Adolescent & Adult Acne

Acne is the most common skin disease during adolescence and early adulthood. Adolescent acne in females between the ages of 14 and 17 and in males between the ages of 16 and 19. Males are affected more severely than females. Eighty-five percent of high school students will have some acne. Ten percent of those with adolescent acne will continue to suffer from it into their 20's and 30's. And sometimes "adult acne" will begin in the 20's, 30's and 40's and later years and continue due to stress and fatigue which can cause increased production of hormones by the adrenal gland with increased levels of androgens. These hormones worsen acne. Six percent of females and eight percent of males in their fifties and later still suffer from the symptoms of adult acne (acne rosacea). Acne rosacea affects more than 17 million adult Americans and approximately 60 million adults in other countries.

Adolescent acne usually begins one to two years before puberty and is caused by stimulation of the facial sebaceous glands by androgens, the male hormones. (Women also produce small quantities of male hormones; this is the basis of acne in women.) It is thought that acne sufferers, rather than having higher levels of the hormones, actually have sebaceous glands that are more sensitive to the hormone.

Today there is a desire to find new and innovative ways to treat acne, rosacea, dermatitis and other skin conditions naturally without the use of drugs, lasers and sometimes harmful chemicals. This is not an unrealistic acne treatment goal. It is possible to live with, control and manage acne treatment safely and effectively.

Most acne suffers have gained much knowledge in their battle with this skin condition, but unfortunately, most of the gained knowledge has not been helpful in solving the problem. Sadly most information available is about acne treatments that do not work, which results in years of frustration for the acne sufferer as usually they continue seeking information and migrate from dermatologist to dermatologist for years in their search for the best acne treatment answer. Knowledge of the symptoms does not solve the 'cause or etiology' of acne.

Three Acne-Causing Factors

Acne is caused by three factors:

  1. Abnormal keratinization of the lining of the sebaceous glands caused by androgen stimulation, resulting in plugging of the gland.
  2. Increased production of sebum by the sebaceous gland due to androgen stimulation.
  3. A bacterium, Propionibacterium acne, proliferates within the gland and modifies the sebum. Propionibacterium acne is a bacterium normally found on the skin.

The plugging of the gland and the action of the bacterium cause an intense inflammatory reaction, resulting in a blackhead (open comedone) or a whitehead (closed comedone). The color of the blackhead is due to melanin granules and is not dirt. Continued plugging and inflammation lead to the pustules (pimples), papules and cysts of acne.

Acne Types And Definitions

Acne vulgaris is the most common form of acne.

Comedonal acne: non-inflammatory lesions such as blackheads and whiteheads

Whiteheads: Whiteheads result when a pore is completely blocked, trapping sebum (oil), bacteria, and dead skin cells, causing a white appearance on the surface.

Papules: Papules are small, red, tender bumps with no head.

Pustules: Pustules are similar to whiteheads, but are inflamed, and appear as a red circle with a white or yellow center.

Nodules: Nodules are large, hard bumps under the skin's surface. Scarring is common.

Cysts: Cysts can appear similar to nodules, but are pus-filled, and have been described as having a diameter of 5mm or more across.

Acne conglobata: highly inflammatory, with cysts that communicate under the skin with abscesses and burrowing sinus tracts.

Acne rosacea: is not true acne. Rosacea, previously called acne rosacea, is a chronic skin disease that affects both the skin and the eyes. Rosacea is characterized by redness, bumps, pimples, and, in advanced stages, thickened skin on the nose. Rosacea usually occurs on the face, although the neck and upper chest are also sometimes involved. A mild degree of eye (ocular rosacea) involvement occurs in more than 50 percent of people with rosacea.

Adult Acne: the result of fluctuating hormones that occur naturally as we mature. Certainly pregnancy can sometimes worsen or improve the symptoms of adult acne because it profoundly affects hormones.

Perioral Dermatitis: tiny papules (red bumps), pustules (pus-filled yellowish bumps) and scaling with intense itching. Perioral dermatitis is usually localized to the surrounding area of the mouth and on the chin, or extend to involve the eyelids and the forehead.

Corticosteroid Acne: caused by the use of steroids. It results in pustular acne on the face, chest, back, arms and thighs.

Baby Acne: Infantile acne generally affects the cheeks, and sometimes the forehead and chin. It is more common in boys and is usually mild. In most children the symptoms settle down within a few months.

Acne cosmetica: acne caused by cosmetics, characterized by small pink bumps, the symptoms of acne cosmetica are usually quite mild, with little chance of scarring.

Acne excoriee: scratched or picked pimples.

Acne conglobata: a form of nodulocystic acne in which there are interconnecting abscesses and sinuses

Nodulocystic acne: a severe form of acne affecting the face, chest and back, characterized by multiple nodules and frequently, scars.

Factors That Worsen Acne

Goals of Acne Therapy

  1. Decrease the abnormal keratinization of the sebaceous gland
  2. Decrease production of sebum
  3. Reduce the bacterial effect
  4. Decrease symptoms of inflammation

Acne Scars

The term "scarring" refers to a fibrous process in which new collagen is laid down to heal an injury. It affects 30% of those with moderate or severe acne vulgaris symptoms. Most people will have acne scars that are mild. However, some will have scars that look significant even to others. There are a number of different looking scars caused by acne. They can be classified as follows: