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What is Acne?

Sunday, 12 April 2009

acneAcne aka pimples is an inflammation of the sebaceous glands of the skin. Acne is a chronic disease that results in regular pimples.

How does acne appear?

Depending on the stage of development and other factors there are several types of acne: comedo or acne comedonica - noninflammatory elements that come out due to plugging of sebaceous glands ducts. The sebum is accumulated in the form of white knot under the skin. Such knots appear 2 to 3 mm in diameter. When the sebum goes out and is oxidized in air, blackheads or open comedo occur.

Acne papulosa или papulopustulosa develop due to inflammation process around the closed or open comedo. With obvious inflammation process such acne may leave scar on the skin.

Acne indurativa are characterized in inflammation process in the deep layers of skin that is always followed by scars after the acne disappears. Acne indurativa are of solid consistence, they bring to inflammation process and edema of surrounding area.

Acne phlegmonosa is caused by the prolonged progress in inflammation process and cavities in skin full of pus. Such cavities (cysts) may merge with others and form cysts of significant sizes. Acne indurativa  and Acne phlegmonosa are often called knotty-cystic acnes.

Acne conglobata indicate to the severe course of the disease and presented by multiple knotty-cystic acne on the face, upper back, chest and belly. Also it is typical for appearance of large comedo areas that afterwards transform into knotty-cystic acnes. Such acne may merge forming cavities with pus. As a rule, Acne conglobata leave rough scars after, and sometimes they are colloid scars. As a rule, Acne conglobata do not vanish after the puberty period and may appear on the skin even up to 40-50 years old.

Acne fulminans is the rare form of acne, and it appears mostly with men at the age of 13-18 years along with the Acne papulosa and Acne conglobata. Quick process includes occurrence of ulcerous surface at the acne place. And all this is accompanied by high temperature, weakness, pain in the joints, in abdomen and other symptoms that say about affection of the organism on the whole but not the skin only.

Acne inverse or hidradenitis suppurativa. Sudoriferous glands ducts may get squeezed after the inflammatory reactions in hair follicle and sebaceous glands. And as a result, the substance as one of the sweat component is accumulated in the skin. As a result, there is inflammation process and occurrence of sinus tracts. Provoking factors are excess weight, rubbing of clothes and itching in these places (axillas, nipples, in the crotch, navel and others).

Do microbes form acne and if they are contagious?

Severe forms of acne (Acne conglobata, Acne phlegmonosa, Acne fulminans) relate to penetration of microorganisms into the skin normally inhabitant with Propionebacterium acnes and Staphylococcus epidermidis, and other microorganisms either. Acne is not contagious since several factors are required for acne to develop, while microbial infection is the consequence of protection barriers break, and appearance of selective medium (sebum).

Where does acne appear?

Acne appears in places where sebaceous glands are located. The areas with significant quantity of sebaceous glands are the facial skin, upper part of thee chest and back. Acne may appear in the other areas either, except for the skin of palms and feet where exclusively sudoriferous glads present.

Why do they appear?

Acne appears as a result of impaired functioning of sebaceous glands. On one hand, this impairment is related to the increased production of sebum, on the other hand the plugging of excretory ducts of sebaceous glands by cosmetic means, dust or other substances.

Factors that bring to the increased secretion of sebum include:

  • Increased activity of sebaceous glands at the age of 12 to 24 years old which is the physiological process of seborrhea to go with the increased secretion of sebum because of genetic factors with long application of corticosteroids and antiepileptic, antituberculous drugs (Isoniazide, Ryfampicyne, Ethambutol), as well as with application of azatioprine, cyclosporine А, chloral hydrate, lithium salts, iodine preparations, chlorine, bromine and vitamins (especially - В1, B2, В6, В12, D2).
  • endocrine diseases followed by raising of androgen level (for instance, polycystic ovary that may be accompanied by hirsuties or hypertrichosis).
  • adrenal and ovary tumors

The factors that bring to plugging of sebaceous glands ducts mainly include cosmetic means containing fat emulsions or oily substances - lanolin, vaseline, olive oil and others. Normally preparations that bring exacerbation or appearance of acne have signs «cоmedonogenic», and «non-cоmedonogenic» on those that do not bring clotting of glands.

Why do adults have acne?

Adults can have acne after application of «comedo relieving» cosmetic means, and in connection with endocrine diseases. If acne appears with adults over 25 years old, it is an alarming sign and the reason to get thoroughly examined. Quite often acne occurs with women at the age of 30-35 who actively start using toning cosmetics. And acne appears as a result of permanent plugging of sebaceous glands. And the longing to eliminate these effects by the thicker layer of cream will result in worsening of acne.

What flushes acne?

Besides of abovementioned factors acne may be provoked by regular trauma of comedo («peeling»), squeezing of acne, work at humid premises with high temperature (for example, in the kitchen).

Does it make sense to cure acne or they will go away?

As a rule, comedo and acne papulosa do not leave scars on the skin that is why if you do not cure it, your skin is not affected further. Papulopustular, phlegmonous, acne conglobata leave scars on the skin that is very complicated to cure (dermabrasion, chemical peeling, and laser peeling of the skin). Various types of pimples are the particular stage of acne, so every consequent stage of acne is quite logical, however it requires particular conditions. Acne papulosa do not necessarily turn into acne conglobata, but if they do, they disappoint the acne bearer. In any event, even with comedo it makes sense to apply cleansing lotions.

Is it possible to squeeze acne?

It is not recommended at all. In the event when acne if followed by infection the squeezing brings to further progress of acne, at first, and, second, to penetration of microbes into the blood flow. Since facial blood-vessel is tightly connected with vessels of the brain, any traumatic manipulations with purulent masses of skin just over the upper lip may bring to serious consequences, including the death.

Do contraceptives affect acne?

It is known that estrogens reduce acne development while progesterone acts on the contrary. Contraceptives containing only progesterone may bring to acute acne. If a woman has more androgens in her organism, then prescription of contraceptives with antiandrogen activity (Diane -35) will lead to reduction or vanishing of acne.

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