All you need to know about Acne Vulgaris (PIMPLES)

Acne (Pimples) is the most common skin condition in teenagers. Although it's common, accurate information about acne is scarce. This can make it difficult to get clearer skin.
Acne vulgaris is a skin disease that affects the hair follicles of the face. It is generally affect teenagers due to their increasing hormones level. The acne can be mild until severe and it usually affects face, back, chest or even scalp.

Technically, acne appears when oil (sebum) attaches the hair follicles of the face. Actually, sebum is functioned to protect and lubricate the skin. Gradually, the hair follicles produce bump and make the bacteria reach the deeper skin surface.

There is no single disease which causes more psychic trauma, more maladjustment between parents and children, more general insecurity and feelings of inferiority and greater sums of psychic suffering than does acne vulgaris.

Teenagers are psychologically vulnerable. They are sensitive to modifications in their bodies and appearance. Acne commonly affects young people at a time when they are undergoing maximum psychological, social and physical change.

Despite its apparent cosmetic nature, the effects of acne can go far deeper than the surface of the skin, and place a heavy emotional and psychological burden on patients that may be far worse than its physical impact.

Symptoms of acne

If you have mild or moderate acne, you may have greasy skin and spots (whiteheads or blackheads) on your face, back and chest. Most spots will not cause any other symptoms. Sometimes, spots that have become inflamed and infected (pustules, nodules and cysts) may be painful.

Complications of acne

Most people have a mild form of acne that usually clears up after their teenage years, but sometimes more severe complications may develop if you have moderate or severe acne.

• Scarring. Up to one in five people with acne have scarring that is socially noticeable. If you pick and squeeze your spots, you may get 'ice pick' scars.
• Hyperpigmentation. This is when your skin becomes darker in the areas affected by acne. You're more likely to have hyperpigmentation if you have a dark skin tone.
• Psychological problems. Acne may cause one to have low self-esteem or feel angry about the appearance of the skin, especially if one had scarring. Talk to a doctor if the acne on your face is making you feel particularly low.

Causes of acne

• Hormones. At around 8 years of age, the adrenal glands start to produce androgens (male hormone/testosterone) and the amount produced gradually increases during puberty. The sebaceous glands respond to androgens by producing more sebum and sometimes whiteheads (closed comedones) may develop in young children. For teenagers, hormonal changes during menstrual cycle and pregnancy may trigger acne.
• Sebaceous gland blockage. The skin cells lining the upper part of the hair follicle duct are not shed as normal but accumulate and form a plug (comedone).  The oil is trapped behind it.
• Bacteria and inflammation. Increased numbers of acne bacteria (Propionibacterium acnes) accumulate in the duct and contribute to the inflammation that develops in the pimples. If one  perspire much, the skin should be washed immediately. If its not wash on time, the bacteria will grow rapidly causing acne.
• Genetics. Hereditary factors contribute, however it is not known exactly how this works. Acne can be hereditary. For example, if both parents had acne  have an increased chance of having it too.
• Stress. Adrenal glands produce more androgens when an individual is stressed. This can make acne worse. Generally, stressful over something is not good for ones health. Stress also can caused acne or even be able to make it worse.
• Diet. Certain diets may contribute to the development of acne, however good scientific data is lacking.e.g peanuts. Eating junk food can increase the growth of bacteria of the acne.

Diagnosis of acne

The Doctor will examine the skin and may ask about the teenage medical history.

Acne is easily recognisable by the distribution of spots on the body. the doctor will recommend the most appropriate treatment for the severity of the acne.

   Treatment

1.      Self treatment: If you have acne on your face, do not wash it as often as possible. It won’t make it clean but it will make it worse. Just wash your face twice a day only. If you wear make-up, remove it immediately before going to bed. Do not use face scrub for your face because it will damage your face skin..

2.      Oral antibiotic:The doctor may prescribe you antibiotics such as erythromycin, doxycycline and oxytetracycline in case you have severe acne.

3.      Oral Contraceptive: The doctor will advise some to take oral contraceptive pills to cure acne. If they have severe acne,

4.      By keeping the skin clean one can help to prevent spots forming. Gently washing spot-prone areas with a mild soap or an unperfumed cleanser in lukewarm water about twice a day is good. Acne isn't an infection, so extra washing won't help.

5.      Topical prescription treatments may be adequate for mild acne and can be combined with oral medications for moderate to severe disease or if the patient is unresponsive.

6.      Topical antibiotic is used once or twice daily. Solution or gel formulas may be more useful for the trunk as they may cause irritation on facial inflammatory lesions.

7.      Lotions may be more cosmetically appealing for the face. It is generally recommended that antibiotics be used as combination therapy with either a topical retinoid or benzoyl peroxide or both.

8.      A combination of topical product is available for once-daily use. Another combination strategy is to apply a topical antibiotic in the morning and a topical retinoid at night.

9.      Antibiotics, the contraceptive pill for females, anti-androgens for females .

10.  First-line oral antibiotic therapy is doxycycline  or minocycline daily. These drugs should not be given to teenage women who are pregnant or attempting to get pregnant because of toxic effects on fetal bone formation.

11.  A second-line oral antibiotic is a macrolide. Although there is well documented evidence of antibiotic resistance to erythromycin, it is still used.

12.  Oral contraceptives with anti-androgenic properties should be considered for acne in girls and women who find topical therapies and oral antibiotics ineffective or only partially effective. Patients often need topical therapy while they wait for the full benefit of the pill to work, which usually takes three months.

Acne Myth No. 1: Poor Hygiene Causes Acne
A lot of people have heard this one — that acne is caused by dirty skin. Some teenagers believe this and end up washing their face numerous times a day, sometimes scrubbing vigorously In fact, washing your skin too frequently and too aggressively can make an acne breakout much worse. Ultimately, this can lead to irritated, traumatized skin that looks worse after treatment, Instead, wash your face only once or twice a day with lukewarm water, a mild cleanser, and gentle motion — no scrubbing or harsh abrasive products needed.
No. 2: Squeeze Those Pimples
When that pimple sprouts, you may not be able to resist the temptation to squeeze it out to try to bring it down to size. Some patients will squeeze pimples in an attempt to try to open up a clogged pore, However, this usually leads to further inflammation, which makes the acne look worse and last longer.
Keep your hands off — and leave that pimple alone. Instead, try using an over-the-counter acne treatment gel, ointment, cream, or lotion to help it shrink.
Acne Myth No. 3: Junk Food Causes Acne
You may have heard that eating greasy foods and candy can cause an acne breakout. Though there are some links between diet and acne, the relationship isn't quite what you may think it is.
"Many people with acne have oily skin, so for a time people thought that greasy foods should also be avoided, However, a number of studies have shown that downing foods like French fries, cheeseburgers, and chocolate doesn’t have any impact at all on the skin's health. But getting that grease on your skin can make an oily complexion worse, clogging pores and leading to an acne breakout.
Acne Myth No. 4: Acne Goes Away on Its Own
You don't have to suffer silently with acne — there are treatments available to clear up acne breakouts and help prevent future pimple problems.
Don't just leave a pimple to swell and mark your skin. There are plenty of treatments — both over-the-counter and prescription — available to help unclog those pores and clear up an acne breakout. Without treatment, dark spots and permanent scars can appear on the skin as acne clears.