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Adult Acne and Lifestyle Treatment Information
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Acne vulgaris is the most common form of acne. Acne vulgaris is a common skin disease that affects 85-100% of people at some time during their lives. Acne vulgaris is a condition of the sebaceous glands of the skin. The sebaceous glands surround each hair follicle and produce sebum, an oily substance, to lubricate the hair. Acne vulgaris is characterized by non-inflammatory follicular papules or comedones and by inflammatory papules, pustules, and nodules in its more severe forms. Acne usually appears on the face, back and chest. Acne vulgaris includes several types of lesions, these individual acne lesions usually last less than two weeks but the deeper papules and nodules may persist for months. This is a skin condition that mainly affects adolescents but may persist or even become more severe in adulthood. Oily skin is common in many acne patients.
There are four main components involved in the development of acne:
1)Follicular epidermal hyperproliferation which clogs the pore causing excess sebum to accumulate providing the right environment for P. Acnes bacteria and accompanying inflammation to occur. Persons with acne frequently have excess sebum production and oily skin. This excess sebum may affect the normal pH balance of the skin and initiates comedone formation.
2)Excess sebum is another component in the development of acne vulgaris. Sebum production and excretion are regulated by a number of different hormones and mediators. Androgen hormones promote sebum production and release but are not the only regulators of sebaceous gland function. Other hormones such as growth hormone and insulin-like growth factors also regulate the sebaceous gland and may contribute to the development of acne.
3)Propionibacterium acnes otherwise known as P acnes this is a microaerophilic organism present in many acne lesions. The presence of P acnes promotes inflammation by producing pro-inflammatory mediators that diffuse through the follicle wall. Hypersensitivity to P acnes may also explain why some individuals develop inflammatory acne vulgaris while others do not.
4)Inflammation may be a primary component of or a secondary component. Most of the evidence to date suggests a secondary inflammatory response to P acnes. Although inflammation is not apparent microscopically or clinically in early lesions of acne, it may still play a pivotal role in the development of acne vulgaris and the comedones.
Mild to Moderate acne vulgaris consists of:
Comedonal acne: non-inflammatory lesions such as blackheads and whiteheads, although some pustules and papules may be present.
Mild acne: with blackheads and whiteheads but also with papules and pustules.
Moderate acne: characterised by more painful, deep-rooted inflamed lesions, which can result in scarring. It is important to treat early to avoid this.
Whiteheads: Whiteheads result when a pore is completely blocked, trapping sebum (oil), bacteria, and dead skin cells, causing a white appearance on the surface.
Blackheads: Blackheads result when a pore is only partially blocked, allowing some of the trapped sebum (oil), bacteria, and dead skin cells to slowly drain to the surface. The black color is not caused by dirt. Rather, it is a reaction of the skin's own pigment, melanin, reacting with the oxygen in the air.
Papules: Papules are small, red, tender bumps with no head. Do not squeeze a papule. It will do no good, and may exacerbate scarring.
Pustules: Pustules are similar to whiteheads, but are inflamed, and appear as a red circle with a white or yellow center.
Severe acne vulgaris consists of:
deep-rooted inflammatory lesions featuring cysts and nodules which are painful and produce scarring. 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 defense mechanism sends bacteria-fighting white cells to the area. This deep-rooted inflammation and infection results in cyst formation.
Nodules: As opposed to the lesions mentioned above, nodules are much larger, can be quite painful, and can sometimes last for months. Nodules are large, hard bumps under the skin's surface. Scarring is common. Absolutely do not attempt to squeeze such a lesion. You may cause severe trauma to the skin and the lesion may last for months longer than it normally would. Dermatologists often have ways of lessening swelling and preventing scarring.
Cysts: Cysts can appear similar to nodules, but are pus-filled, and have been described as having a diameter of 5mm or more across. They can be painful. Again, scarring is common. Squeezing a cyst may cause a deeper infection and more painful inflammation that will last much longer than if you had left it alone.
Types of cyst include:
- 1) Localized cystic: a few cysts on face, chest and back
- 2)Diffuse cystic: wide areas of face, chest and back involved
- 3)Pyoderma faciale: inflamed cysts localized on the face of females
- 4)Acne conglobata: highly inflammatory, with cysts that communicate under the skin with abscesses and burrowing sinus tracts.
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Acne Blackheads and Whiteheads
Acne blackheads are small, dark spots (about the size of a pinhead) caused by discoloration of the surface of a small plug in the opening of a follicle (pore). The acne blackheads are open and dark in color. Blackheads are follicles that have a wider than normal opening due to the large amount of clogged [...] (read more)
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TYPES OF ACNE-PERIORAL DERMATITIS
When treating acne, one sometimes sees an acne-like eruption around the mouth area. Known as peri-oral dermatitis, peri-oral refers to the facial area around the mouth while dermatitis pertains to inflammation, redness or irritation of the skin. In addition, there are usually small red bumps or even pus bumps and mild peeling as the skin is extremely aggravated. Peri-oral dermatitis symptoms characteristically involve the mouth area, but generally do not affect the lips themselves. You may also notice flaking of the skin at the site of occurrence. Many times if the flaking is isolated to the lip area it may be mistaken for chapped lips. Often the skin around the nose is affected too, and sometimes it can affect the area under and around the eyes.
When peri-oral dermatitis expands to include the eye area, it should more correctly be termed "peri-ocular", or even, "peri-orificial" dermatitis. Peri-ocular dermatitis consists of similar flaking and redness with or without the appearance of small papules or pustules. This condition may be wrongfully thought of as acne while others believe it to be a component of rosacea.
The most common causes of peri-oral dermatitis are topical steroid use and fluoridated and/or tartar control toothpaste. Peri-oral dermatitis is often aggravated by fluoridated or tartar-control toothpaste, chapstick, the ingredients in lipstick, and mouthwash. The International Rosacea Foundation, recommends discontinuing the use of fluoridated or tartar control toothpaste for six months may help reduce the symptoms of peri-oral dermatitis. Peri-oral dermatitis is often aggravated by fluoridated or tartar-control toothpaste, chapstick, the ingredients in lipstick, and mouthwash. Peri-oral dermatitis is a common skin problem that mostly affects young women, however, occasionally men and children are affected by it.
The easiest first step for improvement is the prevention by eliminating those factors mentioned above so that the affected perioral dermatitis area may heal. Sufferers of peri-oral dermatitis tend to have oily skin. Some people are more susceptible to peri-oral dermatitis than others, and recent research indicates the occurrence may be related in part to a proliferation of bacteria in the hair follicles.The following conditions or circumstances have been found to aggravate Peri-oral dermatitis:
1) Cleansing the facial skin with the wrong type of soap. A soap-free cleanser such as Cetaphil or Neutrogena is recommended. Avoid harsh scrubbing of the area.
2) Facial scrubs or acne treatments may cause or worsen the condition.
3) Applying face creams regularly to the area bounded by the cheek folds and chin, or around the eyes in the case of peri-ocular dermatitis. These creams include moisturizers, anti-wrinkle creams, cream cleansers, make-up foundation, and sunscreens. Many of the moisturizers and creams currently on the market contain sunscreens or ingredients that can cause or worsen the peri-oral condition. Anti-wrinkle or anti-aging creams contain retinols, citric acids, beta-hydroxy acids or alpha hydroxy acids which increased facial redness and skin irritation.
4) Applying topical steroids to the facial area. The more potent the steroid cream, the more rapid and severe the occurrence of the peri-oral dermatitis.
5) Lip balms, glosses and lipsticks that extend over the actual lip area can also aggravate the condition.
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