Inflammation and Acne
The mention of the word inflammation to most people suggests redness and swelling associated with some form of infection or the other but is that really all? What is important to note is that inflammation is the body's first response to an injurious stimuli and is summarized very briefly in the following definition: "a localized protective response elicited by injury or destruction of tissues, which serves to destroy, dilute or wall off (sequester) both the injurious agent and the injured tissue."
Redness, Heat, Swelling, Pain and Loss of function
In the 1st century AD, the Roman medical writer Aulus Cornelius Celsus described four cardinal signs of inflammation – rubor (redness), calor (heat), tumor (swelling) and dolor (pain), characteristic of the inflammatory process. It is now known that:
Redness results from increased blood flow and pooling of blood following injurious stimuli.
Heat also results from the increased blood flow to the area of injury
Swelling is from edema and accumulation of exudates and clot formation in the affected tissue.
Pain is the result of physical and chemical stimulation of nociceptors (pain receptors) mostly by certain chemical substances known as mediators produced during the inflammatory response. Chemical mediators are classified based on their site of production- those produced within cells are called cellular mediators of inflammation (and include histamine, proteases, prostaglandins, leukotrienes, serotonin and lymphokines) while those produced in the plasma are called plasma factors (and include bradykinin and components of the clotting cascade).
Loss of function was not originally described by Celsus and was only introduced as a cardinal sign of inflammation in 1871 by Virchow. It has been noted that in a number of cases there is usually loss of function of the affected parts which are as a result of pain, reflex muscle inhibition, disruption of tissue structure and fibroplasia and metaplasia.
Types of inflammation:
Depending on the duration, inflammation is described either as acute or chronic. Acute inflammation is:
- Usually sudden onset
- Characterized by most or all of the cardinal signs described earlier
- Vascular and exudative processes predominate
Chronic inflammation on the other hand is:
- Inflammation of slow onset and progress
- Marked by formation of new connective tissue
- May or may not be progressive from an existing acute inflammation
- Usually causes permanent tissue damage
The Acne / Inflammation Connection:
Acne vulgaris is a common skin disorder affecting over 80% of people at some point in their lives. It is characterized by non-inflammatory follicular papules or comedones and by inflammatory papules, pustules, and nodules in its more severe forms.
Four factors have been outlined in the development of an acne lesion and they are;
- Follicular epidermal hyper proliferation with subsequent plugging of the follicle
- Excess sebum
- Propionibacterium acne's activity
- Inflammation
Propionibacterium acne's is an anaerobic bacterium and is a normal flora of the skin; it is present in acne lesions. It has been suggested that while this bacteria is present in the skin of all individuals, it does not produce acne vulgaris in everyone; the reason for this is that people show varying hypersensitivity to the bacterium.
In individuals who are hypersensitive, the presence of P. acne's promotes inflammation through different mechanisms. Inflammation triggers the production of chemical mediators including IL-2α (Interleukin 2-alpha) which induces follicular epidermal hyper proliferation and comedone formation- an acne lesion.
All the factors mentioned above happen to be internal in origin; some external factors may also produce acne including:
- Certain cosmetics
- Medications e.g. steroids and certain anti-epileptics drugs
- Endocrine disorders e.g. congenital adrenal hyperplasia, polycystic ovary syndrome
- Genetic factors
Treating Inflammation and Acne:
The over the counter acne medication Benzoyl Peroxide, which is found in many acne cleansers and creams, is one way to sooth inflamed skin. If you're going to use a product with Benzoyl Peroxide make sure you avoid the maximum strength formulas that can contain as much as 10% Benzoyl Peroxide, instead stick with a gentle formula that has no more then 3%.
In my Acne X Factor guide I'll show you more ways to stop the burning inflammation that often comes with having acne. Know one else is addressing inflammation, but learning how to cool off inflamed skin is a very important part of getting rid of acne.