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HomeSkin Diseases

How to get rid of Acne? - Acne vulgaris - Remove Acne Scar

What is Acne - Acne Scar, Pimples Blackheads?

Acne vulgaris is one of the most common dermatoses. It develops at puberty (teenage) when the sebaceous glands are the most active. In the pre-adolescent period, seborrhoea oleosa and some comedones frequently appear as fore-runners of the disease. In the twenties, it gradually decreases, and is again seen especially in women .after the age of 28, or so (post-adolescent acne), since they usually stop producing children (family planning) and periods may become scanty by that age. It occurs in both girls and boys; in the latter, in a somewhat severer form.

For the development of acne, besides seborrhoea, the hyperkeratosis of the pilo-sebaceous ostia is an important pathogenic factor. A keratinous-cum-sebaceous plug is formed in the follicular neck resulting in the narrowing and sometimes blocking of the canal. In general, a well-developed growing hair interferes with the collection of keratinous and sebaceous material. The growing hair plays the role, as it were, of a needle. That is why acne never occurs on the scalp, and only rarely, on the beard region despite seborrhoea being present in these areas.

Clinical features, Symptoms and Causes of Acne vulgaris

The main localization of acne is the face; then follows the neck, the upper part of the chest, the shoulders and the back. Occasionally, acne is seen on the thighs and buttocks. The distribution is usually bilaterally symmetrical. Seborrhoea oleosa is prominent on the face, and the openings of the sebaceous glands the pores are distinctly visible and patulous.

The primary lesion of acne is the comedone; it signifies a plug composed of dried sebum, epithelial cells and keratinous scales; it fills the pilosebaceous canal. On the surface of the skin, it appears as a slightly elevated white dot, called whitehead; with the passage of time the sulphur constituent of sebum soon gets converted into sulphide turning the whitehead into a black dot, called a blackhead. With a comedone extractor, the entire comedone can be readily squeezed out as a yellowish, cheesy-looking, worm-like mass. Some comedones may persist and remain unchanged, but often an inflammatory reaction occurs.The first stageis erythema which surrounds or engulfs the comedone, and a papule develops-acne papulosa. The comedone is transformed into a moderately firm hemispheric, lentil to bean-sized papule of rose-red color. Most of these papules gradually involute leaving no trace; others suppurate to form pustules resulting from the action of secondary invading micro-organisms, chiefly staphylococci-acne pustulosa. The suppuration may be superficial or deep-seated. The deep-seated pustules take time to involute. Acne indurata is characterized by rather firm, perifollicular nodules of bluish-red colour. They persist for a long time. Many of them eventually become completely or partially absorbed, others transform into cysts-acne cystica. They, however, also tend to persist, discharging from time to time a thin, purulent fluid.

Scarring, usually pitted, is a common sequel of acne, being most marked when the lesions are nodular and suppurative. Sometimes the pits are closely aggregated giving rise to a worm-eaten appearance.

Hypertrophic scars are rarely encountered on the face; they are more frequent on the chest and nape of the neck. Occasionally, these scars become keloidal.

In an ordinary case of acne of moderate severity, various types of lesions may occur ranging from non-inflammatory (Grade I) comedones to indurate or suppurating abscesses, inflammatory papules and pustules (Grade III) a!1dresidual scars, although it is entirely possible that a particular kind of lesion may predominate in an individual case. As a rule acne lesions are asymptomatic; only the deeply suppurating ones are somewhat tender or painful. The excoriations seen on the faces of some acne patients, particularly girls, are the results of the bad habit of picking or neurotic scratching of the lesions.

Diagnosis and Course of Acne vulgaris

The course of the disease is chronic with frequent remissions and exacerbations. There is a tendency to flare up in the premenstrual period. Acne tends to subside in the early twenties, but may persist indefinitely. The mild form is not particularly troublesome. In its more severe form, acne becomes a source of great anxiety to the young. They are profoundly disturbed by the disfiguring scars and the new "pimples", hence this condition can affect the emotional state of a patient.

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