Acne, medically known as Acne
Vulgaris, is a skin disease that involves the oil glands at the base of
hair follicles. It commonly occurs during puberty when the sebaceous (oil)
glands come to life - the glands are stimulated by male hormones produced by the
adrenal glands of both males and females. The word acne comes from the
Greek word akme meaning "the highest point". Acne at its most
basic is a disorder of the pilosebaceous unit, or what is commonly called the
hair follicle or pore. According to the American Academy of Dermatology,
it is the most common skin disorder in the United States.
Acne commonly
starts during puberty between the ages of ten (10) and thirteen (13) and tends
to be worse in people with oily skin. It is estimated that 80% of eleven (11)
to thirty (30) years are affected by Acne. It most commonly develops in the
face attacking over 90% of its victims in that particular region, the back
affecting 60% and the chest 15%.Teenage Acne usually last for five to ten
years, normally clearing out in the early 20s, it occurs in both sexes and all
race although teenage boys tend to have more severe cases (probably because
Testosterone, which is present in higher quantities in young men can make it
worse). Women however are more likely than men to have mild or moderate Acne
into their 30s and beyond (over 80% of adult Acne victims are women). This is
also most likely due to link between Acne and hormones. Dermatologists describe
Acne as a disease of the pilosebaceous units
(PSUs). Found over most of the body.
PSUs, consists of a canal called a follicle, that contains a fine hair. These units
are most
numerous on the face, upper back and chest. The
sebaceous gland makes an oily substance called sebum that normally empties onto
the skin surface through the opening of the follicle (commonly called
a pore). The hair sebum and KERATINOCYTES (these
are cells that line the follicle) that fill the follicle may produce a plug
which is an early sign of Acne. The plug prevents sebum from reaching the
surface of the skin through the pore. The mixture of oil and cells allows the bacteria PROPIONIBACTERIUM ACNES (p.
acnes) that normally live in the skin to grow in the plugged follicle. The
bacteria produce chemicals and enzymes and attract white blood cells that cause
inflammation. When the wall of the plugged follicle breaks down, it spills
everything into the nearby skin sebum, shed skin cells, and bacteria-Leading to
Lesions. People with Acne frequently have a variety of lesions. The basic
lesion called the COMEDO (KOM-e-do) is simply an enlarged and
plugged hair follicle.
TYPES OF LESIONS WHITEHEADS: Whitehead results if the
plugged follicle (Comedo) stays beneath the skin. 
BLACKHEADS: Results when a Comedo reaches the surface of the skin and
opens up (it is called a blackhead because it looks black on the skin’s
surface).
PAPULES: This is an inflamed lesion that usually appears as a small
bump on the skin and can be tender to touch-It is a circumscribed, solid
elevation of the skin with no visible fluid, and comes in varying sizes. They can be purple, pink
or red in color. The papules may be open when scratched and becomes infected
and crusty.
PUSTULES
(PIMPLES): Another type of Acne lesion is pustule, it is a small
inflamed swelling
of the skin that is filled with pus (It is similar to blisters). They may or
may not be tender to touch, pustules most commonly occur on the face, chest and
areas of increased sweating.
NODULES:
Skin
nodules are
slightly elevated lesion on or in the skin. They are larger than Papules. The
depth of the lesion is more significant than the width. Some are free within
the Dermis some are fixed to the skin above or below the Subcutaneous Tissue.
Nodules are painful to touch.
CYSTS:
Cyst is a closed sac, having a
distinct membrane and division compared to the nearby tissue. It may contain
air, fluids or semi-solid materials. Cysts occur within tissues and can affect
any part of the body. They vary in size from microscopic to the size of some
team-sport balls.
CAUSES
OF ACNE
Experts
believe the primary cause 0f acne is a rise in androgen levels. Androgen levels rise when a human becomes an
adolescent. Rising androgen levels make the oil glands under your skin grow;
the enlarged gland produces more oil. Excessive sebum can break down cellular
walls in your pores, causing bacteria to grow. Acne skin also produces more
dead skin cells than is normal, and those skin cells are not being shed
properly (a condition called retention
hyperkeratosis). These dead cells stick to the surface of the skin and
inside the follicles, mixing with excess oil and creating a Comedo. When the pore becomes blocked by cellular debris and oil, a
bacterium that is normally present within the pore grows unchecked.
Propionibacteria acnes (P. acnes) are found in great numbers on acneic skin,
causing inflamed breakouts. Certain factors have been
proven to trigger Acne at different stages in life, they include:
GENETICS
Researchers
believe that the tendency to develop Acne can be inherited from parents. This is particularly something to
consider if you are experiencing adult Acne. Research conducted at the General
Infirmary at Leads, department of Dermatology in the UK suggests that family
factors are important in determining individual susceptibility to adult facial
Acne. Genetic factors may determine the failure of Acne-prone follicles to
evolve into Acne-resistant follicles in early adult life.
Acne gene is called Retention
hyperkeratosis. What this means is that you
have inherited the ability to over produce
dead skin cells, then improperly shed them when you shouldn’t. This results in
abnormally shaped lining of the pore that is prone to clogging, which will
eventually result in Acne lesions if nothing is done about it.
HORMONES
Common Acne in teenagers starts with an increase in hormone
production. During puberty, both boys and girls produce high levels of androgen
which signals the body to make more sebum. According to the America Academy of Dermatology,
testosterone works to stimulate oil gland activity, making an oiler skin more
prone to Acne break-outs.
Androgens are hormones released from the adrenal glands, ovaries and tests.
Testosterone is an androgen hormone, while it is typically thought of as a male
hormone it is present both in male and female.
Menstrual Acne (a flare up of blemish every month that
coincides with menstruation) is fairly common. According to a study published
in the archives of Dermatology, 63% of Acne-prone women experience these
premenstrual flares. They usually strike about seven(7) to ten (10) days before
a woman’s period starts and then subsides as soon as bleeding begins. The
average menstrual cycle is 28days. Each of these days is different hormonally.
In the first half of a woman’s menstrual cycle, the predominant hormone is
Estrogen, whereas Progesterone is predominant in the second half “– OB-GYN-
Elizabeth Gutrecht Lyster, MD. The levels of both hormones fall to their lowest
level of the month as bleeding approaches.
Meanwhile, the male hormone Testosterone
(available in small amount in women) stays at a constant level all month. This
means that before and during menstruation, Testosterone is relatively higher
than the female hormones. These hormonal shifts do all sorts of things to a woman’s
skin. Again the mid-cycle Progesterone rise stimulates the production of sebum.
And as the levels of progesterone increases, skin cells and pores are
compressed shut, as a result pores appear minimized. This also causes sebum to build up beneath the
skin’s surface. Still higher Testosterone levels around menstruation further
activate the sebaceous gland to make even more sebum (Sebum yields different effect in different women. For some, it
produces a healthy glow, for
others,
it creates a chronic oil slick, says Kunin Audrey
MD of dermadoctor.com). The oil provides food
for the bacteria P. acnes. This bacterium causes increased breakouts and
inflammation around the time of women’s period.
BACRETIA
A
bacteria known as Propionbacterium Acnes
(P. acnes) is a normal inhabitant of the skin. It uses sebum as a nutrient
for growth. People with Acne have more propionbacterium
acnes in their follicles than people without acne.
The presence of propionbacterium attracts white blood cells to the follicle. These white blood cells produce enzymes that
damage the wall of the follicle, allowing contents of the follicle to enter the
dermis. This process causes an inflammatory response seen as papules (red bumps), pustules and nodules.
The bacteria also cause the format ion of free fatty acids which are irritants,
increasing the inflammatory process in the follicle.
DIET
It is
a commonly debunked myth that certain foods
cause breakouts, but this is not say that your diet doesn’t matter when it
comes to Acne. Diets high in sugar, refined carbohydrates and trans-fats, and
low in anti-oxide, create systemic inflammation, which manifests itself in the
form of Acne, Rosacea or Premature aging. Diets that is high in pro-inflammatory omega 6-fatty acids,
while low in inflammatory- soothing omega 3 can also trigger Acne.
OTHER FACTORS THAT CAN MAKE ACNE WORSE
Anxiety
and Stress - Mental stress can
affect your levels of some hormones, such as cortisol and adrenaline, which in
turn can make Acne worse. Again, stress can make some people binge-eat. Experts
believe the culprits are most likely the hormone levels, rather than the
binge-eating.
Hot and Humid Climates - When it is hot and humid we sweat more. This can make the acne worse.
Hot and Humid Climates - When it is hot and humid we sweat more. This can make the acne worse.
Oil
based Make-ups - Moisturizing creams, lubricating
lotions, and all makeup that contains oil can speed up the blocking of your
pores. Try as much as you can to avoid such products, water based product are
much better.
Greasy
hair - Some hair products are very
greasy and might have the same effect as oil based makeup. Hair products such
as cocoa butter or coconut butter contain much oil.
Squeezing
the pimples - if you try to squeeze pimples
your acne is more likely to get worse, plus you risk scarring.
MYTHS ABOUT CAUSES OF ACNE.
MYTHS ABOUT CAUSES OF ACNE.
There are several wrongly assumed causes of Acne. These
myths are most likely spread by teenagers or even parent that try to manipulate
their young children to stop them from either eating or indulging in certain
activities. Some of these myths include:
You can catch Acne from someone else- This is completely false as acne is not contagious.
You can catch Acne from someone else- This is completely false as acne is not contagious.
Masturbation causes Acne- This one is a very popular myth especially with teenagers. But that is definitely not true, there is so far no medical evidence
backing such claim. Masturbation doesn't cause acne and neither does sex.
Chocolate, pizza, and French fries cause Acne – Though it is true that
certain food can increase your risk of acne breakout there is however no prove
that pizza or French fries or even chocolate at that causes Acne.
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