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ACNE - Facts & Myths
Acne/Pimples. Nearly everyone has suffered through them, some more than others. They are an almost universal affliction of adolescence. Even one or two “zits"(spots, pimples) can cause much posturing and worrying in front of a mirror. A handful may cause panic. And a face full can result in permanent scarring both of the skin and the psyche. Although acne can't be cured, it can be treated successfully in the vast majority of people. Some cases, especially the mild types, can be cleared up completely. Vigorous treatment of more severe types of acne can help prevent facial scarring. Medically termed as “Acne vulgaris”, this skin disease affects millions of people worldwide annually. It can vary from quite mild to extremely severe. About 80 percent of all teenagers develop acne, but the disease may also start as late as age 25 or 30 particularly in women (Late-onset Acne) . What Causes Acne?
When the duct is blocked, cells and sebum accumulate, forming a plug (comedo). If the plug stays below the surface of the skin, it is called a "closed" comedo or whitehead. If the plug enlarges and pops out of the duct, it is called an "open" comedo or blackhead because the tip is dark. This is not dirt and will not wash away. The discoloration is due to a buildup of melanin, the dark pigment in the skin. Pilosebaceous units are found all over the body, but there are more on the face, upper chest, and back, which explains why acne usually occurs in these places. There are two
main types of acne: non-inflammatory and inflammatory. When does Acne begin? Acne almost always starts when the body begins to mature, at about age 11 for
girls and 13 for boys. Acne tends to be more severe among boys because their bodies begin increased production of male hormones called
androgens that, among other things, stimulate the activity of the sebaceous gland. Girls also produce these hormones, but only
one-tenth as much. The exact role hormones play in the development of acne is not known. What are the Trigger factors? In addition to puberty, a number of other factors can cause, trigger or contribute to the development of acne. Some drugs including
certain hormones, epilepsy drugs, and Exposure to industrial oils and grease and chemicals, such as PCBs, can cause acne. The bacteria ‘Propionibacterium Acnes’ can indirectly contribute to the development of acne by causing skin fats to break down into irritating chemicals. Stress and strong emotions, such as guilt, anxiety and fear, can trigger acne in people who have a predisposition to the disease. The onset of the menstrual period each month can trigger or worsen acne. Some 60 to 70 percent of women notice that acne gets worse the week before menstruation. Birth control pills appear to have an effect on acne in some women. Perplexingly, they cause acne in some cases and clear it up in others. Some oily cosmetics and shampoos can, on rare occasion, trigger acne in people who have a predisposition to it. Contrary to earlier belief, there is no scientific evidence that foods such What can you do to clear up mild acne? Get a nonprescription acne medicine and apply regularly. Over-the-counter drugs containing sulfur, resorcinol, salicylic acid, and benzoyl peroxide are all effective for treating mild acne. Use ordinary hygiene on affected areas, washing your face once or twice daily with your usual soap or cleanser. Deodorant soaps may be used, but they are of no particular value for acne. Avoid any food or drink you know is a trigger. If these measures don't work, see a dermatologist. While it might be tempting to pick at pimples and squeeze blackheads, this can injure the skin and underlying tissues and can cause scarring. Doctors advise patients not to pick pimples. Dermatologists use medical instruments called ‘comedo extractors’ to remove blackheads. How is serious acne treated? One drug dermatologists sometimes prescribe for serious acne is tretinoin/isotretinoin, commonly known as Retin-A. A derivative of vitamin A, Retin-A comes in cream, gel and liquid forms and is rubbed onto the skin once nightly. It is highly effective for treating blackhead acne and modestly effective for treating pimples and pustules. Retin-A usually begins to clear up acne in two to three weeks, although in some cases it's more than six weeks before any improvement is noticed. Scientists do not know exactly how Retin-A works, but research suggests that it both pushes out the comedo plugs beneath the skin and helps prevent their re-formation. It also prevents the cells and sebum from accumulating in the sebaceous ducts. One of the main side effects of Retin-A one that occurs in all users is a heightened susceptibility to sunlight (Photosensitivity). Therefore, those who use Retin-A should stay out of the sun as much as possible, and during sun exposure should minimize its effects with sunscreens and protective clothing. Retin-A users should also avoid sun lamps because their ultraviolet rays mimic those of the sun. Another common side effect of Retin-A is drying, irritation or peeling of the skin. When this occurs, the doctor may suggest patients to reduce the dosage and use non-comedogenic moisturisers. Another recently introduced drug is Adapalene which is available in gel forms and works almost similar to Retin-A but slightly more effective in comedonal acne. Some antibiotics are effective for treating and preventing pustules and cysts of severe acne. Tetracyclines and erythromycin are the most commonly prescribed and are widely used by dermatologists. Treating Severe Cystic Acne For very
severe, disfiguring acne unresponsive to the treatments mentioned, the dermatologist may prescribe isotretinoin, commonly known as Roaccutane.
Also a vitamin A derivative, Roaccutane is taken orally in capsule form. It is highly effective for treating severe cystic acne and
preventing the deep pits and scars that result. The exact mode of action of this drug is not known, but evidence suggests that it
reduces the size of the sebaceous gland and the amount of sebum secreted. It almost completely clears up the disease in most of the
acne patients. Women should
use Roaccutane with extreme caution, however, because it can cause miscarriage and severe birth defects. If a woman becomes pregnant
while taking the drug, there is a great possibility her baby will be born deformed. Therefore, Roaccutane's use is tightly regulated
by FDA and all health authorities. Doctors may only prescribe it for a woman who has had a negative pregnancy test and does not intend
to become pregnant while taking it, and who has signed a consent
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No one knows for sure exactly what causes acne, or why it usually begins in adolescence.
But a number of factors, most importantly heredity, play a role. If one of your parents had acne, there's a good chance you will, too.
If both had it, then the chances are higher. Acne develops when the sebaceous glands and the lining of the skin duct begin to work
overtime, as they do in adolescence. The glands produce more sebum, making the skin more oily. Normally the lining of the duct sheds
cells that are carried to the surface of the skin by the sebum.
as chocolate, nuts, cola drinks, potato chips, french
fries, and other fatty "junk food" cause acne or make it worse. Nonetheless, some people do notice that certain things they
eat or drink do seem to trigger their acne.
