Types of Acne

What is acne?

Acne is the most common of all skin diseases. Some figure has it that eighty percent of all people between the ages of twelve and twenty-four have some type of acne. It is a disorder of the oil glands in the skin. Contrary to some conventional conceptions, it is a problem suffered not exclusively by teenagers. Some people are plagued their whole lives with constant outbreaks of acne.


How acne develops?
The hair follicles, or pores, in our skin are connected with oil glands called sebaceous glands. These glands produce sebum, an oily substance that lubricates our hair and skin. At the same time, dead skin cells are expelled from the pore lining while sebum is being distributed to the exterior surface of the skin.

Most of the time the glands produce the right amount of sebum and the pores are fine. But sometimes when too much sebum is produced, a pore or two may get clogged up. This plug blocks the pore, preventing the sebum or dead skin cells from leaving the pore. The situation could further be aggravated by a build-up of bacteria that live on sebum. This leads to swelling around the pore and acne is the result. This could happen to anybody, young and old.

However, a few eruptions every now and then are not what concern us. We acne sufferers are concerned with those numerous and serious pimples that dotted our face and neck and never seem to go away. As soon as some old ones begin to subside, to our relief, more new ones pop up. The constant battles eventually turn into hopeless struggles.


What causes acne?
Why does acne occur? And why does acne have to be on the face, and not on some harmless spot, like, say...the sole?

The latter question has its answer in our body. It's because the oil glands in our skin are concentrated in the T-zone--the face, the neck, the chest, the back, and the shoulders.

Nobody knows for sure the exact cause of acne. We only know about some of the elements that influence its development, and they are:


heredity,
oily skin or hair,
an increased production of male hormones at puberty,
a hormonal imbalance in women,
some prescription medications,
cosmetics that contain chemicals and vegetable oil,
periods of high stress, and
possibly some nutritional deficiencies.

Types of Acne:

When excess sebum is produced by the oil gland, the dead skin cells around the pore may become more "sticky" and partially block the pore, restricting the flow of oil onto the skin surface. This results in solidification of the sebum which fills the hair duct forming a blackhead (open comedo). The dark color of the blackhead is not due to dirt, but is dried oil and from a pigment (melanin) of the shed skin cells in the openings of the hair follicles.

If the partial blockage becomes complete, excess sebum can't escape. The bacteria "Propionibacterium acnes" (short form P. acnes) that are normally present on the skin are trapped in the pore as well. They make an enzyme that breaks down sebum into a substance called "free fatty acid." Free fatty acid is very irritating stuff, and can cause swelling, redness and pus formation. This is called a whitehead (closed comedo).

Similar but a bit more serious formations are called pustules (pus-filled yellowish bumps), and nodules (firm, larger inflamed swellings below the skin).

Acne vulgaris is the medical term for common acne, which is comprised of open and closed comedones.

If the inflammation is deep and severe, or if the spot is manipulated or squeezed, the pus can burst deep into the skin tissues rather than onto the surface. Swelling and pain take place as the body's activated defence mechanism sends bacteria-fighting white cells to the area. This deep-rooted inflammation and infection results in cyst formation. Cystic acne is the most severe and stubborn of all types of acne, and carries the biggest threat of scarring.

Acne Rosacea mostly appears in middle-aged adults. It is characterized by flushing of the face, and the formation of inflamed bumps on the forehead, cheeks, nose, and chin. The redness on the face sometimes misleads people to think that excessive drinking causes this type of acne. Actually, drinking has nothing to do with the eruption, but is believed to magnify the symptoms. The exact causative factor for this disorder is not known.

For some adults, Acne Rosacea never goes away. Over time, the development of Rhinophyma, or a bulbous nose, can occur, particularly in men.

Perioral Dermatitis is almost exclusive to young women. The presence of tiny papules (red bumps), pustules (pus-filled yellowish bumps) and scaling with intense itching are signs of perioral dermatitis. It is usually localized to the surrounding area of the mouth and on the chin, or extend to involve the eyelids and the forehead.

Some causes of Perioral Dermatitis are due to the use of fluorinated toothpaste, facial creams, or irritants such as strong benzoyl peroxide or cinnamon in the area.

The use of steroids could cause Corticosteroid Acne, among other side-effects to the body. Nasty cases of pustular acne on the face, chest, back, arms and thighs, together with cessation of menstruation, development of body hair, thinning of scalp hair have been reported with the taking of dehydroepiandrosterone. This drug that is supposed to help reverse the effects of aging, increase metabolism, aid in weight loss, help increase energy, among other things, is easily available over-the-counter. Extreme care should be exercised when using this product.

Acne Excoriee des Jeunes Filles is a condition commonly seen in young girls. In this case, minimal acne lesions on the face are exacerbated by neurotic squeezing and pressing of the pimples, trying to rid the contents with the fingers. As a result, hyperpigmentation and stellate contracted scars occur, while often the original underlying acne has healed.

We have listed above the most common acne-type skin disorders. For a more complete list and their images, see Links to Acne Images.


Acne's Natural Cycles
Even if you do nothing to the acnes, most of them gradually heal themselves. As each of these pimples heal, others tend to appear. The healing pimples usually fade to a pink mark that generally disappears in time. However, some pimples leave scars that look like small pits or bumps.

A few other symptoms may be present in women who develop acne due to a hormonal imbalance.

These are:


hair loss,
excessive hair growth, and
weight gain in the upper body only.



Home Care for Acne
Despite the fact that acne negatively impacts people's confidence and self-esteem, the majority of acne patients allow their problem to continue as opposed to only 16% who have seeked medical care. If you are among those who prefer to handle the problem yourself, here are some generally accepted home care steps that can be used to help relieve acne.

These include:


keeping the skin of the face as dry and clean as possible,
washing the face carefully and gently twice a day with an anti-bacteria soap,
using a light, non oil-based moisturizer on the face after each washing,
avoiding cosmetics that contain synthetic chemicals and vegetable oils,
keeping hair clean and off the face,
avoiding picking at or touching blemishes,
avoiding pressure on irritated skin from tight collars or head-gear,
and using over-the-counter products that contain sulfur plus resorcinol that can be applied to the skin to unclog pores and heal acne.
Pregnant women should consult their physician prior to taking any over-the-counter medication. Parents of children and persons with medical conditions are advised to read product labels carefully and consult a pharmacist if they have questions about use.


Western Treatments:

If the above measures do not help with your acne problem, or if your acne becomes infected or swollen, you should go see your doctor first. Your doctor may prescribe:


oral antibiotics,
topical antibiotics applied to the skin, or
other drug therapies.
The choice of drug therapy will vary from person to person and depend on the severity of the acne.

We'll cover in more detail the various treatment options in Conventional Western Treatments.


Chinese Herbal Treatments

Other than Western doctors, I've also tried traditional Chinese medicine.

In Chinese medical theory, "heat" is nearly always involved in acne: wind-heat; damp-heat in the intestines and stomach; or heat in the blood, which appears in severe acne. Emotions also may play a role and may be related to the liver (when there is anger), the heart (sad or overjoy), or the spleen (worry).

Since I have had acne for a long time, my case was diagnosed as chronic acne. Chinese physician would told me it was caused by stagnant qi (energy) and blood. Their approach is to use herbal medicine to rescue heat and cool the body until it finds balance again. In my case, certain herbs were used to disperse the blood so that it did not stagnate to cause acne.

Did it work? Yes and no.

A good, experienced Chinese physician would be able to pinpoint the exact syndrome (in Chinese medicine, a physician will treat syndromes, not diseases or symptoms), use the right kind and right amount of herbal ingredients for the formula. However, there is always a gap between theory and practice. Simple as it may sound, a good physician who can cure chronic diseases, or acne in our case, is always lacking. I have known a couple of good Chinese physicians who have cured acne patients before my eyes. However, the best they could do for me was to improve my conditions.


Alternative Approach

I have found that most Chinese herbal physicians, like their western counterparts, are helpless in dealing with acne. I will talk in more detail about Chinese herbal treatment in the corresponding page. For me, what finally helped control my acne and cleared my face was the alternative approach. This approach combines Chinese and Western medical disciplines. If you can't find solution for your acne problem from either your doctor or purely herbal treatment, try my method. I am confident it can help you. Whether you know it or not, acne is a disease that, if left untreated, may have psychological effects that take a long time to heal. Good luck!