ACNE (PIMPLES)


1.0 What is acne?

Acne (acne vulgaris, common acne) is a disease of the hair follicles of the face, chest, and back that affects almost all males and females during puberty; also known as pimples. Pimples form when hair follicles under your skin clog up. Most pimples form on the face, neck, back, chest and shoulders. Anyone can get acne, but it is common in teenagers and young adults. It is not serious, but it can cause scars.


1.1 What cause acne?

Acne happens when sebaceous (oil) glands attached to the hair follicles are stimulated at the time of puberty by elevated levels of male hormones. Sebum (oil) is a natural substance which lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature so that they are predisposed to clog the follicular openings or pores. The clogged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation.
Inflammation near the skin's surface produces a pustule; deeper inflammation results in a papule (pimple); deeper still and it's a cyst. If the oil breaks through to the surface, the result is a "whitehead." If the oil accumulates melanin pigment or becomes oxidized, the oil changes from white to black, and the result is a "blackhead." Blackheads are therefore not dirt and do not reflect poor hygiene.

There’s no factor causes acne; however some factors are believed to play a role in acne:-
•Heredity: With the exception of very severe acne, most people do not have the problem exactly as their parents did. Almost everyone has some acne at some point in their life.

•Food: Teens are often told to avoid pizza, chocolate, greasy and fried foods, and junk food. While these foods may not be good for overall health, they don't cause acne or make it worse. Although some recent studies have implicated milk and pure chocolate in aggravating acne, these findings are very far from established.

•Dirt: As mentioned, "blackheads" are oxidized oil, not dirt. Sweat does not cause acne, therefore, it is not necessary to shower instantly after exercise for fear that sweat will clog pores. On the other hand, excessive washing can dry and irritate the skin.

•Stress: Some people get so upset by their pimples that they pick at them and make them last longer. Stress does not really cause acne; somehow stress can make it worse.

Anyway, in occasional patients, the following may be contributing factors:
•Pressure: In some patients, pressure from objects, such as helmets, chin straps, collars, suspenders, and the like can aggravate acne.

•Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone [Deltasone, Orasone, Prednicen-M, Liquid Pred] or the steroids that bodybuilders or athletes take). Other drugs that can cause or aggravate acne are anticonvulsant medications and lithium (Eskalith, Lithobid), which is used to treat bipolar disorder. Most cases of acne, however, are not drug related.

•Occupations: In some jobs, exposure to industrial products like cutting oils may produce acne.

•Cosmetics: Some cosmetics and skin-care products are pore clogging ("comedogenic"). Among many available brands of skin-care products, it is crucial to read the list of ingredients and choose those which have water listed first or second if you are concerned about acne. These "water-based" products are usually safe.

1.2 What can we do about acne?

Cleansing and skin care: Despite what you read in popular style and fashion magazines, there is no magic product or regimen that is right for every person and situation.

•Mild cleansers: Washing once or twice a day with a mild cleansing bar or liquid, will keep the skin clean and minimize sensitivity and irritation.

•Exfoliating cleansers and masques: A variety of mild scrubs, exfoliants, and masks can be used. These products contain either fine granules or salicylic acid in a concentration that makes it a very mild peeling agent. These products remove the outer layer of the skin and thus open pores. Products containing glycolic or alpha hydroxy acids are also gentle skin exfoliants.

•Retinol: Not to be confused with the prescription medication Retin-A, this derivative of vitamin A can help promote skin peeling.

Kill the bacteria:
•Antibacterial cleansers: The most popular ingredient in over-the-counter antibacterial cleansers is benzoyl peroxide.

•Topical (external) applications: These products come in the form of gels, creams, and lotions, which are applied to the affected area. The active ingredients that kill surface bacteria include benzoyl peroxide, sulfur, and resorcinol. Some brands promoted on the Internet and cable TV (such as ProActiv) are much more costly than identical products you can buy in the drugstore.

Benzoyl peroxide causes red and scaly skin irritation in a small number of people, which goes away as soon as you stop using the product. Keep in mind that benzoyl peroxide is a bleach, so do not let products containing benzoyl peroxide leave unsightly blotching on colored clothes, shirts, towels, and carpets.

Reduce the oil:
You cannot stop your oil glands from producing oil. Even isotretinoin (Accutane, see below) only slows down oil glands for a while; they come back to life later. What you can do is to get rid of oil on the surface of the skin and reduce the embarrassing shine.

•Use a gentle astringent/toner to wipe away oil. (There are many brands available in pharmacies, as well as from manufacturers of cosmetic lines.)

•Products containing glycolic acid for instance blemish control wipes are also mildly helpful in clearing the skin by causing the superficial layer of the skin to peel (exfoliate).

•Masks containing sulfur and other ingredients draw out facial oil.

•Antibacterial pads containing benzoyl peroxide have the additional benefit of helping you wipe away oil.