For a variety of reasons and in fact not all of which are yet fully understood, acne starts when our sebaceous gland increases its production of sebum and also our skin cells lining the follicle do not shed properly, this is considered as an important underlying acne causes. And over time, they pile up and will block the opening of the follicle, hence a basic acne lesion i.e. an enlarged and plugged hair follicle called the microcomedo is formed. What was known is that this plug is the first step in the formation of any type of acne lesion that may form later, and with different processes that too affect the contents of the follicle to eventually determine what translates to what.
True to be believed, the plug is so small that makes it invisible, which is the reason it is called a microcomedo. If the microcomedo stays beneath our skin and continues to grow, it is called a closed comedo, which looks like a white bump and thus is called a whitehead. Surprisingly no active bacteria are found in a whitehead and its contents are merely the accumulated skin cells and oils that cannot reach the skin surface because of the blockage.
However, in a matter of days, the blockage may sometimes reaches the surface of our skin and become open. In this case, the lesion is then called a blackhead because it looks black on our skin's surface. However, this black discoloration is not due to dirt but a process called oxidation, whereby the air, the oils, and the proteins in our skin will affect each other and cause the contents in the follicle to turn black, and will remain in the follicle to block the follicular opening. It is thick in comparison to the normal contents of our skin. Like the whitehead, no active bacteria exist in a blackhead. Interestingly both whiteheads and blackheads may stay stuck in our skin for a long time.It is good to know that those follicles with their attached sebaceous glands are most highly concentrated on our face and the back but less densely on our chest, upper arms and buttocks. For a more detail understanding on our skin structure, please read here.
What shall we do about these lesions then? It is best to be treated with gentle exfoliation (i.e. the process of removing upper layers of dead skin) and retinoids (products that are generally in the vitamin A family), and surgical extraction is proved to be very effective for this purpose too.
However, our fingernails are not surgical instruments in this case and that picking at these lesions, no matter how tempting it is, can make them worse and thus increase the risk of acne scarring, it is good to adhere to proper acne control and acne treatment for a more satisfying acne clear, acne care and acne free result.
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