Often initiated by hormonal changes as young people approach puberty, acne is the most common skin problem in the US, says the American Academy of Dermatology. Acne affects up to 80% of those in their 20s and 30s.
The most common type of acne is acne vulgaris. The onset of acne is related to changes in the oil glands. In the early teen years, the oil glands that accompany hair follicles begin making more oil (sebum). The combination of extra oil and a particular type of skin cell can block the hair follicle. This results in a pimple, which is referred to clinically as a comedo.
Although the symptoms of acne are often lumped together under the term pimples, there are actually a number of different kinds that may include:
- open comedos (commonly called blackheads: the dark coloring comes from melanin)
- closed comedos (commonly called whiteheads: the follicle is blocked)
- nodules (either inflamed or not, caused by the follicle wall breaking below the skin)
- papules (small, inflamed, elevated portions of the skin, without pus)
- pustules (small, inflamed, elevated portions of the skin, with pus)
The different types last for varying lengths of time, with the shortest being usually two weeks, while papules and nodules sometimes persisting much longer. Acne can be aggravated by a number of changes, including:
- bacterial activity
- hormone activity
- chemical changes in the cells
- injury due to squeezing, face scrubbing, or chemical peels
- chemicals in certain cosmetics, including suntan oil
Acne can occur in different spots. It is most typical on the face, chest, and back.
In determining treatments for acne, the extent and severity will often be ascertained. This can change depending on the aggravating factors mentioned above. There are grading scales, some with as many as 12 ratings, or the acne may simply be classed as mild, moderate, or severe. Each of the classes may suggest different treatment possibilities.
The severity of acne is influenced by several factors. Boys, who have more skin oils, may have worse acne than girls. Heredity can also play a factor, with young people’s whose parents had severe acne being more likely to have severe acne. And some people’s immune systems are simply more sensitive to bacteria in their hair follicles and react more strongly.
Sometimes a primary care physician will suggest or prescribe treatment for acne, or sometimes a patient is referred to a dermatologist, a physician who specializes in treatment of the skin.
Acne is treated in a variety of ways, but it is best to get advice from a healthcare professional to find out more about appropriate treatments available for a particular situation and before initiating a course of treatment.
- Over-the-counter preparations, such as benzoyl peroxide, salicylic acid, azelaic acid, and other active ingredients are the most common. They are available in various formulations, for example, as gels, or creams. Antiseptic washes may also be useful.
- Prescription medications, such as retinoids and adaplene. Some of these preparations carry the risk of birth defects if a young woman is pregnant or becomes pregnant while using them, so directions must be followed with great care.
- Prescription antibiotics, which may be taken orally or applied in a skin preparation.
- Physical treatments, such as cryotherapy (freezing), cauterizing, and phototherapy.
Acne does not always cause scarring, but if it does, treatments are available.