Types Of Acne Lesions

What is Acne

Acne is an inflammatory skin disease which affects the tiny pores which cover the face, arms, back and chest and the oil glands attached to them.

It is an abnormal response in the skin to normal levels of the male hormone, testosterone, in the blood. Both men and women have testosterone circulating in the blood, but in the acne sufferer, this hormone has a profound effect on the skin.

This abnormal response is self limiting and eventually acne does get better without treatment, but there is no way of predicting how long this can take, and it may take years or even decades! Acne can also leave scars which are permanent and are easier to prevent than to treat.

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Acne Described

Acne is a term used for pores on the skin that contain blackheads, whiteheads and pimples. In severe cases, lumps, cysts or nodules may result from plugged pores.

Acne can occur on the face, neck, chest, back and arms. Although acne tends to affect teenagers, it is not unusual for adults to be affected. Acne can be upsetting, particularly for teenagers, diminishing their confidence. Severe acne may lead to permanent scarring.

At least 90% of teenagers develop acne in some form, whether it is a whitehead, blackhead or pimple. Many are able to control their acne by frequently washing with soap and water or by using a special over the counter face wash. However, acne is a condition that needs to be treated correctly.

What are the signs and symptoms of Acne?

Acne is defined by severity, there are two types:

Mild Acne - (“whiteheads” and “blackheads”) is caused by a plug of dead skin cells and oil in the canal that contains the hair, under the surface of the skin. Because the plugs are underneath the skin surface, scrubbing will not get rid of them. In fact, rubbing the skin or using harsh or abrasive soaps can irritate the skin and make the acne worse. Mild acne does not usually leave permanent marks on the skin.

Moderate to Severe Acne - causes large bumps (nodules) and cysts, which may lead to permanent scarring of the skin. With early and consistent treatment, however, such scarring can often be prevented.

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How do Hormones affect acne

At the start of puberty, a whole lot of hormones are released into the body. One of these hormones is androgen. Both boys and girls have androgen, but boys have more of it.

Androgen affects oil glands in the skin of the face, neck, back, shoulders and chest. It makes the glands grow bigger and produce more oil (sebum). Bacteria on the skin make this oil thicken so that the pores become blocked, resulting in blackheads, pimples and cysts.

A teenager is more likely to get acne if one of their parents had it during adolescence. But even in the same family, some people may get worse acne than others.

Girls tend to get it at a younger age than boys and it can worsen or 'break out' at certain times of a girl's menstrual cycle, such as just before a period.

Boys often have more outbreaks than girls, and they often seem to get worse pimples and more cysts.

The causes of acne

Acne is a skin condition caused by overactivity of the glands that secrete oily substances on to the skin. The blackheads and spots usually occur on the face, where the greatest number of these oil-producing "sebaceous" glands exist. The back, chest and shoulders can also be affected.

Several factors are involved in the development of acne. Central to this are the sex hormones, which are produced at puberty. The male hormone testosterone - found naturally in women as well as in men – triggers the sebaceous glands to produce more of an oily substance called sebum, making the skin more greasy. However, most acne sufferers don’t have a hormone problem and their hormones are at normal levels in their blood.

When there is an excess of sebum, the area around a hair follicle and the opening through the skin – the pore – can become clogged. A bug, a bacterium called Propionobacterium acnes, that lives normally on the skin , can thrive within the blocked pore. This infection causes inflammation, which is responsible for the redness and swelling of a spot. Sometimes as in severe acne, the pocket of inflammation witin a pore can rupture, causing damage to the skin that can result in scarring.

Drugs such as certain steroid tablets and some beauty products that block the pores can contribute to acne. Contrary to popular belief, acne is not caused by eating fatty food or chocolate.

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What you can do to Treat Acne

Wash the skin with water and with mild soap if greasy. Do this once or twice a day.

Do not seal the skin with cream or powder. Having cleaned the skin well, squeeze out the blackheads with an expressor available from pharmacies and drugstores. This is much easier if the skin is hot, for example after facial steaming.

Wash your hands well and clean the area to be treated with alcohol based skin cleaner. Do not squeeze them if they are red and painful. This aggravates the infection and causes scars. If the spot has a yellow head you may open it and gently pinch it out with antiseptic on cotton wool.

Pharmacies have excellent creams and lotions for fighting spots which are available without prescription. These contain benzoyl peroxide (it bleaches so take care not to splash the clothing).

Frequent use of solarium sessions or sunlamps is not recommended on medical grounds due to the risk of burning the skin and skin cancer. The occasional use of sunlamps (no more than once a month) may improve the skin condition.

For girls and women some contraceptive pills may help to tackle spots if they are a problem. (These pills are not available without prescription.)

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