Acne (acne vulgaris) is a disease of the hair follicles of the face, chest, and back that affects almost all males and females during puberty. It is not solely caused by bacteria, although bacteria play a role in its development. It is not unusual for some women to develop acne in their mid- to late-20s.
Acne appears on the skin as... • congested pores ("comedones"), also known as blackheads or whiteheads, • tender red bumps also known as pimples or zits, • pustules, and occasionally as • cysts (deep pimples, boils).
What causes acne?
Not only single factor can cause acne, but acne develops when sebaceous (oil-producing) glands attached to the hair follicles are stimulated at the time of puberty by elevated levels of male hormones. Sebum (oil) is a natural substance which lubricates and protects the skin. Associated with increased oil production is a change in the manner in which the skin cells mature so that they are predisposed to clog the follicular openings or pores. The clogged hair follicle gradually enlarges, producing a bump. As the follicle enlarges, the wall may rupture, allowing irritating substances and normal skin bacteria access into the deeper layers of the skin, ultimately producing inflammation. Inflammation near the skin's surface produces a pustule; deeper inflammation results in a papule (pimple); deeper still and it's a cyst. If the oil breaks though to the surface, the result is a "whitehead." If the oil accumulates melanin pigment or becomes oxidized, the oil changes from white to black, and the result is a "blackhead." Blackheads are therefore not dirt and do not reflect poor hygiene.
Occasionally, the following may be contributing factors:
• Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral and topical steroids.Other drugs that can cause or aggravate acne are anticonvulsant medications and lithium, which is used to treat bipolar disorder. Most cases of acne, however, are not drug related.
• Occupations: In some career, exposure to industrial products like cutting oils may produce acne.
• Cosmetics: Some cosmetics and skin care products are pore clogging ("comedogenic"). Foundation is the major cosmetic product aggravating acne in adult.
• Topical antibiotics and antibacterials: These include erythromycin, clindamycin, sulfacetamide, and azelaic acid, benzoyl peroxide • Retinoids: Retin-A (tretinoin) has been around for years, but this preparation often irritative. Newer retinoids which have fewer side effects include adapalene (Differin) and isotretinoin gel. These medications are especially helpful for unclogging pores. Side effects may include sensitivity to the sun. In 2008, the U.S. FDA approved the combination medication known as Epiduo gel, which contains the retinoid adapalene along with the antibacterial cleanser benzoyl peroxide. This once-daily prescription treatment was approved for use in patients 12 years of age and older. • Oral antibiotics: Doctors may start treatment with tetracycline, doxycyclin,amoxicillin and the other drugs. • Oral contraceptives: Most dermatologists work together with gynecologists when recommending these medications. The drugs have always been used for patients having polycystic ovarian syndrome. • Isotretinoin: Isotretinoin is an excellent treatment for severe resistant acne and has been used on millions of patients since it was introduced in Europe in 1971 and in the U.S. in 1982. It should be preserved for people with severe acne, or mild acne which has been unresponsive to conventional therapies like those listed above. The drug has many potential serious side effects. This means that isotretinoin is not a good choice for everyone having acne. • Laser therapy: Recent years have brought reports of success in treating acne using lasers and light based devices, alone or in conjunction with photosensitizing dyes. It appears that these treatments are safe and can be effective. Laser treatment is best thought of as an adjunct to conventional therapy, rather than as a single therapy. • Chemical peels: The superficial peels, such as glycolic and salicylic acid can soften the plugging and shedding the dead cells on outer part of the skin.