Acne are small inflammations of the skin in and around the sebaceous glands, especially in the face. Almost everyone gets acne in puberty. Acne may sometimes continue after puberty or start in adulthood. It is a harmless skin condition, which can be quite inconvenient and cosmetically disturbing.
Cause
In puberty, the amount of hormones in the body increases. It is mostly the male hormones in boys ànd girls that stimulate the sebaceous glands to produce more sebum (skin fat). The sebaceous channels can therefore get clogged. Bacteria in the sebaceous glands transform the sebum into fatty acids. Due to the accumulated sebum and irritating free fatty acids, the clogged sebaceous gland and the sebum channel expand further and further and eventually rip open. The irritating substances get into the surrounding skin and cause an inflammation. This creates pimples and zits.
If both parents or either parent have had severe acne, their children are more likely to get acne as well. Furthermore, acne is not hereditary. The effect of certain foods on acne has not been proven. Acne is not contagious, even if pimples with yellow pusheads have arisen.
Symptoms
Acne doesn’t look the same in everyone. One person may have few pimples, while another has a comprehensive skin condition that can cause a lot of mental problems and can spoil pleasure in everyday life.
Acne includes blackheads, red bumps and pimples. A blackhead (comedo) is a clogged sebaceous gland in the skin. The exit of the sebaceous gland contains a clot of skin cells, together with sebum. There are two types of blackheads: open and closed blackheads.
Subcutaneous pimples are painful red inflamed bumps. They may appear spontaneously, but they can also be caused by squeezing a pimple.
Pimples are sebaceous glands that have become inflamed. Both the pimple and the skin around are clearly red. The pimples are mainly located in the face, but can also appear on the chest and back.
In case of a severe inflammation, subcutaneous inflammations may arise that can leave ugly scars after healing.
Diagnosis
Acne is generally easy to recognize, so that the diagnosis can be made by the general practitioner on the basis of visible defects. The presence of blackheads makes the diagnosis very likely. Additional examination is almost never necessary.
According to the number of pimples and the extent, acne is often classified as mild, moderate or severe. The presence of scars also plays a role in assessing the severity of acne.
Treatment
The treatment of acne is aimed at reducing the production of sebum and stopping bacterial growth and inflammation. A standard treatment for acne does not exist. The severity of the condition, the symptoms, the presence of scar formation, but also age, gender and mental factors determine which treatment will be started.
Mild acne can be treated with local agents in the form of creams, ointments, emulsions and lotions. These agents contain, among other things, benzoyl peroxide, tretinoin and adapalene. In case of moderate to severe acne, medication can be prescribed, such as antibiotics, birth control pills and isotretinoin. Because multiple factors together play a role in the emergence of acne, a combination treatment will usually be needed, so that the condition is tackled on several fronts simultaneously. The treatment of acne always needs some time to take effect. It often takes at least one to three months before a satisfactory result has been achieved.
If the pimples spoil everyday life in such a way that nothing else can be thought about and gloomy feelings dominate, psychotherapy can be a meaningful addition. Behavioral therapy can help to get rid of the urge to pick each pimple, causing acne to worsen or to be maintained.
Prognosis
Acne is a harmless condition that usually disappears after a few years. Lifelong scars can largely be prevented by the treatments mentioned before. Acne usually disappears before the age of twenty-five, but sometimes the condition continues at old age.
Considerations
- Squeezing pimples is advised against, because bacteria can spread in the skin and thus make the condition worse. Moreover, it can cause scars.
- It is wise not to switch medication all the time. If a particular product doesn't work properly, it may be better to add another drug to the treatment.
- By cleaning the skin in advance, the excess sebum can be removed. Excessive washing with water and soap is useless and may even be harmful to the skin. It is advisable to wash the skin daily with lukewarm water, without rubbing or scrubbing.
- Most people who suffer from acne experience improvement when they are in the sun. Especially acne on the back and chest improves under influence of the sun.
- Acne scars can be treated with (micro) dermabrasion, cryotherapy, chemical peeling or laser therapy.
- Acne cannot be prevented. Acne can usually be managed to become ‘quiet’ and to remain quiet until it eventually passes on its own.
Facts
- The term ‘acne’ is derived from the Greek word acme (peak, point, highlight, blooming, achieving maturity).
- Acne is the most common skin condition. The prevalence of acne is 15%. Almost 85% of all people aged 15 to 24 years have at some point to do with acne.
- Boys suffer from acne more than girls, because female hormones counteract the production of sebum.