Acne is a common skin condition and is usually treatable, though sufferers may need treatment for several months. Most people with acne are aged between 12 and 25, but sometimes it can strike older and younger people too. Acne usually affects the face, but can also manifest in the neck, back and chest. The severity can range from mild to severe.
Acne is caused by over-
activity of the sebaceous glands.
Acne is not infectious, so you cannot get it from another person. But it can be hereditary. It isn’t caused by diet or poor hygiene, although some claim that eating oily foods, chocolate etc make their acne worse. Whether increased stress leads to acne is debatable.
Excessive production of male hormones (testosterone) can cause acne, for instance, as well as conditions like poly cystic ovarian syndrome. Some contraceptive pills and certain medicines used for epilepsy can cause acne. Also greasy, poor quality make-up and cosmetic creams can worsen it.
Sebaceous glands under the skin surface make oil (sebum) which keeps the skin supple. The sebum comes out through pores (tiny holes). Hormone changes especially at puberty stimulate the sebaceous glands and make more sebum. That is why acne is commonly seen in teenagers.
When pores get blocked (by thickening of skin and by dead cells) and when sebum collects under these blocked pores pimples occur. There is a bacterium called Propionobacterium acne which is normally found on the skin. It multiplies in trapped serum. Sometimes inflammation occurs making the surrounding skin red.
The spots can get larger and fill with pus. When several pustules are close by they can get even larger and form nodules and cysts. These inflamed spots can heal with time, but do sometimes leave a discoloured area (hyper pigmentation). A small scar can be left on the skin if cysts are ruptured.
Complications
If you pick or squeeze pimples it can cause further inflammation and scarring. Having severe acne is very distressing as it will affect the appearance of a person. Some can even get depressed.
Management
Inflamed acne needs to be treated early to prevent scarring. Wash twice a day with lukewarm water. You can use a suitable face wash or mild soap. Very hot or cold water can worsen acne. Never scrub hard when washing acne affected skin. Excessive washing and scrubbing can increase inflammation and make acne worse. Do not use greasy creams as it may clog pores.
If you have acne it is best to seek treatment from a qualified doctor or a dermatologist. The treatment will depend on the type and severity of acne that you have.
There are various creams/ lotions which are used, eg. Benzoyl peroxide, retinoids and topical antibiotics. Sometimes antibiotics like doxycycline may be used if acne is severe. Usually it takes time for acne to clear with any form of treatment (usually 4 – 6 weeks). Even after successful treatment acne can flare up again.
Symptoms and signs
- Greasy skin
- Black heads (open comedones) – Tiny plugs which block the pores are called comodones. The black colour comes due to the skin pigment.
- Whiteheads (closed comedones)
- Red or yellow spots (pustules)
- Deep inflamed lesions (nodules and cysts)
- Scars
(The writer is attached to the Health Education Bureau )
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