Acne is Not Spots

There are quite a few different forms of acne, depending on how or why the acne developed. Some of the forms of acne are: acne conglobata (chronic boils); acne fulminans (an extreme form of conglobata); acne cosmetica (caused by cosmetics); acne keloidalis nuchae (from shaving); acne medicamentosa (caused by starting or stopping a medication); acne rosacea (redness on the face); baby acne; hormonal acne; cloracne and the common variety: acne vulgaris (better known as ‘puberty spots’). We will concentrate on acne vulgaris.

Acne vulgaris could be defined as: ‘an inflammatory disease of the skin, caused by changes in the pilosebaceous units (skin structures consisting of a hair follicle and its associated sebaceous gland). Acne lesions are commonly referred to as pimples, spots or zits’ (see article on “Acne” in Wikipedia).

Acne is most usually found in white Western teenagers, although it is to be found in every country in the world, so there could be a genetic predisposition to it. It is possible that it could be an abnormal reaction to fairly normal levels of testosterone. For most afflicted, outbreaks of acne last only until the age of twenty or so, probably only a few years or at the most ten. For other people, however, it may be a life-long problem. It usually appears on the face, upper-chest, upper-arms and back. However, an occasional spot does not constitute acne.

Acne vulgaris manifests itself in many ways, including: whiteheads, resulting from pores that are completely blocked, trapping sebum (oil), bacteria, and dead skin cells, causing a white spot on the top; blackheads, caused by pores which are only partially blocked, allowing some of the trapped sebum, bacteria, and dead skin cells to slowly drain to the surface (the black colour is not caused by dirt, but is a reaction of the skin’s own pigment, melanin, with the oxygen in the air); papules, which are inflamed, red, tender bumps with no head and pustules, which are similar to whiteheads, but are inflamed, and look like red circles with a white or yellow centre.

Whiteheads do not often last for a long time; blackheads can last a long time and pustules are what people call spots or zits. Severe acne vulgaris is distinguished by nodules and cysts. A ‘nodule’ is a much larger and more painful kind of pustule and can often last for months. Nodules are large, hard lumps just under the skin’s surface. They often cause scarring and should never for any reason be squeezed, since this could cause them to last for months longer.

A ‘cyst’ can appear like a nodule, but it is pus-filled, and has been defined as having a diameter of at least 5mm and, again, can leave scars and cause pain. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which will last very much longer than if it had been left alone. Dermatologists have ways of lessening swelling and preventing scarring with both nodules and cysts. It is not true that acne sufferers are not careful about cleanliness.

In fact, excessive washing can exacerbate acne. There are many, many fake ‘treatments’ on the market and many, many old wives’ remedies. However, any good skin expert would advise you that there is no sure-fire cure for acne and that the sufferer has to follow a strict regimen of cleansing until the acne just ‘disappears’ on its own.