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The epidermis is a hardened, layered, squamous epithelium. Its density ranges from 0.5 to 3mm. depending on its location. Being the outermost layer of the skin, it is certainly an important site for microbial invasion.

The most common cell of the epidermis (comprising approximately 90% of all the cells of the skin) is the keratinocyte. Fresh keratinocytes are constantly being produced in the stratum basale. When they are moved towards the surface, they undergo a process called keratinization.

This involves the synthesis of a unique protein known as keratin, and the eventual death of the cell. The dead keratinized cells (called squames) populate the external layers of the epidermis with lipids that occupy the intercellular spaces and are slowly sloughed off - a process called desquamation. It has been calculated that the skin surface of the average adult is made of approximately 2 x 10 (9) squames. It takes between 2 and 4 weeks for the passage of a cell from the basal layer to the external layer of the skin, and as a consequence of this process, it has been calculated that the stratum corneum is completely renewed every 15 days.

The keratin present in cells defends the underlying tissues against heat, chemicals, and microbes. Melanocytes are the second most common cells of the epidermis. These have long slender projections that secrete a brown-black pigment termed melanin. This pigment is then transferred to the keratonicytes where it blocks ultraviolet rays, thus defending the skin against its harmful effects, and preventing further actinic keratosis symptoms. The only other cells observed in the epidermis are Langerhans cells (which are involved in the defensive response to microbial invaders) and Merkel cells (which are linked with sensory neurons and are involved in the sense of touch).

Getting to know skin anatomy

The dermis has an extremely complex structure that consists of:

1) Connective tissue including collagen and elastin fibers conferring the skin elasticity; 2) Small finger-like projections (papillae) which reach into the epidermis and have nerve endings sensitive to touch, heat and pain; 3) Hair follicles; 4) Arrector pili muscles for coordinating hair movement; 5) Sebaceous glands; 6) Sudoriferous glands; 7) Nerves; Adipose tissue; and 9) Capillaries and veins.

It is essential to know how and why acne issues occur within your skin’s anatomy. On the keratin lined follicle canal, where the sebaceous glands reside, Proprionibacterium bactaria exists in symbiosis, feeding on and transforming the sebum secreted from the sebocytes cells before it reaches the exterior of the skin. The nascent sebum is largely lipid in structure and also contains DNA, RNA, proteins, and other cellular components that result from the rupture of sebocytes themselves. Proprionibacterium acne is observed only in sebaceous rich areas.

If the substrates in the follicular canals augment due to an active and large sebaceous system and sebum doesn’t evacuate adequately out of the canals, then colonization and high growth rates of Proprionibacterium acne will appear. The resident microbial flora creates biologically active molecules like histamine, extracellular enzymes and peptides, which may trigger the inflammatory response that characterizes acne breakouts.

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- Grant Ferns

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