Skin Lesions

Skin is generally classified into types:

  • Normal
  • Dry
  • Oily
  • Combination

Oily skin is most prone to acne due to excess sebum production. Combination skin on the face may also prompt acne "skin lesions" in oily areas.

"Skin Lesion" is the term used to describe any type of bump on the skin, and there are many different kinds-both acne- and non-acne-related. A blackhead is a common type of acne skin lesion, while freckles and moles-which most assuredly have nothing to do with acne-are also skin lesions.

How Skin Lesions Form


While acne is most definitely problematic, it is a fascinating biological process. Epidermal cells shed and start to clump together, joined by sebum and bacteria. This biological "stew" sticks to the follicle wall. As the clumping becomes greater, the follicle wall grows thicker and begins to bulge. The opening to the surface of the skin becomes blocked, and you have a plugged follicle. This is called a "comedo." (Have more than one, and you've got "comedones"-the plural form of the word.)

Whiteheads and Blackheads

A comedo begins as a simple pimple: a flesh- or white-colored bump under the skin. The pore is completely plugged, so this is classified as a closed comedo. It may also be referred to as a whitehead. We will stress the following throughout this book: Never attempt to open a whitehead yourself, as the real blockage is occurring underneath the skin.

If the pore does open, you have an open comedo-more commonly known as a blackhead. When a closed comedo is exposed to air, it oxidizes, which gives the blackhead its dark color. The dark color is not due to dirt-a common myth.

Squeezing blackheads also won't solve your problem, as the gooey material inside the pore will be forced down to the follicle-and the blackhead will return.


Skin Lesions deep in the skin may become cysts: large fluid-filled sacs that can be up to an inch in diameter, in extreme cases. There is a buildup of blood and/or pus, and the cyst will feel somewhat soft (usually toward the center). It may become red and throb, which is a sign of infection.

Never-and we mean never-attempt to open a cyst by yourself, as it is a guaranteed way to leave a scar on your face. You need to go to a dermatologist, who can properly drain it. In certain cases, a cyst will actually need to be removed surgically so that it does not return. Some cysts, if they cover a large area of skin, may require stitches after removal.


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