Brief overview
- Causes and risk factors: Often hormonal, in addition, stress, certain medications and cosmetic products, among others.
- Symptoms: Thickening of the skin, blackheads, pimples, pustules.
- Diagnosis: Usually based on the external appearance.
- Treatment: You can read everything important about therapy in the article Acne treatment.
- Course of the disease and prognosis: With good treatment, acne vulgaris usually heals quickly, but in individual cases persists until the age of 40 and beyond.
Definition: What is acne?
Acne is the most common disease of the skin worldwide. Acne occurs mainly in adolescents during puberty and is not considered contagious. There are no uniform answers to the questions: “What is acne exactly?” and “How does acne develop?”, since the disease occurs in different forms and due to different factors.
Mild acne or mild forms of acne can usually be treated with washing and care products from the drugstore or pharmacy. In the case of severe or extreme acne, it is recommended that it be treated by a dermatologist.
Almost every teenager is affected by acne to a greater or lesser degree. Acne in adults (late acne or acne tarda), on the other hand, is rarer.
Acne vulgaris: The most common type
Acne vulgaris is the best known form of acne and is also called “common acne”. It is triggered by hormonal changes during puberty (hormonal or hormonally induced acne). Boys are usually more affected by pubertal acne than girls.
While some have only mild acne, others are affected by severe acne (for example on the face). Depending on the severity, acne vulgaris is divided into three subtypes:
- Acne comedonica: It is the mildest form of acne and affects only the face (forehead, nose and cheeks), rarely the back. Acne comedonica is characterized by blackheads that may become inflamed when squeezed.
- Acne conglobata: Acne conglobata is the most severe form of acne. In this case, real nodules form from the pimples, which easily become inflamed and leave visible scars when the acne heals. This form of acne may also cause cystic changes in the skin.
Other types of acne
Other forms of acne may develop when the skin cannot tolerate certain substances found in skin care products (e.g., face cream), medications, or foods. These include:
- Contact, cosmetic or chlorine acne
- Medication acne (acne medicamentosa)
- Doping acne
These forms of acne are special forms of an allergic reaction and can be combated specifically by discontinuing the substance to which the skin is reacting. To determine the cause of the disease, allergy tests at the doctor’s office are helpful.
On the Internet, for example, one also comes across the terms “fungal acne” and “fungal acne”. In fact, there is an acne-like skin disease that is caused by fungi and is often confused with acne vulgaris. However, this skin disease is caused by an overgrowth of yeast fungi (Malassezia) naturally occurring on the skin, which is why physicians refer to it as Malassezia folliculitis.
This supposed fungal acne can be recognized, among other things, by papules and pustules that appear particularly on the face (for example, on the chin or cheeks), on the chest, arms or back.
Newborn acne
In newborn acne (“baby acne”, acne neonatorum), small blackheads are found mainly on the cheeks. They may already exist before birth or form in the course of the first weeks of life. Therapy is not necessary, since neonatal acne disappears on its own within a few weeks.
Infant acne
Most sufferers with infant acne develop acne vulgaris later in life.
Majorca acne
Another special form is the so-called Majorca acne (Acne aestivalis). It is not a typical acne disease, but actually a light allergy or a special form of sun eczema (polymorphous light dermatosis).
In Mallorca acne, small pustules form mainly on the décolleté and on the arms and legs, very rarely also on the face. An unpleasant side effect of this form of acne is itching and a strong reddening, but this only occurs in some cases.
The cause of Mallorca acne (e.g. on the arms or face) is a reaction of sunlight or UV radiation with the sebum of the skin or with the fats in sun creams, which produces substances that are harmful to the skin. Scientists also suspect a genetic predisposition. Young people (women more often than men) with oily skin types are particularly at risk.
It is important to avoid re-exposure to the sun during these days. A cornea-dissolving (keratolytic) therapy may support healing in people who have a predisposition to acne.
Prevent Mallorca acne: Get your skin used to the sun slowly. Also, avoid greasy lotions or sunscreens. There are also special sun protection products for allergic skin that help prevent Mallorca acne.
Acne inversa
Acne inversa is a severe form of acne and usually occurs in the underarm and intimate areas. You can read more about it in the article Acne inversa.
What causes acne?
Acne is caused by various factors.
The most common form, acne vulgaris, is usually hormonal. The cause here is the male sex hormones, called androgens (main representative: testosterone). These are produced not only in men, but also to a lesser extent in women (especially during puberty). However, since they occur in greater quantities in men, men are also more affected by the skin disease.
At some point, the skin at the excretory duct tears open. Contact with atmospheric oxygen causes the blackhead to turn black. This means that blackheads are open blackheads.
The sebum in the blackheads “attracts” bacteria. These break down the sebum and produce cleavage products that promote inflammatory reactions (“blooming pimple”) and stimulate the formation of new blackheads.
Hormone fluctuations (and with them acne) occur not only during puberty, but also under certain circumstances during pregnancy, menopause and when discontinuing the contraceptive pill. The same applies during menstruation, when the skin is increasingly oily.
Other risk factors
But hormones are not the only factor responsible for the development of acne. Studies also show that a hereditary predisposition as well as a strong psychological burden and stress support the development of acne.
In addition, fats in cosmetic products, ingredients in medications and certain foods may stimulate sebum production or contribute to blockage of the excretory ducts. Medications that may cause acne include:
- Anabolic steroids
- Adrenocorticotropin (ACTH)
- Psychotropic drugs
- sleeping pills and sedatives containing bromine
- Neuroleptics (drugs for various mental illnesses)
- Halogens as disinfectants
- Antibiotics
- vitamins B2, B6, B12
- certain drugs for cancer treatment (EGF receptor agonists)
But also taking hormonal contraceptives (birth control pills) may cause acne, depending on the composition of the preparation.
In some people, diet also promotes the development of acne. Here, it may help some acne sufferers to create a diet plan in consultation with their doctor. Very fatty foods and chocolate, for example, have a bad reputation in this respect. Milk and dairy products are also suspected of aggravating acne. However, these correlations have not yet been scientifically proven.
If necessary, various factors such as humidity, cigarette smoke and scratching the pimples worsen the symptoms.
What are the symptoms of acne?
If such a blackhead tears open, air gets to the sebum, causing the blackhead to turn black. If bacteria (propioni bacteria) are added to acne, an inflammation develops – a “blooming” pimple develops.
Acne mainly forms on the face, preferably in the so-called T-zone, i.e. on the forehead, chin and bridge of the nose. Depending on predisposition and skin type, severe acne also appears on the cheeks. Less frequently, the back and chest are affected.
In case of the following symptoms it is advisable to consult a dermatologist:
- large, sore pimples
- sudden deterioration of the skin appearance
- severe psychological stress caused by the pimples
- acne scars
Acne: Scars
How exactly acne scars develop and how they can be removed, you can read in the article Acne scars.
Acne: examinations and diagnosis
Acne is easy to diagnose based on its external appearance. The pustules, blackheads and pimples are usually a clear symptom.
If the doctor suspects that an infection is present, he may take some secretion from the blackheads to have it analyzed. This reveals whether the infection is caused by bacteria, and if so, which ones. The treatment is then based on this.
Acne: Treatment
You can read everything important about acne treatment in the article Acne treatment.
Care tips for acne
Basically, the skin or face cleansing with acne should not be too aggressive. Syndets specially formulated for impure and acne-prone skin enable gentle skin cleansing. For facial and skin care, it is recommended to avoid greasy products and instead advised to use a light moisturizer with an oil-in-water base if you have acne.
If you have acne you want to conceal it with makeup, choose products that are non-comedogenic or reach for antiseptic concealers. To prevent the development of inflammation and scars in existing acne, it is advisable not to squeeze out blackheads and pimples yourself.
Acne: course of the disease and prognosis
Stress and psychological strain may strongly influence the course of the disease. Thus, under certain circumstances, acute stress situations can lead to a sudden outbreak of acne (acne tarda) even in old age.
