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What is acne?
Acne is a chronic and inflammatory disease that involves the skin sites where the hair originates; hair follicles, and the
sebaceous glands. Acne may be a life-long process, and usually starts before puberty, or at the onset of puberty.
However, it can begin in adulthood or even in elderly people. The areas that are typically affected are the face, neck,
upper chest, back and the shoulders.
Acne affects both males and females. At the age of 18, acne is more frequent in men than women. Beyond the age of
23 it is more common in women. The severe inflammatory form of acne is more often in men at any age. Scars rarely
occur in females, except when the lesions are manipulated by the patient.
What causes acne?
The increased production of the hormone androgen in puberty triggers a higher production of sebum by the sebaceous
glands in the skin. The sebum is a natural subtract for bacterial growth, and allows the bacteria to increase dramatically
in numbers, especially Propionibacterium acnes (P.acnes). The sebum is transformed by P. acnes in both free fatty
acids, and other chemicals that produce the inflammation process.
The combination of increased androgen and pro-inflammatory chemicals causes a higher cohesion of the epidermal
cells in the pore areas. This action forms what are commonly known as pimples - the characteristic lesions of acne.
There are closed and open pimples. A closed pimple is a closed pore with a tiny plug. An open pimple, also known as a
blackhead, is also a closed pore with a larger follicular plug. Blackheads are not dirty. The dark colour is due to
increased skin pigment and the sebum contacting the oxygen present in the air.
The plugged pore can become swollen and inflamed, resulting in a pimple of minor or major proportions. The leakage of
the follicles, in the surrounding skin, produces more inflammation, and creates other lesions of acne, such as cysts,
pustules, and abscesses.
The hypersensitivity to the inflammatory process caused by P. acnes, is greatest in individuals with genetic
predisposition. In other words, the problem is very much one of genetic heritage. The same combination of genes that
made you the person that you are: height, hair colour, etc., also made your skin the type that it is.
In early adulthood the androgen levels decline slowly. This fact may contribute to the resolution of acne in the adulthood
period. Some updated studies show a deficiency in the vitamin Pantothenic Acid as the basic cause of acne.
Symptoms?
There may be minor pain, itching, or mild soreness, and very rarely, fever with inflammation and pain in the joints.
Diagnostic tests
Hormone tests can be carried out, and also a skin biopsy which is used to differentiate acne from other possible
diseases.
Does acne have complications?
It can have if it goes untreated. The most important complications are Cyst formation: a big, hard and deep closed pimple
which can lead to scarring, and the effect it can have on Psycho-social development.
What about acne treatment ?
- Early treatment can prevent complications. The acne treatment depends on the type of lesions and the severity
of the acne. No two patients have identical acne.
- The correct treatment can prevent permanent scars.
- Most acne treatments takes 6 to 8 weeks to show significant benefits.
- Diet: acne does not occur as a result of food. However, if there is a particular food that seems to aggravate
your acne, it makes sense to avoid it.
- In most of the females affected, acne tends to be worse during the pre-menstrual cycle.
- Long periods of exposure to the sun can aggravate acne.
- Do not abandon the treatment before the doctor indicates it is safe to do so.
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