Acne is Not Spots

There are various types of acne, named according to how or why the acne arose. Some of the kinds of acne are: acne conglobata (chronic boils); acne fulminans (an extreme form of conglobata); acne cosmetica (caused by cosmetics); acne keloidalis nuchae (from shaving); acne medicamentosa (caused by starting or stopping a medication); acne rosacea (redness on the face); baby acne; hormonal acne; cloracne and the common variety, acne vulgaris (also known as ‘puberty spots’). In this article, we will concentrate on acne vulgaris.

Acne vulgaris can be defined as: ‘an inflammatory disease of the skin, caused by changes in the pilosebaceous units (skin structures consisting of a hair follicle and its associated sebaceous gland). Acne lesions are commonly referred to as pimples, spots or zits’ (from Wikipedia).

Acne is most usually found in white Western teens, although it is to be found in every country in the world, so there could be a genetic predisposition to it. It is possible that it may be an abnormal reaction to quite average levels of testosterone. For most sufferers, outbreaks of acne last only until the age of twenty or so, probably only a few years or at the most ten. For other people, however, it may be a life-long affliction. It usually appears on the face, upper-chest, upper-arms and back. However, an occasional spot is not the same as acne.

Acne vulgaris appears in various forms, which include: whiteheads, resulting from pores that are totally blocked, trapping sebum (oil), bacteria, and dead skin cells, causing a white appearance on the top; blackheads, caused by pores which are only partially blocked, allowing some of the trapped sebum, bacteria, and dead skin cells to slowly drain to the surface (the black colour is not a result of dirt, but is a reaction of the skin’s own pigment, called melanin, with the oxygen in the air); papules, which are inflamed, red, tender lumps with no head and pustules, which are like whiteheads, but are inflamed, and look like red circles with a white or yellow centre.

Whiteheads do not often last for a long time; blackheads do last a long time and pustules are what people usually refer to as spots or zits. Severe acne vulgaris is characterized by nodules and cysts. A ‘nodule’ is a rather larger and much more painful kind of pustule and may often last for months. Nodules are large, hard lumps just under the skin. They often result in scarring and should never for any reason be squeezed, since this could make them last for months longer.

A ‘cyst’ can look similar to a nodule, but it is pus-filled, and has been defined as having a diameter of at least 5mm and, again, can leave scars and cause pain. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which will last very much longer than if it had been left alone. Dermatologists have ways of reducing swelling and preventing scarring with both nodules and cysts. It is not true that acne sufferers are not careful about washing.

In fact, over washing can exacerbate acne. There are many, many useless ‘cures’ on the market and many, many old wives’ remedies. However, any good dermatologist would tell you that there is no sure-fire cure for acne and that the patient has to follow a strict regimen of cleansing until the acne just ‘disappears’ of its own accord.

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