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Free yourself from Acne: The Facts |
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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 |
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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.
- Acne is not related to hygiene. Wash gently twice a day with
mild soap and water. Do not rub, scrub, or wash more often than
necessary.
- It is recommended to avoid exposure to oils and greases.
Topical treatment:
In both sexes, acne in the adults respond very well to
treatment. Topical treatment can include topical antibiotics,
topical retinoids such as tretinoin and iso-tretinoin; benzoyl
peroxide, azelaic acid, sulphur, and salicylic acid.
Systemic treatment: Most of the time the systemic
treatment, or oral therapy, is reserved for cases of moderate to
severe inflammatory acne. In these cases, a combination of
topical and oral treatments are indicated. Oral treatment may
include isotretinoin and/or antibiotics such as tetracycline,
erythromycin, clindamycin, sulphas, etc. Hormonal |
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