Acne vulgaris.
Acne is also called acne vulgaris. This is an inflammatory dermatological condition and affects nearly 100% of people at some stage of their life. Acne vulgaris occurs, typically, in puberty and usually subsides by the age of twenty. However, there are cases that the problem can develop in infancy or be present by the age of forty or even fifty.
Acne is characterized by lesions which are commonly referred to as whiteheads or blackheads. These lesions occur, when tiny pores of the skin called pilosebaceous units, get clogged. Pilosebaceous units are anatomical formations of the skin that contain the hair shaft, the hair follicle, the erector pili muscle and the sebaceous gland. The latest produces grease, which is called sebum, and contributes to lubrication and protection of the skin. The secretion of sebum is regulated by the androgenic hormone testosterone. The higher the level of testosterone in the blood stream, the larger the amounts of sebum synthesized is. Androgenic hormones are produced in large quantities in males and in smaller rates in females. Since the production of these hormones is intense in puberty, adolescents of both genders are prone to acne vulgaris. In fact, nearly 100% of the teenagers present some degree of acne at some stage of their life.
Acne, commonly, appears on the face but it may also be present on the neck, shoulders, trunk, arms, legs and buttocks. In general, acne subsides by itself, especially after puberty, without complications. However, if severe acne cases are not treated urgently and efficiently, cysts and/or scarring may occur.
Pathology of acne vulgaris.
Excessive production of sebum combined with the presence of shaded dead skin cells can result in blockage of the opening of the pilosebaceous unit and consequently, in accumulation of more sebum inside the unit. Bacteria, such as P. acnes, normally being present on the surface of the skin, can contaminate the pilosebaceous unit and start reproducing themselves, since sebum is a nice material for germ cultivation. This process is further promoted by the increased temperature in the infected area. Meanwhile, the swelling caused by the inflammation leads to complete obstruction of the opening and more sebum stagnates inside the pilosebaceous unit. The entire process leads to the development of a formation which is referred to as comedone and it is characterized by the accumulation of puss and the presence of redness, hardness, tenderness, depending on the severity of the inflammation heat and pain. According to its appearance and size, comedones are described as pimples, pustules, papules, zits, nodules, whiteheads, blackheads or just spots. All of them
include
a range of clinical signs of acne vulgaris. If the comedone is deep and ruptures, its infectious material can spread in the surrounding area and lead to the development of deep, rigid, painful nodules or the establishment of persistent, hard to be treated cysts. The difficulty with the latest is that the walls are very thin and can disintegrate during a surgical attempt for removal. In such a case, even if a tiny part of the cystic sack remains in the skin, the cyst will reoccur and potentially get infected again.
Causes of acne and risk factors.
Why people are more or less prone to acne has not been fully understood yet. Hereditary predisposition seems to play a key role, since the problem tends to run in families. Hormonal fluctuations during puberty or due to stressful lifestyle, menstrual periods and pregnancy can trigger the onset of acne vulgaris. Polycystic ovary syndrome, in females, can cause acne. Heavy usage of greasy cosmetic products is an important risk factor for acne, especially if they are not removed before bedtime at night. Increased humidity can make the skin to swell and lead to the first stage of acne by narrowing the pilosebaceous unit pores. Acne vulgaris is a typical aftermath of the use of certain drugs, such as oral contraceptives, barbiturates, anabolic steroids, synthetic hormones and testosterone boosters. In certain cases, high doses of vitamin B12 or pyridoxine may cause or worsen acne. Prolonged exposure to chlorine compounds, especially chlorinated dioxins, can result in severe and persistent acne which is referred to as chloracne. The drug Ecstasy and inhaled solvents can cause acne.
There are a couple of misconceptions about acne risk factors. For instance, it has not been proved that consumption of chocolate, nuts or fried foods can trigger the onset of the problem.
Despite
of the popular notion, celibacy, masturbation or very frequent sexual activity are not related to acne vulgaris. Some people believe that acne can be transferred from one person to another, if they use the same towel, for instance, but this is false. Acne is not infectious.
Complications of acne vulgaris.
Acne vulgaris is just a dermatological condition and by no means can be considered dangerous. However, if it is severe or gets persistent, acne may cause both physical and psychological complications. The former ones include the formation of cysts which can be regularly inflamed and the establishment of scares that may be irreversible. Depression and reduced self-esteem can be the psychological problems, especially in adolescence, when the personality of the individual is still under development. Prevention and treatment are very important, in order the consequences of acne to be minimized or eliminated. |
