The first in the triad is a failure of the skin cells lining the follicles (pores) of the skin to shed in a proper efficient manner, they tend to “stick” together in the depths of the follicle and create what is called a microcomedone. A comedone is just the medical term for a “blackhead”, and a blackhead is just a plug of oil in the follicle. When the top of the plug of oil reacts with oxygen, i.e., oxidizes, it turns black and a “blackhead” forms.

This leads us to the second culprit of the triad, which is excessively oily skin, especially on the face and upper trunk. The amount of “oil” (medical term is sebum) produced is an inherited factor and of course is beyond your control. The more sebum your skin produces the worse the acne may be. However, there are things you can do to decrease the amount of oil your skin produces. The sebaceous glands (oil glands) are stimulated by hormones. So many women will notice the acne becomes worse around their menses and men notice acne develop as they enter puberty. Dairy products, since they are derived from a pregnant cow (or goat or sheep) contain plenty of these hormones. When you ingest the dairy products the sebaceous (pronounced see-bay-she-us) glands are stimulated, the sebum is partially blocked from evacuating the pore by the sticky skin cells and the P. acnes grows and multiplies rapidly releasing its enzymes and creating more pimples. If the oil just sits in the pore, the top of it oxidizes and turns black to form a blackhead. So whatever, you do for your acne, you must give up the dairy products (milk, ice cream, yogurt, cheese). There are plenty of non-dairy substitutes for these that are fortified with calcium and vitamin D. Your dermatologist can tell you about these. The other dietary factors that may affect your acne are “high glycemic index” drinks and food. These are drinks and food (sodas, colas, candy, etc.) that have a high simple sugar content. The exact mechanism of how this exacerbates your acne is not fully understood but giving up this type of high glycemic index product will produce big dividends in your battle against acne.

The final factor in the pathogenesis (biological development) of acne is a bacterium called Propionobacterium acnes, or P. acnes. The P. acnes likes to live deep in the pores of the skin and everyone, to a certain extent, harbors these microscopic critters. However, in patients prone to acne the P. acnes multiply in the sebum rich milieu of the deep follicle, living off your dead skin cells and in the process produces enzymes that can be harmful. Some of these enzymes actually can “dissolve” the follicle wall and release sebum and cellular remnants into the dermis (the deeper layer of your skin). This causes your body to develop an inflammatory reaction to this “foreign” material in the dermis and you have an unsightly, often tender, often deep, pimple. At times the body tries to wall off this foreign debris and an acne cyst may form.

To help control the acne it becomes important to wash your face with soapy water. This helps rid the pores of the sebum and thereby “starve” the P. acnes, and also flushes the pores free of the sticky skin cells within the follicle. Many soaps will help, but CutiCare_MD^® sulfur soap is ideal because the sulfur actually kills the P. acnes and has a mild “exfoliating” (shedding) effect on the top layer of the skin (stratum corneum) which helps to keep the pores open. Our CutiCare_MD^® sulfur cleanser is non-irritating due to its glycerin base. It is free of harmful sensitizers, chemicals, and preservatives. It contains no oils or lanolin (sheep sebum) which, when applied to your face, will make your acne worse. You may need additional treatment for your acne depending on the severity—this can be determined by your dermatologist. However, the CutiCare_MD^® sulfur bar soap used twice daily with the gentle pressure of a washcloth will be an excellent treatment. If you have acne on your chest or back be sure to use CutiCare_MD^® sulfur soap in the shower at least once daily. Remember, not all sulfur soaps are created equally!