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Acne is a common chronic inflammatory skin condition. It occurs mainly in the sebaceous follicles. Acne is more common in people with oily skin. In addition, a 2017 research article found that acne is also present in damaged skin barrier function and imbalanced microecology.

There are five main causes of damaged acne barrier on our skin. Let's see if you have one of them.

1-Severe acne on the face with a large number of inflammatory skin lesions and inflammation of the hair follicles and surrounding areas will damage the skin barrier.

2-Excessive daily cleansing of the facial skin.

3-External use of certain irritating medications or functional ingredients.

4-Failure to moisturise regularly while taking isotretinoin, as isotretinoin can cause facial dryness.

5-Some patients do not take good care of their skin after medical aesthetic procedures, which can also lead to barrier damage.

How can we tell if our skin's acne barrier is damaged in everyday life? The most intuitive way is to observe the condition of the skin with the naked eye. With the exception of excessively oily or abnormally dry skin, sensitive skin will experience discomfort such as tingling and itching rather than the pain of acne folliculitis.

You can also use skin testing devices. Various high-resolution spectral skin testing devices on the market are very helpful in determining whether acne is associated with sensitive skin (damaged barrier). These devices scan the patient's skin to produce red area or red blood images (different devices have different names) and ultraviolet light images (mainly by observing the colour and area of fluorescence), so that we can clearly understand the skin condition. Next, i will show you the test results of skin test instruments through several cases.

Case 1

Analysis:

This male acne patient has oily skin and a history of facial acne for many years. Diffuse erythema of the facial skin can be seen under different light sources. The ultraviolet image does not show much porphyrin fluorescence emitted by Propionibacterium acnes.

The patient reported that he usually over-cleansed and his skin changed from oily to dry. This patient's skin barrier was damaged by over-cleansing, resulting in sensitive skin. Therefore, during treatment, care must be taken to avoid treatments that may aggravate barrier damage and functional skin care products are needed to repair the skin barrier.

Case 2

Analysis: 

This female acne patient had red papules all over her face, diffuse erythema on her skin, and the erythema area was consistent with the porphyrin fluorescence area under ultraviolet light. The patient reported no history of excessive cleansing, so it was suggested that the patient had a damaged skin barrier caused by acne inflammation (related to the proliferation of Propionibacterium acnes) leading to skin sensitivity.

Case 3

Analysis: This female acne patient has moderate acne. The skin erythema is not severe, but it shows "coloured" fluorescence under ultraviolet light. This shows that there is an imbalance in the micro-ecology of the face. The area of fluorescence corresponds to the area of the rash, indicating that the imbalance in the micro-ecology affects the worsening of the acne. Therefore, the recommended treatment is oral tetracycline antibiotics to kill various abnormally reproducing bacteria.

Summary 

1. When the sebum secretion of acne patients is vigorous, that is, we often say that the face produces a lot of oil, it will induce sensitive skin. When there is too much oil, the free fatty acids in acne sebum can cause inflammation, and sebum is the food of Propionibacterium acnes, which will cause the acne bacillus to multiply in large numbers, thereby aggravating inflammation, and inflammation will damage the skin barrier and cause sensitive skin.

2. Many cases of acne secondary to sensitive skin are caused by excessive cleansing. Excessive cleansing can also seriously damage the skin barrier, causing skin sensitivity and redness. In addition, when the barrier is severely damaged, there is an imbalance in the micro-ecology. Not only will Propionibacterium acnes proliferate in large numbers, but other bacteria will also proliferate and multiply significantly, showing 'coloured' fluorescence on the ultraviolet light map of the skin.

3. Acne with sensitive skin needs to be treated at the same time, especially to repair the skin barrier.

Both are difficult to treat. If doctors do not find that patients have secondary sensitive skin, but use highly irritating drugs, this will lead to the production of sensitive skin.