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Suwasáriya(Healthnet)
Acne

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Authors - Dr. Gayani Ariyasinghe (M.B.B.S, D.F.M)
Dr. Sharmila Samaranayake (M.B.B.S, D.C.H)

Authors 2 - Dr. Niranjan Ariyasinghe thru Dr. Gayani

Institution - Health Education Bureau - Sri Lanka

Introduction

Acne is a common skin condition and is usually treatable. You may need treatment for several months. Most people with acne are aged between 12 and 25, but some older and younger people are affected. Acne usually affects the face. It can affect the neck, back and chest. The severity can range from mild to severe.

Causative Agents

Acne is caused by over activity of sebaceous glands.

Acne is not infectious. So you cannot get it from 1 person to the other. But it can be hereditary and run in families. It isn’t caused by diet or poor hygiene. Food with high glycaemic index make acne control worse. Whether increased stress leads to acne is debatable.

Excessive production of male hormones (testosterone) can cause acne. Ex: Conditions like poly cystic ovarian syndrome. Some contraceptive pills, certain medicines used for epilepsy can cause acne. Also greasy, poor quality makeup and cosmetic creams can worsen it.

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Pathogenesis / Action in the Body

Acne

Sebaceous glands under the skin surface make oil (sebum) which keeps the skin supple. The sebum comes out through pores (tiny holes). Hormone changes especially at puberty stimulate the sebaceous glands and make more sebum. That is why acne is commonly seen in teenagers.

When pores get blocked (by thickening of skin and by dead cells) and when sebum collects under these blocked pores pimples occur. There is a bacterium called Propionobacterium acne which is normally found on skin. It multiplies in trapped serum. Sometimes inflammation occurs making the surrounding skin red. The spots can get larger and fill with pus. When several pustules are close by they can get even larger and form nodules and cysts. These inflamed spots can heal with time. But sometimes will leave a discoloured area (hyper pigmentation). A small scar can be left on skin if cysts are ruptured.

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Symptoms and signs

  • Greasy skin
  • Black heads (open comedones) – Tiny plugs which block the pores are called comodones. The black colour comes due to the skin pigment.
  • Whiteheads (closed comedones)
  • Red or yellow spots (pustules)
  • Deep inflamed lesions (nodules and cysts)
  • Scars

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Complications

If you pick or squeeze pimples it can cause further inflammation and scarring. Having severe acne is very distressing as it will affect the appearance of a person. Some can even get depressed.

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Management

Inflamed acne needs to be treated early to prevent scarring. Wash twice a day with lukewarm water. You can use a suitable face wash or mild soap. Very hot or cold water can worsen acne. Never scrub hard when washing acne affected skin. Excessive washing and scrubbing can increase inflammation and make acne worse. Do not use greasy creams as it may clog pores.

If you have acne it is best to visit a qualified doctor or a dermatologist. The treatment depends on the type and severity of acne.

There are various creams/ lotions which are used. Ex. Benzoyl peroxide, retinoids, topical antibiotics. Sometimes antibiotics like doxycycline may be used if acne is severe. Usually it takes time to clear off acne with any form of treatment (usually 4 – 6 weeks). Even after successful treatment acne can flare up again.

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Prevention and Promotion

There is no successful preventive method for acne.

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References

Patient UK articles on acne.

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Last update on : 2011-03-23 12:50:45