WHAT IS ACNE?

The main definition of acne known to most people is pimples.

But there are various stages of acne and differing types of infection and inflammation.

Common Acne or “Acne Vulgaris” begins with just a clogged pore that becomes inflamed with the surrounding skin becoming pink and gradually swelling.

Common acne or pimples are caused by the Acne P or “Propionibacterium Acnes” bacterium which enters the swollen pore and begins to infect the pore and the surrounding tissue.

As the bacteria infects more skin tissue, the simple pimple will progress

1. Papules – small pink swollen clogged pores
2. Pustules – pus develops inside the pore
3. Nodules - very swollen painful pus filled lumps
4. Cysts – major infected multi headed

 

At each stage the potential for scarring also develops as more skin is destroyed by the bacteria. Depending on age and severity and lifestyle – cause can be hormonal, skin care, activity and sensitivity.

Severe Acne - Severe Nodulocystic Acne Acne Conglobata is an extreme infection and it causes deep scarring. Medical intervention is required to fight the bacterial infection. 

Images recognises 2 types of common acne 

1. Adult Dehydration Acne Syndrome
2. Teenage Acne

 

1. Adult Dehydration Acne Syndrome

Also See Teenage Acne Below

Most people (especially adults) think that just because they have a pimple they have “oily skin” and they immediately begin a new skin care routine using oil removing products that strip the skin of any oil and oil free moisturisers. Guess what??? They have actually got dehydrated skin and the little bit of shine is normal oil needed to keep the skin functioning properly with a correct acidic pH and moisture content.  It is rare to find adults in New Zealand to have true OILY skin. We at Images Beauty Therapy have developed a facial / skincare routine that addresses this problem. It requires a commitment to following our recommendations that may seem totally odd and different from what you would expect.

Cause of Dehydration Acne Syndrome

In today’s life style, we exist in a variety of environments from slightly humid to extreme desert due to air conditioners in our shops, meeting places, offices, cars and homes. It has become extremely rare to find a truly oily skin with most people believing a slight sheen of oil on their face after a long day indicates oily skin. Most teenagers and adults today have been brainwashed by major over the counter or supermarket skin care companies that they have oily skin if they have a pimple and then they convince everyone that they have to use harsh cleansing foams and scrubs and oil free moisturisers to get rid of pimples and ACNE.

The reality is that by using these very products you actually perpetuate the very pimples you are trying to get rid of.

Let’s look at what has happened!

1. Our environment has dehydrated our skin, causing cells that form our skin to DRY OUT and deflate like balloons.
2. We are lazy beings, and initially we do very little to care for our skin. Our skin is lucky if it sees a splash of water in the shower.
3. Our skin contains sebaceous glands which produce our natural moisturiser – sebum.
4. Sebaceous glands have little tunnels that connect to hair follicles (the holes that hairs grow out of) and sebum travels down these tunnels and up the hair follicle onto the skin surface.
5. Our sebaceous glands make a small amount of oil, mixed with some water and other molecules that create an acidic solution that is gently secreted on to the surface of our skin to act as our natural moisturiser and bacterial control solution. (Creating “The Skin’s Acid Mantle“)
6. All is fine until maybe an extra dry windy day, or you sit too close to the air con at work or in the car. Our skin is NOW DRY!!!!
7. BUT we ignore it as normal.
8. After some time the sebum (that oil and water mixture we were making in our skin) becomes thicker inside the little tunnels travelling from the Sebaceous Gland to the surface of the skin.
9. The skin cells that surround those tunnels are dry and act like little tiny sponges and suck the water out of the sebum, before it has even reached the skin surface.
10. Now we have a problem, the skin has become congested, the sebum is not reaching the skin surface and the skin is becoming dryer. The signal deeper in the skin is make more sebum – skin is dry.
11. We now start to get dry flaky bits on the skin surface; you can actually feel them as roughness. But because we are making extra oil, we can see this thin layer of oil on the surface of the skin.
12. Next we think, okay, shiny equals oily skin, must change to products to strip that oil away.
13. We think OIL IS BAD!!!
14. The thick sebum stuck in our pores (tunnels) is getting thicker, harder, larger and more visible.
15. They are becoming – BLACKHEADS AND WHITEHEADS.
16. That thick sebum is made of oils that are going slowly rotten and forming– fatty acids – which irritate the surrounding skin cells making them become inflamed and pink and raised. Almost like small volcano’s ready to blow.
17. Your skin is also developing an Impaired Acid Mantle – the skins pH is becoming alkaline
18. The inflammation is the beginning of pimples.
19. And now the acne bacteria gets going, and it likes to eat skin, and our immune system starts a war to try and kill the acne bugs.
20. But we just help everything get worse because
21. We use products to dry out our skin
22. And now we have a big cycle of dry skin getting clogged up and developing more pimples.
23. Our skin tries to fix it with more sebum, but we just make it dryer.
24. And then we add insult to everything and blame the whole problem on our “oily skin”

 

What does Images suggest?

1. Stop using Cleansing Foams or Soap to wash your face!
2. Cleansing Foams and Soap cause dry skin - if you wash your hands too often you will soon notice dry hands. Cleansing Foam contains the same ingrediant found in DISHWASHING LIQUID - Sodium laureth sulphate.
3. Start with a good old-fashioned MILKY CLEANSER made of oil and water emulsified together just like a moisturiser.
4. If you are really dry, try adding vegetable oil to that cleanser and turn it into “cold cream”, this will easily soften your dry skin and the oil helps to dissolve the hardened sebum near the surface of the skin. (oil dissolves oil)
5. Try really softening your skin with moisture rich creams, and masks that soak your skin and really hydrate it. Try dampened tissue left on your skin to allow the water to soak into the skin cells for about 10 to 20 mins.
6. You will notice as you do this that your sebaceous plugs (blackheads) begin to swell and go a whitish colour and even rise out of the pores.
7. When and if this happens immediately cleanse again with the above mixture or massage over the swelling pores with a vegetable oil (canola is good) to dissolve the thickened sebum.
8. Tissue off the oil and dissolving sebum plugs with upward movements moving inwards towards an imaginary central line up the middle of your face. Ask us to demonstrate this procedure. Tissues are able to pick up the CLOG and lift it out of its pore and carry it away. 
9. Afterwards tone and moisturise your skin with a good moisturiser designed for DRY skin.
10. Over time, repeating this procedure will gradually shrink your pores and blackheads.
11. Be warned, as you begin this procedure, you will notice that your pores will grow bigger when you start to moisturise your skin, but this means we are doing the correct thing and your skin is starting to clean ITSELF!
12. It means the sebum is expanding with the extra water content and the surrounding skin cells are filling with water too. The pressure these skin cells exert on the sebum plug push the plug towards the skin surface and gently out of the skin. Your cleansing milk or oil can now dissolve the exposed sebum plug.
13. INFECTIONS are another matter, but because you have started to moisturise your skin, the skin is able to heal itself! Healthy skin functions require good levels of water within and between skin cells allowing the bodies healing “cells” to move about freely to destroy infectious bacteria and repair damaged skin.
14. You will notice that pimples will start to be less red and swollen as the skins natural healing mechanisms begin to function better and your skin begins to fight the bacteria more efficiently.
15. You can help it using TONER. Toner is just a solution that makes your skin acidic like conditioner after shampooing and fabric softener after washing clothes. Acne Bacteria don’t like acid conditions. Toner corrects the Skin’s Acid Mantle. It is this acidity that controls bacterial growth and helps the healing process to begin.
16. Cleansing, toning and moisturising your skin gnight and morning is also important, so Cleanse /tone/moisturise at night because as you work through the day your skin picks up all manner of dirt and pollution plus a build up of dead skin cells and excretions. If you have worn makeup during the day you also must remove it at night.
17. During your sleep your skin is actually active and regenerating itself, therefore it is necessary to clear away debris in the morning before the start of a new day.
18. Moisturiser is very important as this acts just like your natural sebum – it is an emulsion (mixture) of oil and water. Moisturisers or an application of an oil every day acts like a protective layer that prevents dehydration and the evaporation of your skins water (TEWL = Trans Epidermal Water Loss). A fine layer of oil acts like Glad wrap over salad or food – stopping evaporation and drying out.
19. Sun Block (SPF 15 or higher) is an absolute must to protect your newly healing skin from UV damage, and possible hyper- pigmentation (darkening). Fresh Acne scars are very sensitive to damage by sunlight.
20. Finally, to speed things along, go to your enthusiastic beauty therapist here at Images to have extractions of those lovely blackheads and whiteheads. What may take months to correct the slow way will only take weeks with the professional help of your friendly beauty terrorist, oops, therapist.

 

Professional Treatments

We recommend frequent Mini or Deep Cleanse Skin Treatments (we call them Extraction Facials) starting with every week, then gradually, stretched out to 2, 4 and 6 weeks, and as your skin improves we suggest longer appointment gaps. Extraction Facials consist of

• Gentle cleansing with a milky cleanser for either a sensitive / dry skin.
• Often the addition of vegetable oil to the above cleanser to more gently soften and cleanse off the dead skin cells trapped on the surface and to dissolve sebum (skin oil) in the pore openings. We will massage this oily mixture for a few minutes to give it time to soften and dissolve multiple clogged pores.
• We eventually begin using a deep refining AHA cleanser
• We may add a gentle exfoliant or scrub (not used if there is major inflammation or infection)
• If needed we add an AHA Peel to help dissolve the clogged sebum and refine the skin surface and help with the healing process.
• We perform Extractions of Blackheads and Whiteheads – removing the sebum plug from inside a pore (tunnel).
• After a Calming face mask tis applied to soothe the inflamed skin and begin healing.
• Some clients even choose to go home with this mask on to allow added time for healing.
• We will rinse the mask off with mild warm water and gentle movements.
• Finish with a good emollient nourishing moisturiser.
• And of course a SPF to protect.
• This Treatment is also available for Back or Chest areas – (Bacial !!!)
• Microdermabrasion is another alternative treatment on our skin care menu. This treatment is a great alternative exfoliation which can help to unblock pores and help reduce the thickened layer of surface skin (dead dry skin cells). We don’t recommend microdermabrasion when active infection is present.

 

2. Special Note = Teenage Acne

From approximately 11 to 17 the average teenager will experience puberty.
During this period the skin goes through some interesting changes.
Sweat glands and sebaceous glands become more wide spread and with them an interesting cycle of acne begins.
The Skin’s Acid Mantle is an acidic combination of sebum and other secretions of the skin and the resulting pH (acid or alkali) levels become very important in controlling the bacterial growth in the skin and in its adjacent tissues such as pores.
Teenage acne usually results from having an impaired acid mantle, combined with over productive oil glands and the introduction of the Acne P or “Propionibacterium Acnes” bacterium.
The school environment is a wonderful bacterial breeding ground with very low hygiene levels and this therefore sets up the teenager for "catching Acne". Other teenagers with Acne are spreading the bacteria all over the school environment - desks, door handles, shared pens and books. 
Skin care becomes an integral part of the teenager’s day, and it is important to get the recipe correct in order to control and eradicate acne.
It is quite usual for teenagers to spend hours in the bathroom, be very zealous with cleansing and squeezing, trying to get rid of their pimples.
Equally the lazy teenager can completely neglect their skin and end up with no problems.
The skins own natural bacterial control is based primarily on the correct pH of the skin or the correct acid content. 
Old sweat breaks down to alkaline and soap also tends to be alkaline.
Sebum tries to correct this imbalance. The acne bacteria loves these pH changes.

The easiest homecare routine to control acne and pimples is to simply keep the skin clean of dead skin cells, dirt, old sweat and pollution and keep the acidic pH of the acid mantle gently in place with some bonus moisture to keep things happy.

• The foaming scrubs available over the counter and at the supermarket are basically a soap alternative which are mainly detergent –sodium laureth sulphate. This makes foam. It also dissolves skin and oil. Also called dishwashing liquid. It dries skin excessively and in our climate and air-conditioned life style this is often too extreme.
• The more gentle approach is better and less irritating – use a gentle cleansing cream or milk. Gels may also be more refreshing but should not foam. Always check the ingredients list on the back of products and determine if they contain surfactants or Soduium Laureth Sulphates - SLS (soap alternative).
• Toners become very important to teenagers and these are your anti bacterial solutions. They need to be used liberally as they correct the pH gently back to acidic with little or no irritation.
• We often suggest a homemade toner solution of diluted Apple Cider Vinegar – ¼ ACV ¾ Water.
• At night an acne treatment should be used. Applied only to the eruptions. Most contain benzyl peroxide (2.5% ideal strength) or salicylic acid to dry out and kill the bacteria. At night the product can be applied and left on for 8 hours during sleep, this means plenty of time for it to work. A nice gentle alternative is old-fashioned calamine lotion, which is anti inflammatory and antiseptic and dries pimples. Another good alternative is Crystaderm which is a 1% Hydrogen Peroxide lipid stabilised first aid cream.
• It is very important to moisturise the skin, to keep the skin’s natural healing mechanisms working and for faster healing to occur. See the notes on dehydrated acne as most teenagers suffer with this form of acne too. We have been also recommending Rosehip Oil as an alternative to moisturiser.
• Finally sun block is a must to protect any healing skin as the pink skin is very sensitive to sun damage and pigmentation.
• Severe Acne requires medical help with antibiotics and Vitamin A medication.
• We often perform extraction facials for teenagers but we also recommend in severe cases that medical intervention may be necessary if bacterial infection is prevalent and uncontrolled. Prescriptions for some acne treatments and antibiotics are often the best treatment and some teenagers benefit from a combination of medical treatments, Antibiotics, extractions and facials to speed the healing process.

so a simple list

1. Cleansing milk  -  try Aqueous Cream
2. Toner  -  apple cider Vinegar Diluted with water
3. Acne Treatment product - to dry and heal pimple 
4. Moisturiser or Roasehip oil
5. SPF 15 or 30

 

Other Acne Treatments

• Microdermabrasion
• aha peels
• ipl acne
• dermal needling