The skin is composed of many layers of skin cells that lose their moisture and migrate to the outer layer of the skin, where they are shed and replaced by new cells. These skin cells (keratinocytes) also line the inside of the follicle. Normally, the cells are sloughed off and there is no problem.
In the follicles of predisposed individuals, these cells are retained in the follicle and begin to mature into impacted follicles.
These can not be seen or felt. They are like little landmines below the skin waiting to mature into blackheads or whiteheads.
A blackhead is composed of the same components as a whitehead (dead skin, oils, and bacteria). With a blackhead, the opening of the skin allows oxygen to get into the follicle causing an oxidation process that results in the dark color. Blackheads are more easily expressed during the acne facial treatment. Blemishes triggered by blackheads are more on the surface of the skin and result in less scarring than a closed comedone (whitehead).
The blackheads will mature into pustules.
Within the first 72 hours of the papule formation, the white blood cells clump together, forming pus that will migrate to the surface, bringing the impacted material with it. If this process happens quickly, there should be little, if any, scaring.
Whiteheads will mature into inflamed papules.
With a whitehead, the opening of the pore is closed. If air could get in, it would become a blackhead. It is an accumulation of dead skin and oils within the pore…about to erupt into an inflamed papule.
The whitehead matures and gets bigger and bigger until it explodes deep inside the follicle, spilling its contents into the dermal tissue. The body’s immune system sends white blood cells (leukocytes) into the area to attack the impaction. The white blood cells try to dissolve the impaction and inflammation results. This is what causes the scaring. How deep the eruption is within the follicle will determine how much scarring will occur. If the impactions are removed before they progress to pustules, the blemishes will be omitted and acne scarring will be prevented. |