What is acne? Symptoms and causes

Acne vulgaris is 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.

The condition is common in puberty, especially among Western societies most likely due to a higher genetic predisposition. It is considered an abnormal response to normal levels of the male hormone testosterone. The response for most people diminishes over time and acne thus tends to disappear, or at least decrease, after one reaches their early twenties. There is, however, no way to predict how long it will take for it to disappear entirely, and some individuals will continue to suffer from acne decades later, into their thirties and forties and even beyond. Acne affects a large percentage of humans at some stage in life.

Symptoms

The most common form of acne is known as “acne vulgaris”, meaning “common acne.” Excessive secretion of oils from the sebaceous glands combines with naturally occurring dead skin cells to block the hair follicles. There also appeares to be in some instances a faulty keritinization process in the skin leading to abnormal shedding of skin lining the pores. Oil secretions build up beneath the blocked pore, providing a perfect environment for the skin bacteria Propionibacterium acnes to multiply uncontrolled. In response, the skin inflames, producing the visible lesion. The face, chest, back, shoulders and upper arms are especially affected.

The typical acne lesions are: comedones, papules, pustules, nodules and inflammatory cysts. These are the more inflamed form of pus-filled or reddish bumps, even boil-like tender swellings. Non-inflamed ’sebaceous cysts’, more properly called epidermoid cysts, occur either in association with acne or alone but are not a constant feature. After resolution of acne lesions, prominent unsightly scars may remain.

Aside from scarring, its main effects are psychological, such as reduced self-esteem and depression. Acne usually appears during adolescence, when people already tend to be most socially insecure.

Causes of acne

Exactly why some people get acne and some do not is not fully known. It is known to be partly hereditary. Several factors are known to be linked to acne:

Hormonal activity, such as menstrual cycles and puberty
Stress, through increased output of hormones from the adrenal (stress) glands.
Hyperactive sebaceous glands, secondary to the three hormone sources above.
Accumulation of dead skin cells.
Bacteria in the pores, to which the body becomes ‘allergic’.
Skin irritation or scratching of any sort will activate inflammation.
Use of anabolic steroids.
Any medication containing halogens (iodides, chlorides, bromides), lithium, barbiturates, or androgens.
Exposure to high levels of chlorine compounds, particularly chlorinated dioxins, can cause severe, long-lasting acne, known as Chloracne.

Traditionally, attention has focused mostly on hormone-driven over-production of sebum as the main contributing factor of acne. More recently, more attention has been given to narrowing of the follicle channel as a second main contributing factor. Abnormal shedding of the cells lining the follicle, abnormal cell binding (“hyperkeratinization”) within the follicle, and water retention in the skin (swelling the skin and so pressing the follicles shut) have all been put forward as important mechanisms. Several hormones have been linked to acne: the male hormones testosterone, dihydrotestosterone (DHT) and dehydroepiandrosterone sulfate (DHEAS), as well as insulin-like growth factor 1 (IGF-I). In addition, acne-prone skin has been shown to be insulin resistant.

Development of acne vulgaris in latter years is uncommon, although this is the age group for Rosacea which may have similar appearances. True acne vulgaris in older adults may be a feature of an underlying condition such as pregnancy and disorders such as polycystic ovary syndrome or the rare Cushing’s syndrome.

Misconceptions about causes

There are many misconceptions and rumors about what does and does not cause the condition:

Diet. One flawed study purported that chocolate, french fries, potato chips and sugar, among others, affect acne.A recent review of scientific literature cannot affirm either way.The consensus among health professionals is that acne sufferers should experiment with their diets, and refrain from consuming such fare if they find such food affects the severity of their acne.A recent study, based on a survey of 47,335 women, did find a positive epidemiological association between milk consumption and acne, particularly skimmed.The researchers hypothesize that the association may be caused by hormones (such as bovine IGF-I) present in cow milk; but this has not been definitively shown. Seafood, on the other hand, may contain relatively high levels of iodine, but probably not enough to cause an acne outbreak. Still, people who are prone to acne may want to avoid excessive consumption of foods high in iodine. It has also been suggested that there is a link between a diet high in refined sugars and acne. According to this hypothesis, the startling absence of acne in non-westernized societies could be explained by the low glycemic index of these tribes’ diets.Further research is necessary to establish whether a reduced consumption of high-glycemic foods (such as soft drinks, sweets, white bread) can significantly alleviate acne, though consumption of high-glycemic foods should in any case be kept to a minimum, for general health reasons.

Deficient personal hygiene. Acne is not caused by dirt. This misconception probably comes from the fact that acne involves skin infections. In fact, the blockages that cause acne occur deep within the narrow follicle channel, where it is impossible to wash them away. These plugs are formed by the cells and sebum created there by the body. The bacteria involved are the same bacteria that are always present on the skin. Regular cleansing of the skin can reduce, but not prevent, acne for a particular individual and very little variation among individuals is due to hygiene. Anything beyond very gentle cleansing can actually worsen existing lesions and even encourage new ones by damaging or overdrying skin.

Sex. Common myths state that either celibacy or masturbation cause acne and, conversely, that sexual intercourse can cure it. There is absolutely no scientific evidence suggesting that any of these are factual. It is true, though, that anger and stress affect hormone levels and thus bodily oil production. Whether or not any increases in oil production due to stress are enough to cause acne is currently being researched.

Understanding The Different Types Of Acne

Though all pimples form the same way, they often take on different shapes and characteristics, and react differently on different people.  Acne is formed when a hair follicle becomes clogged and what is called a comedo is formed.  As the follicle becomes clogged with more oil, the comedo becomes larger, inflaming the skin around the area and forming what we know of as a pimple.  There are several types of acne, each requiring different methods of treatment.  This article covers some of those types, explaining each and making treatment suggestions.

Non-inflammatory acne often takes the form of a closed comedo, or whitehead.  This occurs when the plugged hair follicle  stays beneath the surface of the skin, and appears on the skin as a small whiteish bump.

An open comedo, or blackhead, occurs when the plug enlarges and pushes through the surface of the skin.  Its dark appearance is not due to dirt, but rather to a build up of the dark pigment of the skin called melanin.  Blackheads are also a type of inflammatory acne.

The mildest form of inflammatory acne is a papule, a small, firm, pink bump appearing on the surface of the skin.  These bumps can be tender to the touch, and are often considered an intermediary step between non-inflammatory and inflammatory acne.

Pustules are like papules in that they are small, round lesions.  Unlike papules, pustules are clearly inflamed and visibly contain pus.  They may appear red at the base with a yellowish or whiteish center. Pustules do not generally contain a great deal of bacteria, but are inflamed due to chemical irritation from sebum components.

Nodular or cystic acne is usually very painful.  Nodules are inflamed pus-filled lesions lodged deep within the skin.  They develop when the contents of a comedo has spilled into the surrounding skin and immune system responds, producing pus.  The most severe form of this type of acne may persist for weeks or even months, eventually hardening into a cyst.  Both nodules and cysts often leave deep scars.

Acne conglobata, a rare form of inflammatory acne, forms primarily on the back, buttocks, and chest.  It is characterized by pustules and nodules, and severe bacterial infection may ensue.

Acne cosmetica is a relatively mild form of acne caused from topical cosmetic products.  It is characterized by small pink bumps, and local inflammation on the cheek, chin, and forehead.  It may develop over the course of a few weeks or months, but usually does not cause scarring.  Since it can persist indefinitely, it is important to find out which topical products are causing the problem and eliminate their use.

It is important to understand what is causing your acne so a suitable treatment can be found.  Before you can solve the problem, you must know its origin.

Treating Cystic Acne, Hard Skinned Pimples!

Referring to a hard personality, we say that “He is a thick-skinned fellow.” If you make this comment in a shop selling skin-care products, you are likely to catch the attention of the alert salesman: Please go to counter number…so and so…The ground for cystic acne is asphyxiated skin (dry on surface, oily underneath) –the thickened skin!

For cystic acne, innovative treatment technologies are now available. It is desirable to start it with external medication. To shrink, lumpy cystic acne, apply a dab of hydrocartisone cream. Have you seen the tailor’s sticker- “Specially made for you” on your trousers? Similar is the case of treating cystic acne. The dermatologist will give a program tailored to meet your needs.

Peel is the most potent formula to mar cystic acne. It provides more exfoliation for oilier, thicker and resilient skin types. It is effective on extremely sun-damaged and thickened skin. It is also excellent for those with cystic acne and asphyxiated skin.

The warmth, moisture and fragrance of herbal steam melts away muscular tensions, clears the mind and lifts the spirit. You may wonder what this has got to do with the cystic acne. Steams are one of the oldest traditional ways of deep-cleansing the skin. The moisture softens the dry outer edges of the skin, making them easier to remove, leaving behind a soothing and fresher complexion. The heat boosts facial circulation and activates the pores and glands which brings dirt and body toxins to the surface.

All said and done, let us take it that everyone is not blessed with smooth, glowing and healthy skin. But, we have to carry on with the available skin and look after it by giving it the importance it deserves. The skin is the final protection for your body and so it is your duty to protect its health and well-being, by understanding its present condition properly.

The importance of caring for your skin

“Packaging is as important as the gift itself” – it’s something that most of the gift manufacturing companies follow very closely.  The same holds good for you too. Your outer-self i.e. your skin is as important as your inner-self. A lot of people do realise the importance of skin care. Well, this is one reason why there are so many skin care products in the market and most of the skin care products seem to do pretty well. We generally tend to associate skin care to just good looks. However, there is more to it than just that. There are multiple benefits associated with a healthy and glowing skin.

Firstly, it has a good effect on you yourself. It makes you feel fresh and energetic. You are able to do more work and are quicker with everything you do. More importantly, the freshness adds to your enjoyment and makes your day. So a healthy skin too plays its part in building confidence. Yes, you can take most of the credit for having achieved that (however, do leave a little for the skin care products too).

Moreover, this flow of positive energy is experience by people around you too and you observe that even they are friendlier with you. You get more respect from others. They are more responsive to your queries. They themselves experience the freshness that you are exuding. They love working with you and for you. Yes, that’s how it works. Some people might even go ahead and ask you about the skin care products you use (you might or might not reveal those secret skin care products to them). Thus, a healthy skin can be instrumental in creating a pleasant and friendly environment around you. On the other hand, carelessness or negligence on this front can make you look unattractive and dull. You will not only look dull but also feel dull. Your work efficiency is reduced. Even the people you meet might not be as friendly. In fact, it might lead to the aging process getting started much earlier.

Thus the importance of skin care cannot be ignored. However, skin care is not that difficult at all.  There are a lot of skin care products available and you can choose the ones that suit you the best. There are various ways in which skin care products are classified and the knowledge about these classifications will help you understand them better and make a selection.

* The first categorisation is based on the skin type – so you have skin care products for oily skin, skin care product for dry skin, skin care products for sensitive skin etc.

* Another way is to categorise skin care products based on their use e.g. you have moisturisers, cleansers, skin care products for exfoliation, toners etc.

* Then you have skin care products for treatment of various skin dilemmas i.e. skin care products for acne, skin care products for stretch marks, skin care products for anti-ageing  etc.

* Another classification is based on the ingredients e.g. herbal skin care products, synthetic skin care products, cosmetic skin care products etc.

However, skin care products are not the only way of skin care. You also need to build some basic skin care procedures in your day to day life (as we discuss in the other article on personal skin care).

Serious skin care

‘Serious skin care’ is about maintaining a healthy and glowing skin all through your life. As you grow older, your body’s natural skin care mechanisms become weaker. So, ‘serious skin care’ is about responding to the changing needs of your skin. Thus, ‘serious skin care’ is about constantly evaluating, analysing and changing your skin care routines. Your skin care routine should change based on the environmental conditions, your age and changes in your skin type.

‘Serious skin care’ is also about awareness. With the technological advancements and research, more and more facts are being brought to light everyday. Also, the composition and nature of skin care products seems to be changing with time. So trying out the new products is also a part of serious skin care.  However, ‘serious skin care’ advises using a new product over a small patch of skin (not facial skin) first, just to see how your skin reacts to it.

‘Serious skin care’ also means knowing how to use your skin care products. Good practices include things like applying the moisturizers while the skin is damp, using upward strokes for better penetration of skin care products, removing the make up before going to bed, cleansing before moisturising or applying make up, using the correct amount of skin care products, etc. Thus, increasing the effectiveness of your skin care products is another focus area of serious skin care.

Some precautions, like avoiding contact with detergents, are also part of serious skin care. ‘Serious skin care’ means being gentle with your skin. Things like over-exfoliation, use of low quality products, and application of strong-chemical based products, are all harmful to your skin. Some people have a wrong notion about serious skin care. For them serious skin care is – using large quantities of products as often as possible. However, this really isn’t serious skin care (and that’s why awareness is so important).

‘Serious skin care’ is also about visiting your dermatologist for treatment of skin disorders. Ignoring the skin disorders can be fatal for your skin and might lead to permanent damage. So, if the things don’t improve with over the counter medication, you should immediately visit a dermatologist. Self-surgery e.g. squeezing of acne/pimples is a big no (it can lead to permanent damage of your skin).

So, seriously serious skin care is more about precautions and preventive measures (than treatment). Serious skin care is about being proactive as well as reactive. In fact, we can say that ‘serious skin care’ is about being proactive about the needs of your skin so that the need for being reactive is reduced to a minimum.