Acne is one of the most common of all skin disorders, particularly among adolescents. It affects almost everyone, whether in the form of a few pimples and blackheads or whiteheads, or with more severe lesions called cysts. Although most people outgrow the problem by adulthood, acne may appear and continue through the twenties, thirties and forties among otherwise healthy people. Women are more likely to have acne as adults; males tend to have more severe acne the age of 20.
Acne usually appears at puberty, when increased hormone activity changes the sebaceous glands, causing them to secrete large amounts of oil, or sebum. These glands drain into canals that empty onto the surface of the skin through tiny openings known as pores. Under normal conditions, the sebum flows out smoothly. If there is an overproduction, however, the pores may become clogged, resulting in a visible lump. If there is no opening on the surface of the skin, the lump may first appear as a whitehead, or closed comedo (a small skin-coloured spot). If there is an opening, however, pigment from nearby cells may accumulate and form a blackhead, or open comedo. Sometimes, when oil and bacteria in open comedones build up, abscesses and cysts may form. This causes the disfiguring look of acne. The lesions resemble small boils, and they may painful and ca lead to scarring. Post-inflammatory darkening of the skin may also occur.
CAUSES
Acne is caused by a basic change in the body’s hormonal system which leads to increased production of an oily substance in the skin glands. Fats in this substance are broken down by bacteria into fatty acids that irritate the skin and result in pimples, pustules and angry, disfiguring inflammations. Although acne can occur at any time of life, it is a problem that afflicts adolescents most, and causes them a great deal of misery.
TREATMENTS
Treatment is directed at keeping the acne lesions under control and promoting healing. The fact that there are dozens of preparations on the market merely means none is completely satisfactory. They act by provoking a fine peeling of the skin and can cause irritation if used too vigorously. Try those preparations which contain sulphur in combination with resorcinol or benzoyl peroxide, substances that have stood the test of time.
There are other tips that can help:
- shampoo the hair frequently so that if does not get oily;
- avoid greasy hair products
- wash all the affected areas three or four times a day with a mild soap;
- and don’t forget to wash hands often and keep them away from the face
- women should avoid facial creams and make-up
Some acne is induced by medication or cosmetic creams. Discuss with your doctor or pharmacist the advisability of using a new preparation, tretinion. This is a vitamin A product which is available without prescription in some areas; it is very effective, but most be used sparingly at first until the skin get used to it. It can cause irritation if not carefully used. Another derivative, the prescription drug Roaccutane, may be useful in severe cystic acne, but it is teratogenic- that is to say, it causes foetal deformities so it must not be used by women who are pregnant or not protected by contraception.
Antibiotics can help by attacking the skin bacteria that accumulate in the comedones, which are a characteristic of severe acne. These bacterial turn the oil in the plugged pores into fatty acids that act as irritants. When enough oil collects, the blocked sebaceaous glad ruptures and bacteria and fatty acids seep into the adjacent skin. The result is irritation, inflammation, pimples and permanent in severe cases.
Antibiotics (usually low does of tetracycline or erythromycin given orally or topically) help to control the inflammatory of acne by blocking the growth of theses bactera.