What can you do about your spots?

Professor Tess McPherson explains that virtually all humans will experience spots at some point in their lives, regardless of skin type. Spots form in the pilosebaceous unit - a hair follicle with a sebaceous gland that produces sebum. An evolutionary theory suggests these glands may have helped babies navigate the birth canal, but hormonal stimulation during puberty reactivates them with less obvious benefit. The conversation establishes that spots are a biological reality, not a personal failing.

• All humans will get spots at some point in their life, even those with dry skin or eczema
• Spots form in the pilosebaceous unit - a hair follicle with a hair and sebaceous gland that produces sebum
• Humans have more and larger sebaceous glands on face, chest, and back, which is where spots tend to appear
• Evolutionary theory suggests sebaceous glands may help babies be 'greasy and slidey' during birth

Tess categorizes spots into three main types: non-inflammatory (whiteheads and blackheads), inflammatory lesions (pustules with pus), and the resulting marks and scars. Blackheads aren't caused by dirt but by oxidized sebum exposed to air. The inflammatory spots involve bacteria called cutibacterium acnes and white blood cells that create pus. Understanding these distinctions helps people recognize what they're dealing with and why different treatments target different types.

• Non-inflammatory spots are comedones - whiteheads (covered) and blackheads (open to air with oxidized sebum)
• Blackheads are black because sebum oxidizes when exposed to air, not because of dirt
• Inflammatory lesions contain bacteria C. acnes and neutrophils (white cells) that create pus
• Deeper inflamed lesions are cystic, including nodules
• One main reason to treat acne is to prevent physical and emotional scars that can last for life