Although there are many types of acne, the one we will consider is the most prevalent in the world and that is acne vulgaris. It occurs in approximately 90% teenagers, both male and female and is the most common cause of scars in the world. Most patients are either self-treated and the problem remits spontaneously or see the family physician or pediatrician. Only a small amount actually end up seeing dermatologists.
The cause of the problem is the formation of a plug in the pilosebaceous unit or oil gland hair follicle complex. These are located on the face, chest, neck and back and that is why there is no acne of the leg etc. The first thing that occurs is a plug in this complex that cuts off the oxygen supply to the area and there is an organism that lives there called p. acnes, that begins to overgrow in this environment and starts the process to the swelling and the pus and eventually can lead to scarring.
What produces Acne?
The primary cause of this thick plug occurring is male hormone—both in girls and boys and a few things play minor roles. Emotions make it worse by having more blood to flow to the face. There is some newer evidence that high carbohydrates may play a role, but chocolate does not. Acne is also not because you are dirty and washing the face many times a day may aggravate it by irritation. Manipulation with the fingers will only make it worse.
Once acne occurs there are a few important items to be taken care of: destruction of p acnes, unplugging the oil gland and treating any scars that may have formed. There are many good methods to treat acne without having to see a physician. One of the best products on the market is ProActive. It does work in most of the cases of acne that it is tried. It contains many of the ingredients you would get from a doctor’s office. One thing you should be careful about is that it contains benzoyl peroxide and may stain cloth—so be careful not to spill.
And how I can cure it?
Dermatologists often use antibiotics either on the skin or by mouth to kill the bacteria in addition to the cleansers and other topicals. One of the most effective procedures in the office is the salicylic acid peel. This particular peel has more ability to get into the oil gland and loosen the plug than any other. the only contraindication is that you cannot have one if you are allergic to aspirin. Another common procedure performed in the office is removal of blackheads and whiteheads (often performed by an aesthetician).
These methods almost always respond to therapy, clear the acne and keep it from scarring. But there are much more complicated therapies from using light and lasers to oral contraceptives to other medications by mouth. One medicine you should be cautioned about is Accutane, which actually has been removed from the market by the FDA because of side-effects. Unfortunately, some doctors get the drug from out of the country and still use it. If you have a doctor that is doing this be certain that he gets blood work every 2 weeks, makes sure you are on birth control pills and follows you closely in terms of depression or diarrhea or other symptoms.
With these modern method to treat acne acne almost always clears, but that does not preclude the fact that patients can develop some significant scars from this disease. In the next communcation I will discuss with you what type of acne scars occur and how they can be treated.