One of the most common and frustrating skin conditions is acne. It can range from a single blackhead to severe cystic acne and can affect anyone at any stage of life. Dermatologists believe that acne is an inherited condition caused by a genetic defect, which leads to over-production of a “physiological glue” in the skin’s follicles.
What is a follicle? A sebaceous follicle is a long, narrow tube, barely larger than a hair’s diameter. The surface of the face is covered with them, and the walls of each tube are lined with the same flat, dead cells of the stratum corneum, the topmost layer of the skin. The stratum corneum is continually shedding cells, which are replaced with new, young cells. The same shedding takes place in the follicle. Normally, oil carries these cells out of the follicle to the surface, where they are shed. However, in people genetically predisposed to acne, these cells cannot reach the surface because they stick together and remain in the follicle.
At the beginning of the acne process, this clump of dead cells is called a “micro-comedone,” and the skin’s surface may appear entirely clear and unaffected. But as the clump of dead cells grows larger, oil is trapped in the follicle beneath the plug. Propionibacterium acnes, a type of bacteria that lives on the surface of the skin and in the follicles, feeds on this oil and produces an irritating fatty acid. Eventually, after several weeks to months, the follicle becomes entirely clogged, and various acne signs appear.
A cream containing 10% glycolic acid dissolves the “physiological glue” that causes the dead skin cells to clump together, allowing them to proceed normally to the skin surface where they are sloughed off. Continued use of the cream prevents this clogging effect from recurring, keeping the skin free from acne and other blemishes.
Dr. Duke, a St. George dermatologist, was once asked why he uses 10% glycolic preparations on his teenage patients. “Zits! The answer is plain and simple: Zits,” he replied. He went on to say that 10% glycolic acid preparations are among the best treatments he has found for teenage acne. “They love it,” he said.
