What is Acne?

Monday, September 14th, 2009 at 11:00 am

whatisacne The word acne is derived from the word acme which means “the highest point”, coming from the Greek akme meaning “point” or “spot”. In 1835. it was originally mispelt, with an ‘n’ rather than an ‘m’.

Acne is a disease which skin oil glands make. It may leave skin scars, but it isn’t dangerous. Our skin has a lot of pores (tiny holes) which are connected to oil glands located under it. Also, the glands are connected to the pores via follicles, small canals. These glands produce an oily liquid, sebum, which carries dead skin cells through the follicles to the surface of the skin. Then, a small hair grows through the follicle blocking it and making pimples grow. Most often pimples appear on people’s face, back, chest, shoulders and neck. Acne comes out when follicles are blocked and infected. Skin cells, sebum and hair being clump together form a clogg which turns into a swelling if it is infected with bacteria. A pimple starts to develop after the plug begins to break down.

There are various types of pimples:

- Blackheads – appear on the surface of the skin, clearly visible, black in colour. Remember that dirt doesn’t make blackheads, so scrubbing your face vigorously in order to remove them will not help.

- Whiteheads – are very small and remain under the skin

- Nobules – large, solid pimples which are clearly visible on the surface of the skin. They can be very painful and are rooted deep in the skin.

- Papules – small bumps, visible on the surface of the skin, usually pink.

- Pustules – clearly viewable on the surface of the skin, red at their base and have pus at the top.

- Cysts – very painful, and are filled with pus. They are clearly visible on the surface of the skin and they can easily cause scars.

How often does acne appear?

Specialists for skin, dermatologists, say that approximately three-quarters of people aged between 11 and 30 get acne at some moment in their life. However, there is no rule, as they can affect people of all races and all ages. Most commonly, adolescents and young adults are affected. But, it is found out that some people even in their fifties can get acne. Despite the fact that acne affects both men and women, men suffer from acne more often. This is because they have more of testosterone, which can aggravate the problem.

What causes acne?

Nobody can definitely say what causes acne. Experts think that this primarily happens in the adolescence period when the level of the hormone androgen rises. As it rises, the oil glands under your skin grow producing more oil. Excessive sebum can break down cellular walls in the pores causing the growth of bacteria. According to some researches, the susceptibility to acne could also be genetic. Thus, hormone changes during pregnancy, greasy cosmetics or medications which contain androgen and lithium may be the reasons why acne appear.

Acne treatment

The way you treat acne depends on how severe and persistent the condition is.

Treating mild acne

Most people usually suffer from mild acne. They are commonly treated with OTC (over-the-counter) medicines which can be bought at a drugstore without the doctor’s prescription. They are usually applied to the skin and are known as topical medicines.

Most OTC products for treating acne may contain the following active ingredients:

- Benzoyl Peroxide – a white crystalline peroxide used in bleaching (flour or oils or fats) and as a catalyst for free radical reactions. It destroys bacteria and slows down your glands’ production of oil. It works as a peeling factor, which clears pores and speeds up skin turnover thus reducing the amount of bacteria in the affected area.

- Resorcinol - helps in breaking down blackheads and whiteheads. It is a crystalline phenol and comes from various resins. Resorcinol is also used against dandruff, eczema and psoriasis.

- Sulfur – Sulfur has been used over centuries for acne treatment, psoriasis and eczema although scientists are not sure how sulfur helps in healing skin diseases. We do know that elemental sulfur does oxidize slowly to sulfurous acid which is a mild reducing and antibacterial agent.

- Salicylic Acid – Salicylic acid is a white crystalline substance very effective in treating inflammation and swelling. It breaks down blackheads and whiteheads, preventing pores from becoming blocked, while at the same time making space for new cells to grow. Besides, it is also used as a fungicide, for making aspirin, dyes or perfumes and can be added to shampoos for the treatment of dandruff.

- Azelaic Acid – It is a saturated dicarboxylic acid found naturally in wheat, rye, and barley which helps reducing bacteria growth, strengthening cells that line the follicles, and stopping oil eruptions.. Azelaic acid also wipes up free radicals thus reducing inflammation. It is recommended to patients with darker skin who have dark patches on their face (melasma), or whose acne spots make brown marks.

- Retin-A – helps unplugging blocked pores. It contains Tretinoin, an acid form of vitamin A, also known as all-trans retinoic acid (ATRA). Also, it is used in treating acute promyelocytic leukemia. Retin-A has been mostly used as a substance against skin aging, and as a chemical peeling.

Acne medications could appear in forms of gels, pads, soaps, lotions and creams. If you have a sensitive skin, perhaps you would rather use a cream or lotion. Gels, mostly containing some percents of alcohol may dry the skin, so it is better for people with oily skin type to use it. OTC medicines have these ingredients in different concentrations. Having that in mind you are recommended to start with the lowest quantity. In the beginning you may experience skin irritation, redness, and/or burning which gradually disappear. However, if this does not happen, go and visit your doctor.

Treating more severe acne cases

If your problem with acne is more serious, you should think of seeing a dermatologist. He may prescribe a medicine which has some of the active ingredients mentioned above, such as azelaic acid, benzoyl peroxide, as well as adabalene. Depending on your case, you will be given the right treatment. You may be prescribed an oral or topical antibiotic. Antibiotics are excellent against the growth of bacteria and inflammation. Erythromyocin and Tetracycline are most commonly prescribed.

Treating a cyst with interlesional corticosteroid injection

If it comes that an acne cyst is severely inflammed, there is a high risk of rupturing which often results in making scars. As a prevention, a dermatologist may inject a diluted corticosteroid. It will lower the inflammation and speed up healing. In just a few days the cyst will “melt” .

Isotretinoin

Isotretinoin is a strong oral retinoid, used for the treatment of severe acne cysts, as well as severe acne that has not given desirable results to other medications and treatments.

Oral contraceptives

A great number of women with acne have found out that taking certain oral contraceptives can clear it, as they suppress the overactive gland. But, if the woman smokes, has a period disorder, suffers long from migraines, or is over 35, she should consult her gynecologist first before she starts taking this medication.

Oral antibiotics

In case a patient suffers from a severe or moderate acne, he or she is prescribed oral antibiotics. These oral antibiotics are used to lower the population of Propionibacterium acnes (P. acnes), a kind of a bacterium usually found on the skin which is multiplied rapidly in blocked follicles. In the beginning the dosage will be given in high amounts, and then as the acne reduces so will the dosage. Antibiotics are not taken for more than six months. However, as time passes the P. acnes can become resistant to the antibiotic in which case another antibiotic should be given.

Topical antimicrobials (topical = applied to the skin or mucus membranes)

The aim of topical antimicrobials for the treatment of acne is to reduce P. acnes populations. Some of them are clindamycin, erythromycin, and sodium sulfacetamide. They are used in treating severe and moderate acne. You may be prescribed a topical retinoid by the specialist. They prevent whiteheads and blackheads from increasing and unclog the pores. Topical retinoids are a derivative of Vitamin A and are very popular for the treatment of acne. Examples of topical retinoids prescribed in the USA are adapalene, tazarotene, and tretinoin.

Taking care of your skin if you have acne (or are prone to acne):

- Don’t burst the pimples. If you do that, it may spread the infection, causing more blocking and worse swelling and redness. Popping pimples causes scarring.

- Wash your face about two times a day. Do not wash it more than that. Use a mild soap made especially for people with acne, and warm water. Avoid scrubbing the skin. Experts recommend the use of an OTC lotion which has benzoyl peroxide.

- If you have to get rid of a pimple quickly because you have to go to some event, such as a wedding, or occasions which involve public appearance, ask a dermatologist to treat it for you.

- Keep your hands from touching the face. When you speak on the telephone do not let the receiver touch your face – there might be sebum and skin residue on it.

- Always wash your hands before touching your face. This means wash them before you apply lotions, creams or makeup.

- Glasses may collect sebum and skin residue so make sure to keep them cleaned regularly.

- Clean the makeup from your face before you go to sleep. Use only makeup that is nonceomedogenic or nonacnegenic which does not have oil and does not clog up the pores.

- You should allow your skin to breathe. If you have acne on your back, shoulders or chest wear loose clothing. Avid wearing tight garments, such as headbands, caps and scarves, but if you have to wear them they should be cleaned regularly.

- Too much sun makes your skin produce more sebum. Several acne medications make it more likely that you will get sunburnt.

- Keep your hair clean and away from your face as it collects sebum and skin residue.

- If you shave your face, you should be very careful. Use either an electric shaver or safety razors and make sure the blade is sharp. Soften your skin or beard with warm water and soup before applying the shaving cream.

- Anxiety and stress – due to mental stress that affects the levels of some hormones, like cortisol and adrenaline, the problem with acne can become worse.

- Menstrual cycle – girls and women’s problem with acne tends to become worse one or two weeks before their menstrual period. This probably happens because of hormonal changes in the body. Some people say that during this period they eat more chocolate and think that getting more acne is connected with that. However, experts believe that is not the main reason.

- Oil based makeups – makeup containing oil, moisturizing creams, lubricating lotions, can speed up the blocking of your pores.

- Hot and humid climates – people sweat more when it is hot and this can make the acne worse.

- Greasy hair – some hair products may be very greasy and they can produce similar effects as oil based makeup. Such are hair products with cocoa butter or coconut butter.

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