One of the most common skin diseases is acne. Especially during puberty, this form of severe pimple formation occurs and usually disappears again by itself from the age of 20.
What is acne?
Especially during puberty, acne, pimples and blackheads occur more frequently. However, some people also suffer from this skin disease later. Every teenager develops pimples, blackheads and blemished skin in the course of puberty. Acne is the aggravated form of this natural formation. It is primarily the inflammation of the sebaceous follicle. Initially, this produces non-inflammatory comedones, which are merely annoying for aesthetic reasons. Over time, however, inflammatory efflorescences develop, for example pustules or nodules. Acne is particularly common in adolescence, occasionally in newborns and rarely in adults. Typical signs of pronounced acne are pimples, pustules, blackheads, inflamed sebaceous glands and, in some cases, purulent vesicles.
Causes
Naturally caused acne results from the sebaceous follicle producing too much sebum. This initially develops into a comedo. Psychological factors such as stressful situations, but also physical stress, for example due to smoking, can strongly promote the development of acne. As soon as the first comedones have formed, the bacterium Propionibacterium acnes comes into play. It promotes the inflammation of the blackheads and thus leads to the typical appearance of the disease. Acne can also be caused by external influences. These forms occur more frequently in adults and newborns, since young people develop natural acne more quickly and external influences only encourage it. Due to excessive UV radiation, the lipids contained in sunscreen, for example, react with free radicals in the skin and can lead to acneiform skin. Other cosmetics can also lead to the development if they do not give the skin enough room to breathe. In other cases, chemical substances are to blame for the development. Medications containing lithium or corticosteroids, but also direct contact with chlorine or tar can provoke a reaction of the skin.
Symptoms, complaints and signs
The symptoms that develop depend on the form of acne from which a patient suffers. In acne comedonica, which is most common in women, open and closed blackheads form and become visible as small black dots. The blackheads are particularly common on the nose and chin and are often accompanied by oily skin sheen. However, inflammation rarely occurs in this form of acne. In contrast, inflamed pimples filled with pus and reddish papules are typical for acne papulo-pustulosa. Sometimes small nodules also form, which can become painful. The pimples and pustules predominantly affect the forehead, chin and cheeks. They also often spread to the neck, chest and back. Inflamed pimples filled with pus can leave scars after they heal. This risk is especially high when patients squeeze the pus pimples, which also usually aggravates the inflammation or spreads it to other areas of the skin. In rare cases, acne conglobata occurs, affecting men more often than women. In this form of skin disease, patients suffer from highly inflammatory nodules that can grow up to two centimeters in size and often mutate into deep abscesses.
Course
In girls, pubescent acne usually develops at the beginning of the 12th to 13th year of life; in boys, acne usually appears one to two years later, but then also lasts correspondingly longer. The first signs are typically a strong expression with purulent pimples and blackheads. But also a generally oily skin, as well as greasy hair indicate an acne disease. As a rule, pubertal acne does not need to be treated by a doctor, but can be favorably influenced by cleanliness and facial hygiene. Sometimes, however, severe forms of acne occur, where not only the face, but also the back, chest and buttocks can be heavily affected by pimples and blackheads. Here it is favorable to have this extreme form of acne treated by a dermatologist to prevent scars as far as possible.
Complications
Acne occurs mainly in adolescents who are just at the age of puberty.At this age, acne can be relatively widespread. This disease does not necessarily need to be treated, as it is not a harmful situation. However, if the patient feels uncomfortable with it, the acne can also be treated with medication. In most cases, acne disappears on its own. In this case, however, the period of healing can be relatively long. In other cases, acne can also worsen, leaving severe scars on the skin. If the acne is treated by a doctor, the treatment is usually done with medication or with a cream or ointment. With medications there are some side effects, such as headaches or a general dry skin. Those who use ointments and creams against acne will also often suffer from dry and cracked skin, as they remove the oil from the skin. If acne is very severe, the condition can also lead to psychological problems. These include a general feeling of malaise or depression due to bad and blemished skin. These can be further exacerbated by incidents at work or school. In most cases, acne finds a positive course of the disease.
When should you go to the doctor?
Acne disease during puberty is normal. However, this widespread skin disease can take different forms and pass through several stages. Even newborns and young children can be affected by certain forms of acne. Visits to the dermatologist are not absolutely necessary for mild forms of acne. However, these should be made if those affected suffer from the acne condition. In some people, acne persists into adulthood. This also represents a reason to see a dermatologist. At the dermatologist’s office, it is first determined how pronounced the skin is affected and what form of acne it is. Without this determination, treatment cannot take effect. Acne can be occupational or triggered by medication. Acne inversa, chloracne or alcohol-related acne must be treated differently than ordinary pubertal acne. In addition, acne may have hormonal causes, which may also require treatment. Gynecologists or andrologists are responsible for this. Physiological acne, which occurs frequently in pubescent adolescents, can be treated with commercially available creams, lotions and cleansing fluids. However, if it develops into a more pronounced form with purulent inflammation and boil formation, a visit to the doctor is advisable. This is advisable against the background of possible scarring. Each form of acne requires different treatment strategies.
Treatment and therapy
All cases of acne that go beyond the mild form must be treated by a dermatologist (dermatologist). Drug treatment aims to prevent the formation of new blackheads, heal the inflammation and positively influence the cornification process in the sebaceous follicle. Initially, a cream is prescribed, which is mixed with alpha-hydroxy acids. These have a comedolytic effect and dissolve the first blackheads. They also have an effect against their new formation. As a rule, at least three months must be treated with the cream. At the same time, antibiotics can be administered to fight the bacteria on the skin that are partly responsible for acne. They are either also applied as a cream or taken in tablet form. In addition, there are many other treatments that work in a similar way. In women, it can help to additionally administer hormones. Usually affected women produce too many androgens, which can promote acne. Therefore, they receive targeted therapy with female hormones to gradually resolve the acne.
Outlook and prognosis
In most cases, acne is mild, meaning the symptoms are not particularly severe. In these cases, acne subsides on its own after the completion of puberty and the stabilization of hormonal balance, and scars do not remain. If acne persists into adulthood, the prognosis is less favorable. Visible, deep scars usually remain. Although the scars can be reduced, the skin will not look completely scar-free, which can sometimes cause psychological problems for those affected. Otherwise, the patient does not have to fear physical impairments.Rarely does acne persist beyond the age of forty – the prognosis is thus always favorable. In acne inversa (a particularly severe form of acne), the skin changes can promote the development of skin cancer. Those affected should have their acne treated by a dermatologist at regular intervals. With regular checkups and treatments, the prognosis is favorable even for acne inversa.
Prevention
Acne can only be prevented to a limited extent. Since it results from an interplay of internal physical relationships over which the person himself has little influence, he can only avoid external causes as far as possible. For example, cigarette smoking should be avoided as a matter of principle, and a balanced diet can also help to maintain the health of the skin. Cosmetics should always be thoroughly removed after wearing to allow the skin to breathe. Pimples should never be squeezed, otherwise acne will spread.
Aftercare
After acne is cured, various circumstances may require follow-up care. Many sufferers are left with scars that they find unsightly or that even cause them tangible problems. The discoloration of the scars (usually reddish with a light complexion) disappears on its own after a few months. More severe scars, however, additionally form depressions or elevations. Depending on the severity and the degree of suffering, various treatment options are available to soften or even eliminate such scars. Especially the gentle therapy methods can be applied by the affected persons themselves with the help of home remedies or over-the-counter products. Dermatologists and professional cosmeticians have means at their disposal with which clear results can be achieved more quickly. However, these initially attack the skin tissue more strongly, making it susceptible to undesirable effects such as inflammation or discoloration. Therefore, methods such as abrasion, laser therapy or TCA peels should only be performed by specialized personnel and under medical supervision. Since acne can basically occur at any age, recurrence is possible even after successful therapy. Affected individuals should continue to follow the same principles with regard to their diet and personal hygiene that are useful for the prevention and treatment of acne.
What you can do yourself
Acne does not necessarily have to be treated by a doctor. Most of the time, the pimples can be reduced independently through proper skin care and some home remedies. First, it is recommended to clean the affected areas of the body several times a day with a fresh washcloth. Before applying creams, nourishing steam baths with additives of rosemary, chamomile or sea salt are recommended. Honey and curd also help with acne and provide the skin with moisture and minerals. To prevent acne from spreading further, pimples should not be touched or squeezed if possible. Inflamed or burst blackheads are best disinfected with alcohol-based facial tonic. In addition, creams and peelings with a high fat content should be avoided in order to prevent further skin irritation. If these measures show no effect, the pill may also help. The pill can help improve the appearance of the skin, but it should only be used as a remedy for acne in consultation with a gynecologist. Finally, a healthy lifestyle also helps. A balanced diet, exercise and adequate sleep reduce acne and contribute to a clear complexion in the long term.
