What Is Acne Vulgaris?

Introduction:

Acne or acne vulgaris is a common condition that usually starts in the teenage years when sebaceous glands become active. However acne can also occur in childhood and even in infancy, but it is rare. Some individuals have an inherent tendency to have hyperactive sebaceous glands, a risk factor for future acne problems.

What Is Acne Vulgaris?

Acne vulgaris is an inflammatory skin condition of the pilosebaceous unit, which runs a chronic course and is self-limiting. It is one of the most common skin conditions affecting teenagers. The hair follicles get blocked due to dead skin cells, bacteria, and excess oil (sebum). This leads to pimples, blackheads, whiteheads, and even cysts. Other than that, one of the common causes of acne is hormones, especially during puberty.

Who Is at Risk of Having Acne?

Acne affects about 85 % of people all over the world. People can have acne at any stage, but most get acne during puberty, which can persist into their 30s and beyond. Moreover, five percent of people over 45 years of age still have acne, and people of all ethnic groups can have it.

What Is the Cause of Acne Vulgaris?

Acne vulgaris is caused by hormones, oil, and bacteria. It is common in puberty when the hormone androgen increases and sebaceous glands produce oily substances called sebum. The sebum and dead skin cells come into the skin pores and hair follicles, and then they get blocked due to excess sebum, dead cell, or bacteria. The sebum from sebaceous glands cannot escape through the pores leading to acne.

Acne is commonly seen on the face, forehead, chest, upper back, and shoulders, as these areas have the most sebaceous glands, and the hair follicles are connected to these glands.

Therefore the main factors which lead to the formation of acne include -

• Excess oil (sebum) production.

• Hair follicles clogged by oil and dead skin cells.

• Bacteria.

• Inflammation.

In women, acne may continue into their 40s also because of hormonal changes and other causes, which include -

• Hormonal changes during pregnancy or in periods.

• Some medicines.

• Certain cosmetic products.

• High humidity.

• Excessive sweating.

• Polycystic ovary syndrome or PCOS (a hormonal disorder causing enlarged ovaries).

What Are the Symptoms of Acne Vulgaris?

Acne signs or symptoms may vary according to the condition. The symptoms can be mild, moderate, or severe. A patient can notice any of the following symptoms, which include -

• Whiteheads (white-colored, closed plugged pores).

• Blackheads (black-colored open plugged pores).

• Papules (small red or tender bumps).

• Pimples (pustules or papules with pus at their tips).

• Nodules (large and painful lumps under the skin)

• Cystic lesions (painful and pus-filled lumps under the skin).

According to the severity and type, it can be classified into the following categories such as -

Mild Acne - The patient has less than 20 black or whiteheads in this case. Whiteheads are small flesh-colored bumps, while blackheads have a dark center. Pimples can also be seen in some cases of mild acne.

Moderate Acne - Patients have many blackheads, whiteheads, and pimples in moderate situations.

Severe Acne - In this case, widespread nodules or cysts can be seen, which are larger, more solid, and more painful than pimples.

What Are the Risk Factors for Acne Vulgaris?

The risk factors for acne include some of the following, which can even worsen the condition in some people, such as -

1. Age - Acne can be seen in people of all age groups, but it is most common in teenagers.

2. Hormonal Changes - The hormonal changes during puberty or pregnancy can cause increased acne on the skin.

3. Family History - Genetics is also responsible for acne. As in cases where both the parents have acne, there is a high chance the child will also have acne.

4. Oily or Greasy Substances - Acne can appear on the skin when it comes into contact with cosmetic products such as oil or oily lotions and creams.

5. Friction or Pressure on the Skin - This can occur due to items such as cellphones, helmets, tight collars, telephones, and backpacks that cause pressure or friction.

What Are the Complications of Acne Vulgaris?

People with darker skin are more likely to experience acne complications than lighter-skinned people. Some of the common complications that can be seen in these people are -

• Scars - After the acne is healed, the acne scars (pitted skin) and thick scars (keloids) are one of the most common complications. These do not go away quickly and must be surgically treated in case of large-sized scars.

• Skin Changes - When the acne gets healed, the affected skin becomes darker (hyperpigmented) or lighter (hypopigmented).

What Are the Misconceptions Related to Acne?

There are various theories or misconceptions which people think can lead to acne or can worsen their conditions, such as -

• Greasy Food and Chocolate - People think eating fatty foods or chocolate leads to acne.

• Hygiene - Having dirty or unhygienic skin is not the cause of acne. However, scrubbing the skin too hard or using harsh chemicals or soaps can irritate and make acne worse.

• Cosmetics - The makeup or beauty products do not necessarily affect acne. Still, oil-free cosmetic products should be used that do not clog the pores, and it is advised to remove makeup regularly.

What Is the Treatment of Acne Vulgaris?

The treatment of acne includes one or more treatment methods, depending upon the severity of the condition. A dermatologist can formulate a treatment plan to control the spreading of acne, avoiding scarring or any other damage to the skin and making acne scars less visible.

The acne medications work by controlling the oil production or sebum or by treating the bacterial infection. The acne treatment can go from weeks to months, depending on the condition, which includes -

• Mild acne can be treated with benzoyl peroxide or salicylic acid, available in creams, gels, and washes.

• Moderate acne often requires antibiotic therapy, including Doxycycline, Minocycline, Azithromycin, Erythromycin, and Tetracycline. One of these drugs can be used with topical treatment for a few weeks.

• Severe acne is also treated with antibiotics and topical medication. If these medicines do not successfully treat the condition, the physician advises the oral drug Zenatane (Isotretinoin). But, this drug can cause serious adverse effects on the body and should be taken only as per the advice of the doctor.

Some other treatments have also been used to treat acne, which includes -

• Several laser treatments also help treat acne and are often used with other treatment methods. These treatments are expensive, require repeated sessions to treat the condition for several months, and have variable efficacy.

• Laser resurfacing, plastic surgery, and dermabrasion may help reduce the prominence of old acne scars.

Conclusion:

In most cases, acne is short-term and heals with time. However, acne and scars can cause anxiety and stress and may affect the social life and confidence of the person. Therefore, proper counseling and guidance are required for patients suffering from acne, and they should seek medical advice if the condition worsens.