Acne
Acne is classified as a skin disease because it results from the Propionibacterium acnes bacteria which multiplies and spreads through the sebum or oil that naturally moisturizes the skin layer and hair follicles that then become inflammed. This disease can affect anyone between the ages of approximately ten and forty.
Acne appears on the epidermal layer of the skin, but develops from the dermal layer containing the sebaceous glands and hair follicle roots, in addition to blood vessels and nerves. These components are what give rise to different types of acne and the need for specific treatments that will be discussed in the following pages which provide an overview of acne.
What is Acne?
Acne is not merely a pimple or complexion problem, it is a disease of the skin that causes the propionibacterium acnes that is naturally present in the skin to multipy through the dermis and epidermis skin layers. The bacterial multiplication can be non-inflammatory or inflammatory. Infection may then spread from the sebaceous glands through hair follicles, blood vessels and tissue containing nerves in the face, neck, chest, arms and back. While some believe that acne does not affect the general health, the spread of infection can affect physical and mental health. The effect and severity can vary depending on type of acne.
Types of Acne
Besides the most common type of acne called acne vulgaris, there are other medically identified kinds:
- Acne conglobata
- Acne miliaris necrotic
- Tropical acne
- Infantile acne/Neonatal acne
- Excoriated acne and Acne fulminans
- Drug-induced acne/Acne medicamentosa (Steroid acne)
- Acne aestivalis
- Halogen acne (Iododerma, Bromoderma, Chloracne)
- Oil acne and Tar acne
- Acne cosmetica
- Occupational acne
- Acne keloidalis nuchae
- Acne mechanica
- Acne with facial edema
- Pomade acne and Acne necrotica
- Blackhead
- Lupus miliaris disseminatus faciei
As can be seen from the number of types of acne and the classification, acne can be identified based on cause or the part of the body impacted by acne. Each type of acne may also develop from a range of different causes. General causes will be discussed in the following section on Causes of Acne.
Causes of Acne
The main cause of acne as mentioned previously is the multiplication of the propionibacterium acnes bacteria that then causes sebum from the sebaceous glands to clog the skin pores and cause lesion or cyst-type eruptions. A major contributor to acne is hormonal change. Other causes of acne include:
- Hormones and Life Cycle
- Genetics (Hereditary)
- Infections
- Diet and Lifestyle Choices
- Psychological (Stress)
Hormones and Life Cycle
Hormonal changes occur throughout human life cycles, such as gestation, birth, puberty, menstruation, menopause, towards becoming elderly and passing away. Hormonal changes during puberty, menstruation, menopause and pregnancy can cause enlarged sebaceous glands, hair follicles and pores producing excess sebum that blocks the pores causing the eruptions.
Genetics (Hereditary)
During pregnancy, some women develop polycystic ovarian syndrome or cushing’s syndrome, where under or over production of hormones impacts the oil-producing glands, hair follicles and the thickness of the skin. Such syndromes and diseases resulting in acne can be hereditary, as is the tendency for acne to be present in certain families.
Infections
As mentioned, the propionibacterium acnes bacteria can cause inflammation and infection of the skin spreading acne. Certain conditions, like polycystic ovary syndrome and others, can cause infected cysts, further spreading infection through the skin and body.
Diet and Lifestyle Choices
Both men and women enjoy exercise for a healthy lifestyle. Some opt to use anabolic steroids or have increased protein in their diets to build muscle, others use hormones for contraception. Others take drugs for recreation, to lose weight or for medical treatment that impact hormones and diet. Altering hormone and nutrition levels can cause acne.
In certain occupations and environments, people are exposed to chemicals easily absorbed through the outer epidermal skin layer that can also trigger changes in the sebaceous glands and also hormones resulting in acne.
Psychological (Stress)
Hormones such as cortisol, GH and norepinephrine increase within the body and are released during times of high stress or psychological trauma. Such hormonal changes can trigger outbreaks of acne.
Diagnosing Acne
Acne is diagnosed according to the type of eruption, the cause, the severity, and whether the acne is inflammatory or non-inflammatory. Medical providers may classify the acne, such as through the Leeds, Cooks or Pillsbury acne grading scales.
Acne Treatments
The treatment for acne depends on the type of acne, the cause, and the severity. Acne is not curable, but it can be managed through lifestyle factors and therapy. A number of medical treatments exist that include:
- Natural acne treatments or regimens, such as Clear Pores or Aloe Vera
- Sunlight and sea water
- Acne cleansers and soaps
- Non-comedogenic moisturizers
- Prescribed acne gels or ointments, such as Benzoyl Peroxide
- Hormonal treatments, such as the combined pill
- Antibiotics, such as Retin-A or Tazorac
- Oral drugs, such as Acutane
- Anti-inflammatories, such as Ibuprofen and Naproxen
- Intralesional steroids, such as Cortisone injections
- Dermabrasion and Phototherapy
- Acne surgery
- Laser treatment