Acne is an inflammatory disease of the hair follicle, known as the pilosebaceous apparatus, and its associated sebaceous glands. It is most common during adolescence (in girls, ages 11 to 16, and in boys, ages 14 to 18), but can occur at any age. Liv Hospital’s dermatologist Associate Professor Goncha Gyukdemir explains:
Why does acne occur?
There are 4 main factors: increased oil production in the skin known as sebum, increased stickiness in the hair follicle, microorganisms on the surface of the skin, and inflammation. Acne requires the active production of sebum. During adolescence, male hormones (androgens) stimulate sebaceous gland growth and sebum production increases. People with acne have an oilier skin type than other people. Some of the hormones that stimulate sebum could lead to other problems in girls and women, such as an increase in body hair or irregularities with menstruation. The hair follicle cells increase in acne sufferers and can cause blockages. Pimples form, commonly referred to as blackheads (the clinical term is open comedones) and whiteheads (closed comedones).
Microbial effects on the skin
The accumulation of certain microbes on the hair follicle causes acne. These are the bacteria Propionibacterium acnes, Staphylococcus epidermidis and Pityrosporum ovale.
Inflammation
Some certain substances that are released by the bacteria can lead to an inflammatory reaction
To what extent do hereditary factors play a role in the development of pimples?
If either parent has suffered from acne, there is over a 50% chance that the child will also have the disease.
How do hormonal problems cause pimples?
Before adolescence, the sebaceous glands are quite small and cannot cause pimples. Hormonal factors that occur during adolescence and afterwards (hormones secreted in the ovaries and in the testes) cause the sebaceous glands to grow and accumulate excess oil on the skin. Androgens (mainly the androgen hormone - testosterone) are present in both men and women. The androgen level rises during adolescence. Androgens can cause the sebaceous glands to function excessively, and this leads to the appearance of pimples.
What situations can cause acne?
- Acne (juvenile pimples)
- Certain foods: chocolate, nuts, peanuts
- Specific medications: steroids, bodybuilding related medications.
- Menstrual cycle
- Sunlight
- Cosmetics
- Heavy sweating
- Psychological factors and stress
- Smoking
- Recent research suggests that "hidden diabetes" (reactive hypoglycaemia) could cause acne formation.
How is acne manifested?
Acne manifests mainly on the face, back, chest and upper arms. It can be expressed in blackheads, red swellings, inflamed sores, and cysts. Pimples that go untreated for a long time can manifest as bulging or sunken scars on the skin.
Recommendations for the treatment of acne
Skin cleansers (pH-neutral soap), external treatments (creams, lotions), benzoyl peroxide medications, antibiotics (clindamycin, erythromycin, tetracycline), retinoids (vitamin A derivatives), azelaic acid, salicylic acid, sulphur, resorcinol.
Systemic treatment
Antibiotics (tetracycline, doxycycline, minocycline, erythromycin, clindamycin), retinoids (vitamin A derivatives), hormonal drugs (contraceptive pills).
Physical treatment
Removal of a comedone (black spot), chemical peel (removal of a scar through chemical peel process), "dermabrasion" - skin peeling method with special equipment), derma rollers, laser treatment, plasma therapy (PRP).