Skin Diseases, General

ACNE
(common acne, acne vulgaris)

Although no one suffering from acne dies or is often hospitalized, it is not a minor disease, for it can be not only disfiguring, but also embittering, altering the personalities of many sensitive young people. Acne affects more than $0 percent of all teenagers in varying degrees of severity, striking hardest at those who have the misfortune of inheriting an oily skin.

The basic cause is a step-up in the production of androgen (male) and estrogen (female) in maturing teenagers. The increased production of these hormones stimulates the sebaceous glands of the skin to produce an oversupply of sebum, an oily substance that keeps the skin normally pliable and healthy. The sebum plus other biochemical factors clogs up the pores, resulting in blackheads and whiteheads (a blackhead is not dirt but the result of oxidation of the skin and oil). Acne has no relation to sexual indulgence or lack of it; nor will sexual intercourse cure this disorder.
Although not as deeply implicated as once thought, such foods as chocolate, nuts, milk, and so on are still a factor in a majority of cases, For girls, menstruation can be an aggravating factor.

The Danger: Besides the possibility of scarring and pitting, severe acne can cause psychological problems, affecting social development.

Symptoms: The lesions appear on the face, neck, shoulders, upper chest, and back, presenting a crop of pimples, blackheads, and whiteheads ranging in size from pinhead to a small pea. Some lesions develop into abscesses and cystic masses, which hang on for a month or more until they finally rupture and heal, leaving scars and pittings. The skin becomes flabby, without tone, and remains oily.

Removal of pimples or blackheads by finger squeezing can only bruise the skin, making it more vulnerable for spreading infection than ever.

Ultraviolet lamps and sun lamps should be used only under a physician’s directions, because of the potentially harmful effects on certain skins if misused.

Tetracycline (250 mg daily before meals for a month or more) and other antibiotics can be very helpful. Hormone treatments are sometimes valuable but need very careful administration by the dermatologist and the gynecologist.
For home treatment there are a large number of lotions and ointments that can be bought over the counter, that cause a mild degree of peeling, loosening the hardened sebum. Benzoyl peroxide, sulfur compounds, Resorcinol, and vitamin A acid have been proven useful.

For best results, a dermatologist should be consulted in arriving at a good regimen, which most often will include medication available only by prescription and must often be reevaluated as the condition changes. As in all skin disorders, therapy must be individualized for each patient.

Prevention: Acne cannot be prevented, but constant, energetic treatment will noticeably reduce its severity. The use of greasy make-up on a skin condition can only worsen it.

Outlook: Usually the patient has one bad year. Inevitably, however, acne disappears. After twenty-five it is much less common.