HEALTH GUIDE: Acne

What is acne?

Acne is a skin disease usually caused by inflammation of the sebaceous gland follicles that frequently occurs during adolescence. This stage of life is often characterized by impure skin caused by blackheads and pimples. Although these are annoying, they are harmless. Due to incorrect sebum production and other factors, inflammatory skin changes develop into pus-filled spots on various parts of the body which make the healing process more difficult.

However acne is not just limited to teenagers. Older adults and babies who can have ‘baby acne’ may also develop this skin condition.

Causes

Acne originates in the sebaceous glands which are located at the roots of the hair. Each skin hair has a sebaceous gland at the end of its root. Its task is to produce an oily secretion that protects the skin's surface from environmental influences and dehydration. But when this follicle produces too much sebum, the excretory ducts become blocked and pimples and as well as blackheads (also called comedones) form, resulting in characteristic inflammation. Psychological factors and stress also help promote outbreaks.

Hormones often play a role in causing acne. Excessive production of male sex hormones – the androgens – means adolescents suffer during puberty. Shiny skin, greasy hair or acne are dependent on genetic predisposition transmitted by parental genes.

In some cases the skin's appearance worsens after the consumption of certain foods. Likewise chemical ingredients in cosmetics may aggravate acne so skin care products should also be used cautiously. Certain creams or oils clog up the pores resulting in the skin being blocked and therefore unable to breathe. As a consequence the acne progressively worsens. While medications may help to alleviate or even eliminate acne symptoms, some have a side effect of promoting this ailment. This however varies from patient to patient and the condition should always be discussed with a dermatologist.

Symptoms

Typical acne symptoms include numerous papules (swellings), blackheads and pimples that often develop on the face, cleavage, neck and upper back. The severity of the symptoms varies greatly from patient to patient and doctors distinguish between mild, moderate and severe acne. These are subdivided into non-inflammatory and inflammatory acne. The mild form is non-inflammatory which in everyday language is simply referred to as blackheads or pimples.

Severity

  • Mild form: blackheads appear as black dots. However the discolorations are in no way due to the skin being unclean. They are caused by the combination of the skin pigment melanin and oxygen in the air. The dark blackheads exhibit open pores. It is also possible to see light-coloured ones which have closed pores resulting from the sebum. Excess sebum multiplies with a bacterium and in this way leads to the inflammatory acne pimple.
  • Moderate form: the number of acne pimples is more pronounced. Over time, small lumps and pustules develop into all-out pus-filled spots.
  • Severe form: the skin is covered with pustules and raised papules. They increase in such a way that additional lumps form on the skin that are reddish in colour and very painful. Scars from this type of acne often remain.

Acne pimples are very stubborn, develop very slowly and persist long-term. Normal pimples develop in exactly the opposite way over a very short time and heal effortlessly. A further variant of this disorder is neonatal acne which is subdivided into newborn and infant acne. With newborns small blackheads form on the cheeks and disappear within the first few weeks of life. Infant acne only occurs during the first six months of life and mainly comprises small pus-filled pimples on the forehead and cheeks. Neonatal acne should always be examined by a doctor and treated if necessary. This is also the case with acne in children.

Mallorca acne is a different variant affecting 20 to 40 year olds where the skin reacts to UV rays. The typical swellings form all over the body, though seldomly on the face, and are characterized by severe redness and increased itching.

Diagnosis

A dermatologist can usually identify acne by looking at the affected areas of the skin. But for a precise diagnosis further details need to be asked during a medical history interview. These include:

  • How long has the skin condition existed?
  • What form do the symptoms take?
  • Is medication being taken or applied for acne?
  • What about special dietary habits?
  • Do any underlying diseases exist?
  • Is there any family history of acne?
  • Has the patient been in contact with chemicals such as tar, oil or chlorine?

If the acne is severe, the dermatologist will use swabs or arrange a blood test to determine the triggering bacterial species. This is crucial for the ensuing treatment.

Treatment

he doctor will choose medication either for internal or external use, such as cream, depending on the severity of the disease. The physician should always keep an eye on the ingredients and combination of the medication. An acne treatment usually includes remedies with the following ingredients:

  • Benzoyl peroxide which kills bacteria.
  • Prescription-only anti-inflammatory antibiotics to combat bacteria.
  • Prescription-only retinoids to prevent corneal growth and reduce the formation of blackheads. These cause side effects.
  • Azelaic acid which is antibacterial and anti-inflammatory.
  • Alpha-hydroxy acids that moisturize, are anti-inflammatory and promote scaling of the outer horny layer.

Severe acne in women is mostly due to the excess production of acne-promoting androgens (male hormones). A targeted therapy using female hormones can restore the skin's balance. Neonatal acne and acne in children must always be treated by a competent dermatologist.

In cases of mild to moderate acne, microdermabrasion can sometimes help. This is a painless and gentle process that removes strong cornification and enables sebum or excess secretion to flow naturally again.

Prevention

An outbreak of acne is unpreventable. Should initial symptoms appear, various measures can positively influence the progression of the ailment. This however presupposes that the causal triggers are known.

Preventive measures

What helps to minimize acne?

  • Do not sunbath in intense sun.
  • Use skin-friendly care products in general and acne cream in case of an outbreak.
  • Eat a healthy diet.
  • Refrain from alcohol and nicotine.
  • Refrain from touching blackheads and pimples.
  • Avoid stress.

What else helps?

A change of diet. There is much debate about which foods promote acne and which do not, though this is only a reference point. Ultimately each inflicted person can identify these foods for themself by a process of elimination. Avoiding sweets and using less dairy products in the long term will certainly show initial results. An acne diet should always contain plenty of vitamins and be rich in fibre.

Conclusion

Create brief time-outs for yourself – times when you just do things that improve your general well-being. This could be reading a book or a spontaneous motorbike trip with friends It does not matter what you do as long as it's fun! Even these small distractions will progressively bring you closer to an inner balance, which can additionally aid the skin’s healing process!

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