Acne

Acne is one of the most distressing skin conditions which is notoriously persistent and can

eventually aggravate the skin condition and facial appearance. Also known as pimples,blackhead,

blemishes or zits, acne lesions do not heal easily. If one resolves, others would crop up to

worsen things further. This seems to be an ongoing combat and an ever-lasting cycle which is

frustrating and very tiring as well. In young people pimples can be a nightmare leading to shyness

and lack of social activity with peers. If not treated these acne can cause scarring when they

become adult which often shows up as very tiny dimples on the skin.
What is Acne?

Acne, known as Acne Vulgaris in medical terms, is one such skin condition that principally occurs

because of the overproduction of oil by the oil glands (sebaceous glands). The oil is produced by

the skin for its lubrication, but when produced in excessive amounts, the skin tends to get

trapped in the blocked oil ducts and this result in inflammation, swelling and eventually the

development of comedones or acne, pimples. Whiteheads and blackheads are simple terms used to

describe open and closed comedones in the skin surface.

When acne occurs in deeper skin lesions, it is known as cysts.

Hormones play an important role in the producing acne, which is a very common skin condition in

the teens. However, people of any age can get acne including young, adults and sometimes middle

aged people. Adult women often experience acne because of the hormonal changes occurring within

their system during pregnancy, during their menstrual cycles and / or with the use of

contraceptive pills.

However, the brighter side of the story is that acne can now be treated and eliminated completely

by some medicines and self-care methods like proper washing of the skin and the use of over-the-

counter acne creams and lotions. But if the acne is severe in nature, you need to see an expert

dermatologist to determine the further course of treatment. Once the acne is controlled, some

prevention strategies can be used for keeping the skin clear of any further breakouts.

Acne lesions do not depend on age, sex, color, race or ethnicity. More than 90% of the people

falling in the age group of 12-17 suffer from mild to moderate acne lesions. About 40% of the

teens experience severe acne problems as well.

Types of Acne

Acne is known to plague different people at different times. There are different types of acne as

well ranging from mild to moderate and sometimes severe.

All acne outbreaks as a basic lesion which is the comedo – an inflamed hair follicle plugged with

bacteria and oil. This comedo lurks below the skin surface and waits for the appropriate condition

to develop into an enlarged lesion, which is not visible to our naked eye. As our skin produces

more and more oil regularly, bacteria tends to flourish inside the inflamed follicle. The skin

surrounding the region becomes progressively more inflamed and the white blood cells start

fighting against these intruders.

Acne can either be non-inflammatory or inflammatory.

Non-inflammatory Acne:

Closed Comedo (whiteheads)- Whitehead are caused when the pores are completely blocked and the

sebum (oil), dead skin cells and bacteria are all trapped inside, thus causing white appearance on

the skin surface. This acne appears as small, white bumps.

Open Comedo (blackheads): Blackheads are caused when the pores are partially blocked, thus

allowing some trapped sebum, dead skin cells and bacteria to drain to the skin surface. The

blackish color however, is not due to dirt. It is rather caused due to the skin pigment melanin,

which reacts with oxygen present in the air. Blackheads are usually stable and are stubborn as

well; they cannot be treated easily.

Inflammatory Acne:

Papules: These are mild forms of inflammatory acne appearing on the skin as well, firm and pink

colored bumps. These are usually tender when touched and are usually considered as the

intermediary step between inflammatory and non-inflammatory lesions.

Pustules: Similar to papules, pustules are also small and round lesions, but they are inflamed and

also contain pus which is visible to the naked eye. They are reddish at its base and are whitish

or yellowish at the center. Pustules are not loaded with bacteria; the inflammation caused is

generally due to chemical irritation from the sebum components like fatty free acids.

Nodules: Nodules are generally large and inflamed lesions occurring deep inside the dermis. These

are hard and painful lump beneath the skin, while papules develop at the skin surface; nodules

develop deep inside the skin. Nodules are severe forms of acne lesions.

Cysts: Very large and inflamed acne lesions are known as cysts. They usually feel very soft and

fluid-filled lumps beneath the surface of the skin. Cysts are also very painful.

Symptoms

Acne or acne vulgaris appears prominently on one’s face, chest, neck, shoulders and back. It is

likely to last for months and years altogether.

The different types of acne are basically the symptoms of the condition. Mild acne develops in the

form of blackheads and whiteheads. Sometimes, these skin eruptions might develop into some sort of

an infection deep within the pore of the skin.

Severe acne is likely to produce many pimples that would cover a large area of the skin. Cystic

lesions might also appear which are very large and usually deep. But there is one form of skin

condition called Acne Rosacea which is quite different from acne.

Rosacea is not acne vulgaris, but it often raises confusion as the appearance of both the

conditions are almost the same.

Diagnosis

There are no such tests involved for diagnosing acne. However, the doctor might ask you about your

medical history and some physical examinations might also be required. Women are asked questions

pertaining to their menstrual cycle. No special tests are required.

Treatment

There are different treatments available for acne, such as:

A) Topical treatments: Topical options help in drying up the skin oil, thus killing the bacteria

and preventing acne. Generally, over-the-counter topical lotions containing benzoyl peroxide such

as Benzac, Panoxyl, Pro-Active. Benzoyl Peroxide are sold in strengths of 2.5%,5%,and 10%. General

sales only permits 2.5% benzoyl peroxide for such brand as pro-Active but pharmacies can sell

higher strengths. Other ingredients containing keratolytic properties such as Resorcinol, sulfur,

lactic acid and salicylic acid may also be used. These products are extremely helpful for treating

mild acne lesions.  However if these treatments fail, you can seek doctor’s help for stronger

prescribed ointments. Treatments like adapalene (Differin) and tretinoin (Renova, Retin-A,) are

good examples.
Crystacide cream which contains hydrogen peroxide is a recent introduction to the OTC market and

is great for those acne breakouts or those black heads that tends to become infected and ugly

looking.

B) Isotretinoin: These are used for deep cysts. Irotretinoin (Roaccutane or Isotane) is one of the

powerful medications available for treating acne and acne scarring. This particular medicine is

reserved for severe acne forms, but has certain side effects. Pregnant women must not take

Roaccutane as it has been associated with birth defects.  A 2 year break from Roaccutane is

recommended for women whom wish to conceive.

B) Antibiotics: Antibiotics such as doxycyline(Doxine) and minocyline (Mino-Tabs) are prescribed

for moderate to severe acne for reducing bacteria and fighting inflammation. Antibiotics are

usually recommended for months along with topical products.

C) Cosmetic procedures: Microdermabrasion and chemical peels are helpful in treating acne. These

procedures can treat acne scarring, fine lines, wrinkles and sun damage.

D) Vitamin A: High dose Vitamin A such as Thompsons Vitamin A 10000IU is a useful natural supplement for acne but again contraindicated in pregnacy and lactation.

Prevention

As your skin improves with ongoing treatment and medication, you need to take some preventive

measures to stop new outbreaks.

A) Wash your face two to three times a day with mild cleansers such as Cetaphil cleanser or even better Benzac

wash. This helps in removing excess oil from the skin along with the dead skin cells. However, too

much of washing might cause skin irritation.
B) Always use over-the-counter acne creams to keep the skin dry.
C) Do not use heavy makeup; even if you do, remove every bit of makeup once you are back home.
D) Always wear loose-fitting clothes to prevent acne occurring on the chest and back.
E) Shower twice daily to remove excess dirt and oil from the skin.

With proper medication and preventive measures, it is possible to control acne and prevent further

outbreaks.