There are several different kinds of acne, depending on how or why the acne started. Some of the forms of acne are: acne conglobata (chronic boils); acne fulminans (an extreme form of conglobata); acne cosmetica (caused by cosmetics); acne keloidalis nuchae (from shaving); acne medicamentosa (caused by starting or stopping a medication); acne rosacea (redness on the face); baby acne; hormonal acne; cloracne and the common variety, acne vulgaris (also known as ‘puberty spots’). In this article, we will concentrate on acne vulgaris.
Acne vulgaris may be described as: ‘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’ (from Wikipedia).
Acne is most common in white Western teens, although it does occur in every country in the world, so there could be a genetic predisposition to it. It is possible that it may be an exceptional reaction to fairly normal levels of testosterone. For most sufferers, the condition lasts only until adulthood, probably only a few years or at the most ten. For other people, however, it can be a life-long affliction. It most often affects the face, upper-chest, upper-arms and back. However, an occasional spot does not constitute acne.
Acne vulgaris appears in various forms, which include: whiteheads, resulting from pores which are totally blocked, trapping sebum (oil), bacteria, and dead skin cells, resulting in a white spot on the top; blackheads, resulting from pores which are only partially blocked, allowing some of the trapped sebum, bacteria, and dead skin cells to slowly drain to the surface (the black colour is not caused by dirt, but is a reaction of the skin’s own pigment, called melanin, with the oxygen in the air); papules, which are inflamed, red, tender lumps with no head and pustules, which are like whiteheads, but are inflamed, and look like red circles with a white or yellow centre.
Whiteheads do not often last for a long time; blackheads do last a long time and pustules are what people usually refer to as spots or zits. Severe acne vulgaris is distinguished by nodules and cysts. A ‘nodule’ is a rather larger and much more painful type of pustule and can sometimes last for months. Nodules are large, hard lumps just under the skin. They often result in scarring and should never for any reason be squeezed, since this could make them last for months longer.
A ‘cyst’ can look like a nodule, but it is full of pus and has been described as having a diameter of at least 5mm and, again, can leave scars and cause pain. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which may last very much longer than if it had not been squeezed. Skin experts have methods of reducing the swelling and preventing scarring with both nodules and cysts. It is not true that acne sufferers are not meticulous about washing.
In fact, excessive washing can irritate acne. There are many, many useless ‘treatments’ on the market and many, many old wives’ remedies, but any good dermatologist would advise you that there is no known cure for acne and that the patient should follow a strict regimen of cleaning until the acne just ‘goes away’ of its own accord.
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