The Risks and
Side Effects of Prescription Acne Medications
To understand how it is possible that the root of acne may be linked to the food we consume, it is first necessary to understand the makeup of the body’s largest organ-the skin and how that organ interacts with other body processes.
The skin actually has a large number of purposes. One of the major purposes of the skin is to, of course, cover the body and protect deeper tissues from injury as well as excessive drying and the invasion of foreign organisms that could harm the body. The skin also acts as a huge excrement organ. What this means is that it is the skin’s job to get rid of toxins accumulated within the body.
While the skin may appear to be a smooth covering, it is actually composed of many different components, all of which play critical roles in the skin’s major body functions. The principal composition of the skin is a layer of vascular connective tissues known as the corium or cutis vera as well as an external covering of epithelium, referred to as the epidermis or cuticle.
Organs with very special and specific functions are contained beneath the surface layer. These organs include the sudoriferous and sebaceous glands as well as hair follicles. In addition to these specialized organs, the epidermis is composes of stratified epithelium made up of four layers. Beginning from the inside out, these layers are known as the stratum mucosum, stratum granulosum, stratum lucidum and stratum corneum.
The stratum mucosum, also known as the mucous layer, is comprised of many different layers of cells. The stratum granulosum makes up approximately two to three layers of cells which are flattened and contain a substance known as carmine. It is thought that this substance is associated with the keratinization process within the human body; or sloughing off of dead skin cells.
The stratum lucidum is comprised of cells closely packed together with some amounts of flattened nuclei as well as very small traces of kerathoyalin.
While hair is not commonly thought of as having anything to do with acne due to the fact that in most cases acne occurs on parts of the body where hair is relatively sparse, compared to the scalp, hair and hair follicles are very much a part of how the skin ‘behaves’ and thus how acne tends to develop.
Obviously, the scalp contains the largest amount of concentrated hairs on the human body; but hairs are also found on just about every other part of the body with only a few exceptions, such as the soles of the feet. The hairs located on the human body tend to vary in thickness, length and even color; depending on where they are located. Even when it is quite difficult to discern hair; you can rest assured it is there.
As small as a strand of hair is, it is actually comprised of many different components; just like the skin. The primary components of a single strand of hair include the root; which is the part that is actually implanted into the skin and a shaft, the part that protrudes from the surface.
This is not all; however. The root of the hair extends on to include a hair bulb and a hair follicle. The follicle itself extends down into the subcutaneous cellular tissue. A compact layer of fibers and cells are arranged around the follicle, extending from the bottom of the follicle all the way to the actual entrance of the ducts of the sebaceous glands.
Considering how much trouble they can cause in the form of acne when they are overstimulated, sebaceous glands are actually small, sacculated, glandular organs that are found throughout the majority of the body, but are extremely numerous on the face and the scalp. Each and every sebaceous gland is comprised of a single duct from which a cluster of alveoli emerge. In most cases, the cluster will only contain between two and five; but there are some cases in which there may be as many as twenty.
A rather transparent membrane is contained within each alveolus, retaining several epithelial cells. Toward the outside, the cells are generally small. Moving in toward the center of the alveolus, the cells are found to be larger and contain fat; with the exception of the very epicenter. This area is a type of cavity that is actually filled with debris and fatty matter; known as the sebum cutaneum.
It is important to understand the functions of each of these layers when studying acne and the root causes of acne, because the severity of acne may impact one or more of these layers. Many people commonly believe that acne is a surface problem only, when in fact; it can reach deeply into the layers of skin, making it that much more difficult to eradicate.
Technically speaking, acne is a disease which takes place in the pilosebaceous unit in the skin. This unit is comprised of several different components, including the hair follicle and a sebaceous gland, discussed in further detail a little later on. These are then connected to the actual surface of the skin by a duct.
The hair passes through this duct. Sebum is produced by the sebaceous gland. While the practical purpose of the sebaceous gland and the resulting sebum produced by this gland is to assist the body in keeping the skin and hair moist; this is where troublesome problems of acne are instigated.
Besides keeping skin and hair moist, sebum also has another purpose; to carry cells which have been shed by the glands to the surface of the skin. This makes up part of the body’s natural excrement and shedding process Further problems with acne occur when the body begins to slough off dead skin cells at a faster than normal rate. This is known as hyper-keratinization. Studies now indicate that there is a link between the body entering this phase and the foods that we eat, leading to increased problems with acne; but we’ll get to that a little bit later.
Pilosebaceous units are actually located in many various places on the human body, not just the face; however the most common locations do include the face, chest and back. It is believed that this is the reason why acne most commonly coincides with these same locations.
It must be kept in mind that not all sebum, or oil, on the skin is bad. After all, this is nature’s way of protecting the body and keeping it from becoming dried out. Therefore, it is not wise to try to completely eradicate sebum within the skin altogether. Sebum is not the problem, it is the overproduction of sebum which leads to hyperkeratinization and blocked pores; resulting in acne.
When acne begins to develop what actually happens is an immune response from the body. While it may seem strange to consider that the annoying, embarrassing and often painful, pus filled postules that are associated with acne are really just another way for the human body to protect itself; it is important to understand this reaction in order to begin understanding how to control and eradicate acne.
As sebum is overproduced, a sort of warning flag goes up within the body. The human body recognizes that too much sebum provides a very inviting environment for bacteria. In order to counter this, the body induces an immune response. As inflammation sets in, cells within the body begin sticking together to form a layer that will block the duct. After the duct is blocked, there is no way for dead cells and additional sebum to escape and they therefore become backed behind the blocked duct. A plug within the duct is then effectively formed, known as the comedo.
After the comedo is formed; one of two things may happen. Either the sebum and cells that have accumulated will remain below the surface of the skin or the comedo will begin to open, allowing the plug to emerge from the blocked duct. In the first scenario, the result is known as a closed comedo or whitehead. The second situation results in an open comedo; also commonly referred to as a blackhead.
Sebum is composed of fatty materials which accumulate within the blocked pore when the body overproduces sebum. As bacteria begin to build within the pore, it becomes inflamed and before you know it a pimple exists.
The bacteria within the pimple need nourishment to survive and what the bacteria thrives on best is the presence of sebum. As the body is already overproducing sebum; the bacteria flourishes resulting in even more problems with acne.
Most treatment options focus on unblocking the pore and reducing the amount of sebum production in order to kill off the life source of the bacteria. In most cases, treatment options are sough in over the counter medications; which may provide some temporary relief but does nothing to attack the actual root cause of the acne incident.
The diagram below shows an example of the skin along with it’s corresponding hair follicle, sebaceous gland and other parts. Upon examination it is easy to see how once the follicle becomes plugged with excess sebum, there is no other alternative but for the skin to try to expel the debris through an eruption in the skin.
While the blemishes, zits and pimples that cause anxiety for millions of people are commonly referred to as acne, there are actually many different forms of this skin condition; which can be further classified as inflammatory and non-inflammatory.
The smallest type of acne an individual might notice is a blocked pore known as a microcomedo. In many cases, these blocked pores are so small that they are not even able to be recognized by the human eye and can only be noticed with the aid of a microscope. They begin to develop as the follicle walls are stretched by sebum trapped inside. Despite their small size, blocked pores are the impetus to further, more painful, skin conditions.
The next development in the progression of acne is referred to as a blackhead, which is really a micromedo which has progressed without rupture. Micromedos may also progress into what is known as a whitehead. The difference between whiteheads and blackheads lies in the whether it is open or closed.
Blackheads, while commonly believed to contain dirt due to the color, actually contain tightly compacted cells of the follicle and sebum. Whiteheads are closed and do not contain pus, as both whiteheads and blackheads are non-inflammatory. Acne inflammation may occur when sebum intrudes into the surrounding tissue.
The most common type of pimple is referred to as a papule. These are the small, firm and reddish colored lesions that appear on the surface of the skin. In some cases, they may contain pus while in other cases they do not. Pustules clearly contain pus; usually just beneath the surface of the skin.
While pustules can be disturbing for the individuals who suffer from them, they are not the most severe form of acne. Nodules, also known as cysts, normally contain a large amount of pus and are usually quite large. This form of acne can be painful and may extend deeply into the skin.
Next: A look at the glycemic index and how it relates to Acne
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