What is acne? Types of acne. Causes of acne.
Acne is a disease of the hair follicles, and their concentration is greatest in the face, behind the ears, shoulders, upper chest and back. Sebum production is high in newborns, after which it gradually decreases until a new peak is reached at the beginning of puberty. At the end of this age period follows a relatively constant level of sebum secretion without expected peaks. This explains to some extent the frequency of the disease in adolescence. There are some major causes of acne:
■ Genetic predisposition - There is heredity in acne, and the probability is higher in two parents with a history of acne.
■ Increased sebum secretion - Patients with acne have larger sebaceous glands that secrete more sebum.
■ Overcolonization with P. acnes and S. epidermidis - These bacteria are normal inhabitants of the hair fat follicle. In people with acne, their amount is significantly increased. They secrete enzymes called lipases, which lead to the formation of free fatty acids. The latter have a comedogenic and inflammatory effect.
■ Impaired keratinization - The process of formation of a normal stratum corneum is altered. In the hair-fat follicle there is an increased accumulation of keratinocytes, which leads to its obstruction and the formation of comedones.
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OurSkinWithin is a blog of Dr. Maria Ratkova, in which she shares her experience in the field of clinical and cosmetic dermatology. The information provided is medically accurate, accessible and impartial.
Types of acne
Depending on the severity of the clinical picture, we distinguish several types of acne:
■ Acne comedonica - This is the mildest degree of acne. It mainly affects the skin in the face. It is clinically manifested by the presence of open and closed comedones (so-called blackheads). No scars or pigmentation are formed.
■ Acne papulo-pustulosa - It is a common variant, usually developing during puberty. Engages the skin of the face, less often that of the back. Inflammatory lesions - papules and pustules - are mainly observed, but comedones are not excluded either. The skin is red and inflamed. There is a risk of developing scars and post-inflammatory hyperpigmentation.
■ Acne conglobata - Severe acne, involving men more often. The disease most often starts during puberty. It affects the skin of both the face and the upper half of the back. It is clinically manifested by papules, pustules, nodules and cysts, which can be painful. As a rule, severe scars form.
■ Acne fulminans - A rare but extremely severe form of acne. Men suffer above all. There is an association with steroid hormones. The lesions involve the skin of the face and back and are mainly represented by cysts and nodules. The general condition is worse, the patients have dropped out and are febrile. Heavy and disfiguring scars form.
Treatment of acne
Therapy is determined by the severity of the clinical picture, age, sex and general condition of the patient. You can learn more about acne treatment at this page.