Symptoms of Acne

Acne usually affects the face but can also affect the neck, back and chest. It may take one of two forms – non-inflammatory and inflammatory. Non-inflammatory acne is the milder form, with few whiteheads and blackheads over the face. Inflammation of whiteheads results in pimples and pustules, which may progress to pus containing cysts.

• Comedones (whiteheads and blackheads): These result from the clogging of skin pores with sebum and dead cells. Whiteheads are skin coloured bumps whereas blackheads result when a pore is only partially blocked, allowing some of the trapped sebum and dead cells to slowly drain to the skin surface.

• Papules: These are small, red and occasionally tender bumps caused by inflammation or infection in the hair follicles.

• Pustules: These are tender, red bumps akin to papules and are tipped with white pus.

• Nodules: These are larger, solid, painful lumps directly underneath the skin resulting from a collection of secretions deep within hair follicles. • Cysts: These are similar to nodules but contain pus. Cystic acne may result in deep scars.

• Acne alters production of collagen production. This leads to thinning of the skin and depressed or thicker scars.

People with acne, especially teenagers, may find it difficult to deal with this skin condition emotionally and may suffer from depression, embarrassment, frustration and poor self-image.

Causes of Acne

Acne is caused by an increased level of specific hormones (androgens) usually during puberty. Because of higher hormone levels, the sebaceous glands in the hair follicles produce excessive sebum (oil), and there is greater turnover of skin cells lining the follicles.

Normally sebum helps to remove dead cells from hair follicles. It also spreads over the skin to lubricate and protect it. When too much sebum is produced, and the extra cells clump together, the resultant plug (comedo) blocks the opening of the hair follicles. The blockages lead to mild forms of acne and blackheads.

Pimples, pustules, nodules and deep cysts are more severe forms of acne involving follicle wall breakdown, inflammation, redness and puss. Deeper skin layers are affected and pain and scarring can result

Primary Acne Causes

• Increasing sebum or oil production within the pore.

• Pores blocked by dirt and dead skin cells.

• Infection with bacteria, which grow and multiply in the oil plug, resulting in inflammation.

Precipitating factors in Acne

• Factors contributing to blocked pores: Cosmetics, oils, greases, and hairsprays, humidity, sweating and damp clothing may lead to blockage of pores.

• Medications: Certain drugs increase oil production and cause blocked pores. Anabolic steroids and progestin (contained in birth control pills) are examples of drugs that cause acne.

• Inflammation: Frequent squeezing or picking and repeated cleansing may damage the skin and worsen the inflammatory process.

• Menstruation: This is one of the most common acne triggers. Women tend to develop new spots 2-7 days before the menstrual cycle begins.

Diagnosis of Acne

You will generally be able to make a diagnosis of mild acne on your own and treat it with over-the-counter products. Consult your doctor if you are unsure about the diagnosis or if the acne is severe. A simple visual inspection is all that is needed to arrive at a diagnosis. No tests are required. Your GP will examine you to assess the severity of the condition. Remove any traces of makeup to allow your doctor to examine your skin properly.