ACNE
Pimples or acne vulgaris is a recurrent problem of the pilosebaceous glands (sebaceous glands are attached to hair follicles in the skin). These glands are most numerous in the face, chest, back and upper arms. Thus pimples tend to come out in these areas.
Almost al teenagers will experience some form of pimples. The peak incidence in females is 14 - 17 years and in males, 16 - 19 years. However, acne may well extend in to fourth and fifth decades of life.
There are different reasons or factors for the appearance of acne. These factors interact with each other.
1. There is an increase in sebum production.
2. Arrangement of the keratin or skin cells of the glands and its ducts become disorganized and cause plugging.
3. There is an increase in the population of the bacteria Propinobacterium acnes.
4. There maybe an increased level of the hormone testosterone or an increased senstivity of the glands to it.
There are different appearances of the lesions of acne:
1. Comedones
- blackheads
- whiteheads
2. Papules
3. Pustules
4. Nodules
5. Cysts
Some people may develop only a mild form of acne which is self-limiting. This will not require any special treatment other than good skin care like washing with a good cleanser and avoiding harsh cosmetics. However, most will require some form of treatment. This may be over the counter remedies or prescription medication. Good motivation and compliance is essential in treatment. There are no instant cures for pimples. Treatment may last several months or even years.
There are numerous medications which can be applied on acne (especially for the blackheads, whiteheads, and papules). There are the benzoyl peroxide products, tretinoin products, and topical isotretinoin. Some products have varying strengths. It may be better to start with the weakest and if necessary use the stronger concentrations later. Most of them will cause a little stinging sensation and redness, but this should be temporary.
For those with a lot of lesions, especially pustules, one might also have to use topical antibiotics like Erythromycin and Clindamycin. For severe cases, it may be necessary to take oral medications like systemic antibiotics, hormones (estrogen), oral isotretinoin, etc. but this warrants a doctor's supervision. Some type of lesions may need local injections.
Along with these medications, good skin habits are essential. Avoid picking or pinching acne lesions. Wash the face morning and evening with a mild soap. (Washing too often may deprive the skin of essential oils.) The relationship of food and appearance of pimples has not been definitely established. It would be wise to have a well-balanced diet and maintain a healthy lifestyle. Stress and lack of sleep can make one more prone to pimples. Some women may associate appearance of more pimples around the time of their menstrual periods. Greasy cosmetics and skin products may also trigger eruptions.
Pimples are not life threatening but may irreparable scars, physically and psychologically. Avoid this by practicing good habits and consulting a certified dermatologist before things get out of control. Call your dermatologist.
