Acne Facts- Inflammation

Acne is mostly an inflammatory reaction of your body to skin lesions caused by sebum outbreaks to cells lining the hair follicles, and by similar lesions inflicted by chemicals produced by the development of acne bacteria within blocked pores.

Acne treatment must repair skin lesions and address inflammation, blocked pores and acne bacteria, and always try to avoid loss of tissues as in ice pick or pitted acne scars or abnormal fibrotic or keloid scars.

When we’re hurt or seriously ill, our first response is to call a doctor or head for the nearest emergency room. But faster than you can dial 9-1-1, the body’s internal emergency response team is already on the scene. Responding instantly to biochemical distress signals from damaged tissue, specialized cells and proteins have already started to seal off the injured area, destroy damaged tissue and kill invading bacteria.

It’s called the inflammatory response, and the pain, heat, swelling and redness we associate with injury are signs that it’s working.

Inflammation is the body’s first line of defense against injury and infection, but it’s a double-edged sword. An out-of-control inflammatory response can destroy healthy tissue and cause more damage than the original problem. Keeping it under control means the immune system must maintain a balance between fanning the flames of inflammation and cooling it down.

Acne is an inflammatory skin condition which main characteristic are superficial skin breakouts. And those may or may not get infected with the acne bacteria that live within the hair follicles.

Did you know that Propionibacteria acnes, the bacteria that is the main responsible for acne infections lives in symbiosis with our body, feeding on our damaged cells, helping the sebaceous glands to transform them into sebum, and metabolizing all components of sebum into fatty acids with antimicrobial properties?

The thing is when sebum flows through out the hair follicles to the surface of the skin it helps to lubricate our skin and takes care of our skin as it contains lactic acid and fatty acids. Both acids avoid the growing process of certain pathogenic bacteria and fungi, which always prepared to thrive especially when our immune system becomes impaired.

The thing is that when sebum doesn't flow in the best way and ends up getting trapped by either clog pores or pinched-off sebum glands - OUCH!- it breaks or damages some of the lining cells of the sebum tracts. And guess what? Our body readily responds to the Ouch signs. Of course! It isn't deaf to them, unlike us that often have little ability to listen to signs of danger or even to those letting us know of approaching perils.

Yes, the body answers in almost the same way it learned to react during the many years of our evolutionary drift. By sending to the site where the injury is located and insult all its forces of immune system soldiers (lymphocytes, macrophages, neutrophil) overloaded with chemical weapons to eliminate the attackers, without consideration even for its own cells that might happen to be in the way and also do get eliminated. After all it can be seen as a matter of life or death!

This is what we mean by "inflammatory reaction". And, Oh Boy! You might as well bet all those soldiers are really inflamed!

A model of the pathophysiology of inflammatory acne and skin damage



The diagram above shows a complex model of the pathophysiology of inflammatory acne and skin (dermal) damage. In inflammatory acne lesions, NF-κB sign is activated (a transcription factor critical for up-regulation of many proinflammatory cytokine genes). As a result, inflammatory cytokine genes (eg. TNF-α and IL-1ß) are activated. These primary cytokines will spread the inflammatory answer by acting on endothelial cells to prepare adhesion molecules (eg. ICAM-1) to facilitate recruitment of all inflammatory cells into the skin. TNF-α and IL-1ß will also help to stimulate the proliferation of secondary cytokines, such as IL-8, which can cooperate in the movement of the inflammatory cells tending towards the increased concentration of these particular chemicals. By using their cell surface receptors, TNF-α and IL-1ß not just amplify the NF-κB signaling cascade, but also trigger the activation of MAP kinases (mitogen-activated protein kinase) to stimulate AP-1 mediated gene transcription (another important transcription factor involved in inflammation). As a consequence of activator protein 1 (AP-1) activation (cJun induction), AP-1-driven matrix metalloproteinases (MMPs), a type of zinc-dependent protease enzymes, are produced by resident skin cells. Along with neutrophil collagenase and neutrophil elastase enzymes brought to the site by (PMNs) polymorphonuclear leukocyte inflammatory cells, they synthesize extracellular matrix proteins such as collagen and elastin. After this it comes the matrix synthesis and renovation. This is not a perfect solution. Most of the imperfections could leave clinically untraceable deficits in the arranging or forming, or both, of the skin layers. Nonetheless, when they happen to a significant extent in time, along with sustained procollagen synthesis, acne scarring gets clinically visible. American Journal of Pathology. 2005. Inflammation and Extracellular Matrix Degradation Mediated by Activated Transcription Factors nuclear factor-κB and Activator Protein-1 in Inflammatory Acne Lesions in Vivo. Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, US.

Now of course there are factors that "produce " hyperactivity of our glands, blocked pores, bacterial infection and the like. Stress is the hands-down primary producer of sebaceous glands hyperactivity that may become acne inflammation. And, there are many other contributing factors as well. These can include, rubbing and squeezing pimples, pressure pressure or friction (head bands, caps, etc), lifestyle, birth control pills, cosmetics, climate and diet, but stress is the Big Kahuna! Now, "stress" is another story, and you may afterwards go to our FAQ and find more about the biology of stress & acne.

Again, you can not blame your own body for producing huge quantities of sebum. The complication is how it responds to damage applied to the cells that border the sebum passages. When the canals get overcharged with sebum pushing to get to the surface -where it belongs-, or when they aren't able to reach the skin surface due to blocked pores and pinched-off sebum glands.

Okay! You will treat very oily skin and blocked pores with an acne treatment product, for a determined period of time, and until your skin is back in order. And you may as well think about changing just some of your nutritional customs to avoid sebum canals pinched-off by the pressure of extreme humidity attracted by toxins expelled within your skin by your lymphatic system, as you may learn about by going to the Acne & Rosacea FAQ and the links there on skin detoxify and in regards to the union between adult acne and dairy products or acne and diet.

Now, what's with the inflammatory reaction which occurs every time those events re-occur as it is guaranteed due to your natural hormonal imbalances? Well that is unless you live in a wonderful, totally stress free world. That perhaps is not a very attractive realm though.

Mediating the inflammatory frenzy will prevent acne scarring

The inflammatory response has one all-important goal: respond immediately to detect and destroy infection or toxic material in damaged tissue before it can spread to other areas of the body. In its zeal to protect the body, it will destroy as much tissue as necessary to accomplish this goal. Left unchecked, a hyperactive inflammatory response can even react to the traumatic effects of accidents, burns or surgery on the body and start attacking healthy tissue.

Like everything else in the human immune system, the inflammatory response is controlled by an incredibly complicated communications network made up of multiple cells, cascading signal pathways and feedback loops. It starts when scavenger cells called neutrophils arrive at the site of injury or infection. They surround and engulf toxins, microbes or damaged tissue and broadcast biochemical “SOS” signals calling for reinforcements. Complement proteins join the fray triggering the production of powerful, pro-inflammatory molecules and tissue-destroying enzymes. This intensifies the response and causes inflammation to spread to surrounding tissue. Once activated, the feeding frenzy will continue until the immune system sends an all-clear signal to indicate that the crisis is over.

Did you understand? Modulating the inflammatory response is the answer for success! Calm down you guys (immune cells), past are those moments when bacteria and other micro-organism were kings. Or is it nothing but wishful thinking? Is it not true that we carry on and inside our body three times more bacteria than the number of cells our organism is composed of?

The thing is that our body contains the records of all past battles, fought to take care of our organism whenever broken or injured and doesn't hear just any argument invented by the pharmaceutical or cosmetic firms that sell anti acne products aiming to control bacteria.

During our evolution, injuries and wounds were a problematic threat to our organism, not just due to blood loss, but also due to tissue injuries or infection from the attack of foreign attackers such as dirt, splinters and bacteria. The adult wound recovery method that evolved to respond to these threats has two main characteristics: First, there is a fast and robust inflammatory response, with recruitment of active macrophages, neutrophils and lymphocytes to the injury site; and second, there is a fibrotic "walling-off" response to separate the foreign body, with liquefaction of adjacent tissue that might lead to abscess formation and also scarring.

In fact, acne wounds are in this respect similar to any kind of skin injury. Our body answers with the same powerful inflammatory knee-jerk to the sebum that is meant to get to the skin surface but stays clogged inside the hair follicles as if it where a foreign body; or when sebum production is exacerbated and the first flow of sebum through the previously empty duct causes shear forces of sufficient magnitude that injure the walls of the sebum canals or the pilosebaseous glands.

Inflammation increases when acne bacteria (Propionibacterium acnes) and other happy bacteria always present on the surface of the skin (Staphylococcus aureus, Staph. epidermidis, diphtheroids, streptococci, Candida, etc) start to proliferate without control in punctured or broken skin. The problem grows if right there the deliciously rich feeding fatty sebum is plenty.

"An abscess and its subsequent scar is not an evolutionarily optimized end point for today's injuries, Dr. Mark Ferguson, D.D.S., Ph.D., professor in the faculty of life sciences at the University of Manchester, England, says. The abscess and scarring response, with its massive inflammatory overdrive, is optimized for a very different type of skin lesion than those occurring nowadays where hygiene and clean faces and bodies rule. The abscess and scar is induced by this inappropriate inflammatory response..."

Lesions that affect the cells lining the sebum canals, appearing due to a sudden overflow of sebum or pinched-off sebum glands, happen in otherwise clean skin with no dirt or contamination by foreign bodies. These wounds should therefore be great candidates for healing with no complications using a regenerative injury healing method rather than a scarring method. The outcome should be marked by scar less recovery.

The healing process inside the hair follicles should be very similar to what our body accomplishes for fetal wounds which heal quickly by renewing cells and leaving absolutely no marks.

Something is missing in all the other treatment products out there.

Something that would tell your body that it is being taken care of properly and doesn't need to overly react with its inflammatory battalion. Not just the natural or artificial ingredients that fight against the symptoms, when it is already too late: acne bacteria gone uncontrollable, occlusion of the ducts (microcomedones) and then enlarged comedones that transform into inflammatory wounds.

This is a vicious cycle that causes continued and/or increased obstruction of the outflow of the sebum, which in turn can lead to to more pressure, inflammation and continue or progressive infection.

This continued obstruction, with or with no infection, leads to the formation of cysts. Infection of a cyst produces the formation of an abscess which leads to local tissue destruction. If this destruction of skin tissue has involved the connective tissue elements of the skin or subcutaneous tissues to a sufficient degree, the healing process is frequently accompanied and/or followed by the formation of a scar.

Acne scars can vary from minimal to extensive and severely disfiguring problems which are eternal consequences of acne. While the mechanism by which acne begins and lasts for an indefinite time may and frequently does come to a halt as a result treatment or by itself but the scars remain for life unless they are eliminated.

An effective support for our body's immune system anti-acne resources

Fortunately we've found, by chance and keen observation, a more effective model. One adapted as a contrasting evolutionary immune response and cell renewal system, by a family of invertebrates ( animals without a spine). It is named innate immune system, also present as a first line of protection and immediate maximal response against infections and foreign substances in the body, and opposite to the delayed structured response of our adaptive (or acquired) immune system.

The innate immune system is comprised of the cells and methods that defend the host from contamination with other organisms, in a non-specific manner. This indicates that the cells of the innate system recognize, and respond to germs in a generic way, but unlike the adaptive immune system, it doesn't give long-lasting or protective defensive immunity to the host.

Although apparently less complex than the immune systems of the vertebrates, invertebrate immunity is way older regarding its evolution, and likely served as the progenitor to sophisticated vertebrate systems, and also has apparently served all these animals well enough to maintain their lineage living for the past several hundred million years.

Invertebrates also answer to injuries and insults from the environment by renewing damaged cells, and even entire organs and the skin they contain, with no immoderate inflammatory response and trigger really fast results and an orderly, totally orchestrated, skin regeneration and remodeling without aberrant scar healing! Yes, this is made by very small creatures that all of us, arrogant people, many times considered an inferior form of life, in a less evolved period.

Unlike clever herbal, botanical, chemical or cosmeceutical concoctions fabricated in a pharmacy, or by the cosmetic industry, a complex and totally natural substance secreted by spineless creatures of a specific type of land invertebrates is already a complete and balanced solution for scar less healing of skin lesions -and its effects on acne & rosacea skin disorders may far exceed attempts to imitate life's genius in a laboratory.

We tell you all the facts about the natural skin healing characteristics of this substance -the second part of the response -, at the INGREDIENTS link in the top menu! But before anything else we have to warn you, for some people despise these forms of life or viscerally respond to them with disgust. Others learn after the fact to be wiser as they can not be thankful enough for the blessings such natural solutions provide.

You may have stumbled upon this little creature in your backyard, if you live in one of those areas of the world with Mediterranean weather and soil conditions. Maybe you even noticed it has a skin with the same cells and structures that our skin is made of: collagen, elastin, and all the molecules our skin is made of.

But his way of acting when the skin or some of its organs are damaged and then attacked by micro-organisms is very different than our own strong innate inflammatory response. It copiously makes and bubbles and bathes in the ONLY natural secreted substance made by a living mollusk -as a result of its amazing evolutionary drift of billions of years- to moisturize its skin in a deep way and effectively while at the same time taking care of the skin with antimicrobial peptides, antioxidants, and molecules that activate the orderly regeneration, rebuilding or renovation of whatever cells and structures may be hurt.

For our skin, it does, from the outside, the same and more. It not only strengthen the body's ability to ingest and eliminate infectious particles or dead/dying cells and supports the job of the antimicrobial peptides that our skin fabricates, such as the ß-defensins, but it also amazingly restores balance to skin disturbed by innate hormonal disorders, such as acne and rosacea, and not just to skin bothered by lesions and injuries that appeared as a result of accidents, hazards or environmental contamination, damaging UV radiation, parasites, bacteria, fungus, virus or chemicals.

The molecules in this biological substance inform the body that it is being taken care of and needs NOT react to bothering agents with uncontrolled inflammatory responses, for it is being supplied with the correct proteins, enzymes and nutrients required to easily control bacteria and to trigger scar less regeneration. Thus it is in a totally different way than our evolutionary drive has taught us humans to over- react to those factors, from the inside, as the most effective ways to thrive in an environment that was dominated by infectious bacteria.

For this was homo sapiens reality for thousands of years till society was taught hygiene and modern science discovered antibiotics -which by the way have an anti-inflammatory reaction that is now assumed to be a way more important reaction for people who suffer severe acne and rosacea than it is the anti-biotic reaction (which means anti-life) that destroys bacteria.

Topical application of this substance created by this small mollusk, soon right after the first signs of acne pimples helps the cells from initiating the signaling cascade that leads to acne inflammatory responses and healing through the scarring pathway. It seems to accomplish this by changing the normal environment in a way that helps the scar less healing pathway.

The biological substance works for its maker in such an irreducible complex way that it can be a task to try to explain how specifically it regulates the response of the immune cells, especially of the macrophages, which are the oldest and most consistently kept immunologic competent cells known. When these cells are activated, they stimulate a cascade of events which enhances immunity. All the functions, including phagocytosis (ability to eat foreign cells, other materials and particles), release of certain cytokines (intercellular "messages") and the processing of antigens are clearly improved.

From the very beginning of our attempts to market a product for skin care made with this natural component, our own customers where telling us that it doesn't just relieve the effects of acne breakouts & rosacea, it can also prevent acne breakouts and rosacea when used two to three times a day on clean skin as a routine skin care regimen to maintain skin clear of spots. It helps also with the repair of daily and accumulated damage created by exposure to UV radiation and by free radical oxidation.