Acne is an inflammatory disease of the skin, caused by changes in the pilosebaceous units (structures of the skin which consists of a hair follicle and its associated sebaceous gland). Acne lesions are commonly referred to as pimples, blemishes, plooks or "zits.Acne is most common during adolescence, which affects more than 85% of adolescents, and often continues into adulthood. [2] For most people, acne diminishes over time and tends to disappear, or at least diminish, after one reaches their early twenties. There is, however, no way to predict how long it will take to disappear completely, and some people continue to suffer from acne decades later at thirty and forty and beyond.
There’s a lot of myth and misunderstanding about acne.
Exactly why some people get acne and some do not is not fully known. It is known to be partly hereditary. Several factors are known to be linked to acne:
* Hormonal activity, such as menstrual cycles and puberty
* Stress, through increased output of hormones from the adrenal (stress) glands.
* Hyperactive sebaceous glands, secondary to the three hormone sources above.
* Accumulation of dead skin cells.
* Bacteria in the pores, to which the body becomes ‘allergic’.
* Skin irritation or scratching of any sort will activate inflammation.
* Use of anabolic steroids.
* Any medication containing halogens (iodides, chlorides, bromides),
* Exposure to high levels of chlorine compounds, particularly chlorinated dioxins,
Development of acne vulgaris in later years is uncommon, although this is the age group for Rosacea which may have similar appearances. True acne vulgaris in adults may be a feature of an underlying condition such as pregnancy and disorders such as polycystic ovary syndrome or the rare Cushing’s syndrome. Menopause-associated acne occurs as production of the natural anti-acne ovarian hormone estradiol fails at menopause. The lack of estradiol also causes thinning hair, hot flashes, thin skin, wrinkles, vaginal dryness, and predisposes to osteopenia and osteoporosis as well as triggering acne (known as acne climacterica in this situation).
Available treatments
There are many products sold for the treatment of acne, many of them without any scientifically-proven effects. Generally speaking successful treatments give little improvement within the first week or two; and then the acne decreases over approximately 3 months, after which the improvement starts to flatten out. Many treatments that promise big improvements within 2 weeks are likely to be largely disappointing. However short bursts of cortisone can give very quick results, and other treatments can rapidly improve some active spots, but not usually all active spots.
Modes of improvement are not necessarily fully understood but in general treatments are believed to work in at least 4 different ways (with many of the best treatments providing multiple simultaneous effects):
* normalising shedding into the pore to prevent blockage
* killing P. acnes
* antinflammatory effects
* hormonal manipulation
A combination of treatments can greatly reduce the amount and severity of acne in many cases. Those treatments that are most effective tend to have greater potential for side effects and need a greater degree of monitoring, so a step-wise approach is often taken. Many people consult with doctors when deciding which treatments to use, especially when considering using any treatments in combination. There are a number of treatments that have been proven effective.
