What Is A Spot?

Keratinization Questions
What Are Spots?

Also called a zit or a pimple, a spot is a small inflamed lump on the skin which may or may not contain pus. In order for a spot to form, a hair follicle must be blocked. A hair follicle is a canal in the skin that contains a single hair. There are between 3 and 5 million hair follicles (in other words hairs) on the body. Each follicle runs through the epidermis and dermis, the two layers of the skin (see skin structure and function). Blocked hair follicles are also the primary cause of acne.

Hair Follicles

To understand how a spot forms, first we need to look at the hair follicle, which plays a central role. Technically the hair follicle is made up of 3 parts:

1. Sebaceous gland: This gland looks like a cluster of grapes and it role is to pump out oil (sebum) to coat and condition the hair and the skin. The oil rises to the surface of the skin keeping it lubricated, waterproof and protected against infections. It also helps carry dead skin cells out of the hair follicle to the surface of the skin where it can be shed. People who suffer from acne produce too much sebum.
2. Sebaceous duct: This is a tiny tube that steers sebum and dead skin cells from the sebaceous gland into the hair canal.
3. Hair: The actual hair that sprouts out of your skin pore (technically called follicular orifice). Hairs help sebum travel up through the skin layers.

How Spots Form

Step 1: Pores Become Blocked
Every day millions of skin cells die, they are pushed to the surface of the skin where they are shed (known as desquamation). Sebum carries the dead cells to the surface. Occasionally however the exit route of sebum (via the pore, a tiny opening on the surface of the skin) in a hair follicle becomes blocked by an excess of sebum production. Dead skin cells and keratin (keratin is an important hair, skin and nail protein) become clumped up with the sebum blocking the pore further (this process is technically called abnormal follicular keratinization).

Step 2: White Head Or Black Head Formation
The trapped sebum, dead skin cells and keratin act like a cork in a bottle, locking all substances inside the hair follicle so that they cannot escape to the surface. The cork, or plug is called a microcomedo. You can’t see a microcomedo at first. However, over time as pressure builds up, the hair follicle blows up and becomes visible (now called a comedo). There are 2 types of comedo:
a. Blackhead: the comedo gets bigger and pops through the surface of the skin. It looks dark in color, not because it is dirt, but because it contains melanin, the pigment that gives your skin color. When melanin is exposed to the air it turns black.
b. Whitehead: the comedo stays below the surface of the skin and remains light colored because the melanin is not exposed to oxygen.

Step 3: Inflammation
The blockage can remain as a comedo (whitehead or blackhead) or it can become inflamed, turning into a spot on the surface of the skin. In order for comedones to move up the chain and become inflamed, a certain bacteria called propionibacterium acnes needs to be present. People who are prone to acne (what is acne?) and spots tend to have more of this bacteria knocking around waiting to cause damage. When this bacteria becomes active, it triggers an immune response in the body to send white and red blood cells to the hair follicle as a defense response. The resulting ‘battle’ causes inflammation and pus.

Spots do not form because someone has forgotten to wash their face, nor even by eating lots of greasy fatty foods. It is not the oil on your face or in your stomach that cause spots, but rather the oil IN your skin.

• Got another question? See: Skin Care Questions

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