Tuesday, October 27, 2009

Acne is Not Spots

By Frank Williams

There are several different types of acne, depending on how or why the acne arose. Some of the kinds of acne are: acne conglobata (chronic boils); acne fulminans (an extreme form of conglobata); acne cosmetica (caused by cosmetics); acne keloidalis nuchae (from shaving); acne medicamentosa (caused by starting or stopping a medication); acne rosacea (redness on the face); baby acne; hormonal acne; cloracne and the common variety: acne vulgaris (better known as 'puberty spots'). We will concentrate on acne vulgaris.

Acne vulgaris can be defined as: 'an inflammatory disease of the skin, caused by changes in the pilosebaceous units (skin structures consisting of a hair follicle and its associated sebaceous gland). Acne lesions are commonly referred to as pimples, spots or zits' (from Wikipedia).

Acne is most common in white Western teens, although it does occur in every country in the world, so there may be a genetic weakness to it. It is possible that it may be an abnormal reaction to fairly average levels of testosterone. For most afflicted, outbreaks of acne last only until adulthood, probably only a few years or at the most ten. For other people, however, it may be a life-long affliction. It usually affects the face, upper-chest, upper-arms and back. However, an occasional spot does not constitute acne.

Acne vulgaris appears in various forms, which include: whiteheads, caused by pores which are totally blocked, trapping sebum (oil), bacteria, and dead skin cells, resulting in a white appearance on the surface; blackheads, caused by pores which are only partially blocked, allowing some of the trapped sebum, bacteria, and dead skin cells to slowly drain to the surface (the black colour is not a result of dirt, but is a reaction of the skin's own pigment, called melanin, with the oxygen in the air); papules, which are inflamed, red, tender bumps with no head and pustules, which are like whiteheads, but are inflamed, and appear as red circles with a white or yellow centre.

Whiteheads do not usually last for a long time; blackheads do last a long time and pustules are what people usually refer to as spots or zits. Severe acne vulgaris is distinguished by nodules and cysts. A 'nodule' is a rather larger and much more painful sort of pustule and can often last for months. Nodules are large, hard lumps just under the skin. They frequently cause scarring and should never for any reason be squeezed, since this could make them last for months longer.

A 'cyst' can appear like a nodule, but it is pus-filled, and has been defined as having a diameter of at least 5mm and, again, can leave scars and cause pain. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which will last very much longer than if it had been left alone. Dermatologists have ways of lessening swelling and preventing scarring with both nodules and cysts. It is not true that acne sufferers are not careful about washing.

In fact, excessive washing can exacerbate acne. There are many, many fake 'cures' on the market and many, many old wives' tales, but any good skin expert would tell you that there is no known cure for acne and that the patient should follow a religious regimen of cleaning until the acne just 'goes away' of its own accord.

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