ACNE

Acne is a disorder of the skin's oil glands. Oil glands make a substance called sebum that normally rises up through a hair-containing canal called a follicle and empties onto the skin surface. The precise cause of acne in newborns is not known, but some researchers speculate that it may be due to the transfer through the placenta of hormones from the mother or of acne-causing medication (such as lithium and phenytoin) that the mother may have been taking.

During adolescence, rising hormone levels called androgens stimulate increased oil production and also increase the number of oil glands and the amount of sebum they produce. The increased production of sebum causes blockage of hair follicles, leading to the formation of small bacteria-filled cysts called comedones. If these comedones remain intact and do not rupture, they can progress into open comedones (whiteheads) or closed comedones (blackheads). When comedones rupture, an inflammatory reaction occurs and can spread into the surrounding tissue and all forms of inflammatory lesions are formed such as papules, pustules, cysts, and nodules.

FORMS OF ACNE

There are various forms of acne, the most common forms include:

1. Acne Vulgaris is the most common form of acne, which includes several types of pimples. These acne lesions include blackheads, whiteheads, papules, pustules, nodules and cyst.

   Definition of terms:

   • Papules - inflamed lesions that appear as small, pink bumps on the skin
   • Pustules (pimples) - inflamed pus-filled lesions that are red at the base
   • Cysts and nodules - large, inflamed, pus-filled lesions that are lodged deep and can drain, causing pain and scarring

   Lesions can cause scars ranging from small, depressed pits to large elevated blemishes, depending on the severity of the condition and the individual's skin type.

2. Acne Rosacea can look similar to acne vulgaris, and the two types of acne are sometimes confused for one another. Usually occurs in people over the age of 30. It appears as a red rash, which is normally confined, to the cheeks, nose, forehead and chin. Bumps, pimples, and skin blemishes often accompany the redness. It is more prevalent in women, but often more severe when found in men. Left untreated, it can cause swelling of the nose and the growth of excess tissue, a condition called rhinophyma.

SEVERE FORMS OF ACNE

1. Acne Conglobata is the most severe form of acne vulgaris and is more common in males. It is characterized by numerous large lesions, which are sometimes interconnected, along with widespread blackheads. It can cause severe, irrevocable damage to the skin, and disfiguring scarring. It is found on the face, chest, back, buttocks, upper arms, and thighs. The age of onset for acne conglobata is usually between 18 and 30 years, and the condition can stay active for many years. As with all forms of acne, the cause of acne conglobata is unknown.


2. Acne Fulminans is an abrupt onset of acne conglobata, which normally afflicts young men. Symptoms of severe nodulocystic, often ulcerating acne are apparent. As with acne conglobata, extreme, disfiguring scarring is common. Acne fulminans is unique in that it also includes a fever and aching of the joints. Acne fulminans does not respond well to antibiotics.


3. Gram-Negative Folliculitis is a bacterial infection characterized by pustules and cysts, possibly occurring as a complication resulting from a long-term antibiotic treatment of acne vulgaris.


4. Pyoderma Faciale - this type of severe facial acne affects only females, usually between the ages of 20 to 40 years old, and is characterized by painful large nodules, pustules and sores, which may leave scarring. It begins abruptly, and may occur on the skin of a woman who has never had acne before. It is confined to the face, and usually does not last longer than one year, but can wreak havoc in a very short time.

RISK FACTORS THAT MAY CAUSE OR WORSEN ACNE

• Family history of acne


• Greasy / oily cosmetic or hair products containing vegetable or animal fats - pore-clogging (comedogenic) cosmetics, sunscreens, moisturizers, greases, and oils


• Hormonal changes associated with adolescence, pregnancy, or menstruation (acne tends to flare up 2 to 7 days before menstruation begins)


• Certain medications such as corticosteroids, androgens, oral contraceptives, lithium, halogens, isoniazid, phenytoin, phenobarbital, and high levels of iodine (such as from kelp)


• Environmental irritants such as industrial cutting oils, tar, wood preservatives, sealing compounds, and other pollutants


• Sweating and friction, such as from headbands, back packs, bicycle helmets, or tight collars


• High levels of humidity


• Squeezing and picking comedones


• Being overweight - increased insulin production can signal the body to release extra male hormones, called androgens, which are involved in pimple formation


• Stress!


• Poor diet - Excessive sugar, trans fats, fried, salt, and processed foods. Insufficient intake of water, healthy oils, fruit and vegetables, and fiber


• Excessive intake of foods such as chocolate, caffeine, carbonated beverages, milk products, and seafood and other iodine-rich foods


• Tumors in the adrenal glands, polycystic ovarian syndrome (especially when adult acne occurs with irregular menstrual periods), and other health conditions can cause acne

Proper examination / diagnosis by your naturopathic physician is recommended to rule out any of these conditions.

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