Disorder of the follicles and sebaceous glands – inflammatory disease of the pilosebaceous glands characterized by comedones, papules, pustules, inflamed nodules, superficial pus-filled cysts, and (in extreme cases) canalizing and deep, inflamed, sometimes purulent sacs.

Causes

Imbalanced interaction among hormones, keratin, sebum and bacteria, setting in usually at puberty, due to an increase in androgens

 

The hyperactivity of the pilosebaceous glands (which are microscopic glands in the skin that are responsible for the production of sebum) is aggravated by the presence of a microorganism – Propionibacterium acnes – which cause a breakdown of the of certain elements in the sebum, resulting in a overproduction of free fatty acids that irritate the follicular wall

 

At times, this can cause inflammatory reactions in the form of abscesses

Symptoms and signs

Superficial acne: blackheads, whiteheads, inflamed papules, superficial cysts, occasionally large cysts

 

Deep acne: deep inflamed nodules, pus-filled cysts that often rupture producing abscesses

 

Lesions occur most commonly on the face, but they can also spread to the face, neck, chest, upper back, and shoulders

 

According to the severity of its occurrence, acne frequently results in scarring and hyperpigmentation

 

A differential diagnosis might indicate the presence of two other similarly manifesting disorders: rosacea (no comedones), corticosteroid-induced acneiform lesions (follicular pustules at a similar rate of development, unlike acne, where lesions are present at various stages of development, and no comedones as well)

Advice

Superficial acne:

Topical antibiotics (clindamycin or erythromycin)

Azelaic cream

Topical tretinoin (retinoic acid)

Other topical drugs: benzoyl peroxide, OTC (over-the-counter) drugs, sulfur-resorcinol combinations

Some oral antibiotics might be helpful

 

Deep acne:

Topical treatment mostly unsatisfactory if used by itself

Oral antibiotics to reduce the presence of bacterial microorganisms at skin level – tetracycline, minocycline, erythromycin, doxycycline

In severe forms of deep acne – oral isotretinoin is recommended, but significant side effects manifest in approximately all patients – highly teratogenic (may cause birth defects or cause miscarriage altogether), dryness of the conjunctivae and mucosae of the genitalia, chapped lips, mild to severe forms of depression

MISCONCEPTIONS
  • Vigorously washing one’s oily-prone face cures acne – in fact, it further destabilizes the already imbalanced system of the sebaceous glands

     

    Acne can be cured solely through dramatic changes in diet

     

    Acne can be cured solely by taking up sports

     

    Acne is related to one’s sexual activity

     

    Excessive use of antibacterial soaps helps eliminate acne – studies have shown they do not significantly reduce the number of bacteria

     

    Acne just needs to ‘run its course’

     

    Picking at one’s skin helps eliminate acne

Statistics

Approximately 85% of people between the ages of 12 and 24 experience at least minor acne

 

A growing number of adults (more women than men) experience acne late into their 30s, 40s and even 50s

 

The isotretinoin drug called Accutane was declared in 2005 as enabling a total of 500 potential adverse side effects (including high risks of child deformity in pregnant women and suicidal ideation), ranking it the fourth highest on the list of dangerous medications

Did you know?

Nowadays, virtually all forms of acne are treatable

 

For effective results and significantly lower chances of relapses, the treatment might have to be administered even after visibly reducing acne

 

Tips for preventing acne: change pillowcases as often as possible; keep a separate towel to be used exclusively on the face – wash it and change it regularly; when using a towel dab it gently instead of rubbing on the skin’s surface

 

Keeping a healthy balance of skin moisture is essential

 

Noncomedogenic and oil-free derma-cosmetics can be safely used to lightly cover any acne-related imperfections

 

Famous celebrities who battled acne: singers Seal, Katy Perry, Alicia Keys, Victoria Beckham, Lorde, Rihanna, P. Diddy; actors Julianne Hough, Cameron Diaz, Brad Pitt