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If the comedone reaches the surface of the skin, it is known as an open comedone, or blackhead. The blackish dot visible to the eye is not dirt, as many people think, but a darkening of the plug of sebum and cells due to oxidation. Open and closed comedones may be fairly inactive and remain in the skin for a long time. More troublesome acne lesions occur when the comedones become infected, inflamed, or burst open. The bacteria Propionibacterium acnes, normally found in healthy skin, tends to multiply rapidly in comedones where sebum and dead skin cells abound.
Propionibacterium acnes breaks down sebum into irritating substances that create inflammation and swelling in the follicle, ultimately leading to redness, pus, and the formation of the classic pimple or pustule. As the comedone enlarges, it may cause the follicle to break open, spilling sebum, dead cells, bacteria, and pus into the surrounding skin.
This may cause more severe acne lesions such as acne papules, which are red bumps, boils, nodules, which are large painful solid lesions under the skin’s surface, or cysts which are swollen, pus–filled lesions. Nodules and cysts can cause pain and scarring. By squeezing or poking acne blemishes, you may be causing the follicle to rupture, worsening your acne and increasing the likelihood of scars.
Points regarding etiology
- Endocrine factors.
- Seasonal changes.
- Patient exposed to heavy oils, grease, polyvinyl chloride, tar etc.
- Occlusive or tight clothing.
- History of previous medication.
- Associated symptoms of fever.
- Treatment history of the past for the same.
- Effects of emotional stress and mental upsets.
A physician will make a visual diagnosis by looking for the various types of acne lesions. The doctor will also note any hormonal changes in the patient that might be a trigger for acne. Occasionally, other skin conditions may resemble acne. Very rarely, a skin biopsy may be done if the diagnosis is in question, though this would generally be performed only in older adults. After making a positive diagnosis, your physician will take note of how severe your acne is and then decide on the appropriate treatment for your skin.
Unfortunately, acne is not entirely preventable. Regardless of habits, the majority of teenagers will encounter acne in some form, as will a large percentage of women around their menstrual periods. By washing the face gently twice a day with a mild cleanser and refraining from picking any lesions, one can reduce the chance for acne outbreaks and permanent scarring. For other kinds of acne–those caused by industrial oils or sports equipment that rubs the face, chest, and back–avoiding these situations when possible could also prevent outbreaks.
Treatment For Acne
Acne is a common problem for adolescents which often requires medical treatment. Since it is most commonly seen around puberty and adolescence, severe acne could cause emotional problems, depression and can even lead to suicide in extreme cases. There are many over–the–counter preparations available for acne and there are prescription medicines available through a doctor for the more severe cases.
Treatments for acne are both local and systemic. Just as acne varies from mild to severe, acne treatments vary from mild to drastic, depending on the severity of the problem. The basic treatment for acne is to remove whatever has been blocking the duct of the sebaceous glands and, if necessary, treat the infection. This is done either through medication applied to the skin or taken internally.
There are many topical treatments for acne that are available over the counter without a prescription. The safest and most common treatment is ordinary soap and water. Other common topical preparations include hypo–allergenic soaps, combinations of sulphur and resorcinal, salicyclic acid ointments and washes, and benzoyl peroxide. The aim of this medication is to cleanse the area, dry up the oiliness, peal the skin and discourage or kill the acne bacteria. Low doses of antibiotics, such as erythromycin may also be added to these ointments.
Systemic acne medications include antibiotics, such as tetracycline, erythromycin and minocycline, which attack the acne bacteria, and vitamin A derivatives, called retinoids. These are available only on a doctor’s prescription. Risks of acne medications Benzoyl peroxide (BP) has been used in dermatology for many years and is widely used as a peeling agent to treat acne. People using products containing BP should avoid excessive exposure to the sun.
Vitamin A derivatives: One such derivative is isotretinoin which is taken internally and can cause severely deformed babies if it is used by a pregnant woman, even for a short time. Isotretinoin is derived from vitamin A and prescribed for the treatment of cases of severe acne that are difficult to treat by other methods. It must be prescribed for each person, and no one should share a prescription with someone else, particularly with a woman who may be pregnant.
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