Many people believe that dirty skin is the beginning of all acne. Common misconceptions are that blackheads originate from dirt embedded in the pores or that greasy hair brushing against your forehead will cause pimples.
These cleanliness myths have set thousands of acne sufferers to scrubbing their faces with every harsh soap and abrasive instrument they can find. During my teens, I washed my face with pumice stone until it became bloody. For years, I also washed several times a day with the kind of antibacterial soap surgeons scrub with before an operation. Pat, a friend of mine, remembers washing at least a dozen times a day when she was nineteen and couldn’t understand how her two sisters, who hardly ever washed their faces, could have ‘peaches-and-cream’ complexions.
You cannot scrub away acne or cleanse the dirt from out from your pores. Why? Because it isn’t dirt! The impaction, known as a blackhead, which shows up on the skin as a dark speck is really thousands of dead skin cells which have sludged up in the pore along with the skin’s own oil and other natural debris to create a small mass. When this mass pushes to the surface it turns black upon exposure to oxygen in the air and also darkens from the buildup of skin pigment in the dead cells. The blackhead is not dirt but an actual anatomical impaction that may extend two millimeters (1/16 inch) below the surface of the skin. No amount of soap and water will scrub it away. In fact, if you scrub too hard you can break down the wall around the acne impaction and cause a flare-up.
Furthermore, despite current skin-care lingo, you cannot cleanse "deep down inside the pores." You can only clean the surface of the skin. All the skin machines, brushes, facial masks and facial vacuum cleaners will only affect the surface. It is physically impossible to go deep into the pores. All the "deep cleansing" you hear about is just skin-care promotional hype.
While we are destroying myths, let’s get another thing straight. The size or shape of your pores cannot be changed. Their size is genetically predetermined. Pores can neither be "opened" nor "closed"; they have no muscles to accomplish this feat. That bit of conventional wisdom that says hot water opens pores and cold water closes them is simply not true. Pore openings stay the same size unless an impaction such as a blackhead pushes up and dilates the opening. In fact, hot water or steam artificially creates the effect of closing the pore openings by causing the surrounding skin to temporarily swell and cold water, if anything would cause the pore openings to seem larger or more "open"; just the opposite of popular dogma.
When we take a good close look at a cross-section of the skin and pore (in the next chapter), it will become eminently clear that acne impactions develop deep below the surface. Surface cleansing can never reach acne nor can dirt on the surface cause acne in the first place. In the early stages of acne, pimples tend to appear first on the nose and forehead. Therefore it was and still is believed that hair dangling in the face causes the very common and numerous blemishes on teenage foreheads. Naturally, girls pick hairdos with bangs and boys comb their hair to swoop down over the pimples in an effort to hide them. And then mother yells, "Get that dirty hair off of your face! Look! Can’t you see it’s making you break out?!"
The truth is, you’d have the acne on your forehead with or without the dangling hair. Remember that the acne impactions are two millimeters below the surface of the skin. It is the oil being produced at that level that creates the problem. It is not due to further surface oil from hair. However in some cases, certain hair conditioners, or pomades, which contain potent oils, may cause some irritation (see Chapter 9).
While no amount of soap and water will wash away the acne, regular sensible washing should be part of your skin-care regimen. I rarely have to tell an acne patient to wash. More often I have to tell them to wash less frequently! Washing two or three times a day with mild soap is sufficient. When we get to your special acne control regimen in Chapter 13, exact instructions on how to wash will be given. In the meantime, please forget all your cleansing notions and potions. They only clean the surface. They do not resolve the problem in the pore. Be aware that acne is a process occurring deep inside, far deeper than any soap, cream, or washcloth can ever penetrate.
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