne in any degree, the increased hormone level cannot be the whole cause of the increased sebum production. The follicles of affected persons must for some reason react stronger upon the higher hormone level.

Dietary factors, like eating too much fat, too much sugar or the wrong kind of fat may aggravate acne by some individuals. Lack of vitamins, minerals and essential fatty acids may also contribute to development of acne.

Poor digestion, lazy colon and constipation aggravate acne in some individuals, probably due to productions of toxins in the intestines. Lazy colon may be caused by dietary faults, like lack of fiber.

Very frequent washing and use of strong soaps aggravate acne, and does not alleviate the condition as many think. Rubbing, scrubbing or squeezing the skin may also aggravate acne.

Here are some other factors that may contribute in causing acne or aggravating the condition.

- Stress

- Some contraceptive agents

- Environmental or domestic pollution.

- Humid environments.

- Some antidepressants.

- Testosterone and anabolic steroids used for treatment or by body-building.

- Use of some types of greasy cosmetic products.

- Some antiperspirant products.

- Exposing the skin for chlorine or other halogens, or medicines containing halogens.

- Women may get aggravated acne 2-7 days before menstruation.

Sometimes Acne is so severe that special medical treatment is required, and sometimes the causes of acne necessitate medical treatment. But you can do much yourself also. Here are listed things you can do yourself to prevent or treat acne:

- Do not consume a great amount of fat.

- The fat you add to the food should be natural oils. Olive oil is ideal, but use other types of oils too, like flaxseed oil, fish oil, other marine oils, walnut oil, sunflower oil,  and soy oil.

-However, do not use only soy oil as many tend to do.  Using only soy oil, walnut oil and sunflower oil, will give you too much of some fatty acids and too less of others.

-Flaxseed oil has a special good effect against acne.

- Eat much fish and seafood and not so much meat. Especially fat fish is good.

- Eat food with a high fiber content to regulate the digestion, like vegetables, whole cereals, full corn bread and fruit.

- Do not use greasy or heavy cosmetics that clog your skin and are difficult to wash away.

- Do not use strong irritating antiperspirants.

- Do not wash with strong soap or cleaners that dry up your skin and take away all the natural oily protection in your skin.

- If you perform body-building, do not use anabolic steroids or other hormonal supplements.

- Use clothes that allow air to reach your body surface to avoid collection of humidity and overheating of your skin.

You can rinse your skin with mild products especially made to dissolve the plugs in your pores, and to make the environment in your skin unfriendly to bacteria causing infection.

Rinsing milks or solutions to treat acne is one option. Some of these shall be flushed away after rinsing, others shal be let dry and stay on the skin.

Bar soaps with ingredients to treat acne is another option. They are used as any other bar soap.

When acne causes great irregularities in the skin with great heaps of plugging substances in the pores, you can occationally also use a rinsing cream with abbrasive power, a so called acne scrubs.

You can also find rinsing gels or creams to be used during night and flushed away in the morning.

After the rinsing, you should apply some treatment gel, cream, toner or lotion onto your skin to achieve these effects:

- To make your skin soft and elastic.

- To protect your skin against the environment.

- To acts further to dissolve the clogging of your pores.

- To soothe and alleviate inflammation.

- To kill the bacteria causing infection or make an environment hostile for the bacteria.

- To stimulate the skin to clean itself.

- To stimulate the skin to heal.

- To be used as a isolating layer between the skin itself and cosmetics

Supplements taken by mouth to nourish your skin may be useful. The purpose of these supplements is more or less the same as that of nourishing creams.

- To make the sebum more fluid so it drains more easily.

- To stimulate the substance exchange and cleaning processes in your skin,

- To stimulate your skin to heal,

- To give your skin building nutrients necessary to heal.

Ingredients often used in these supplements to stimulate the cleaning and healing processes in the skin are: Vitamins A, C, B1, B2, B3, B6, C, D, E, Folic acid, Beta carotene, Bioflavonoids, Magnesium, Copper, Zinc, selenium, anti-oxidants from Green tea, Metylsulfonyl methane.

Nutrient found in these products used as material to rebuild damaged skin and to give a sebum with better consistency are: Evening primrose oil, Olive oil, Flax seed oil, Borage oil, Soy oil, Wheat germ oil and Lecithin.

6. Ingredients used in topical products

Knut Holt