Acne vulgaris (or simply acne) is a common human skin disease, characterized by areas of seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), nodules (large papules), pimples, and possibly scarring. Aside from scarring, its main effects are psychological, such as reduced self-esteem and in very extreme cases, depression or suicide. In adolescence, acne is usually caused by an increase in androgens such as testosterone, which occurs during puberty, regardless of sex. Acne more often affects skin with a greater number of oil glands; these areas include the face, the upper part of the chest, and the back. Acne occurs most commonly during adolescence, affecting an estimated 80?90% of teenagers. Acne usually improves around the age of 30 but may persist into adulthood. Permanent scarring may occur. Signs and Symptoms Typical features of acne include: seborrhea (increased oil-sebum secretion), comedones, papules, pustules, nodules (large papules), pigmentation, uneven skin colour and possibly scarring. The appearance of acne varies with skin colour. Some of the large nodules can appear on the buttocks, groin, and armpit area, and anywhere else where sweat collects in hair follicles and perspiration ducts. Cystic acne affects deeper skin tissue than does common acne. Scars Acne scars are the result of inflammation within the dermis brought on by acne. The scar is created by the wound trying to heal itself resulting in too much collagen in one spot. Acne scars are often referred to as ?ice pick? scars. Ice-Pick Scars : Deep pits, that are the most common and a classic sign of acne scarring. Box-Car Scars : Angular scars that usually occur on the temple and cheeks, and can be either superficial or deep, these are similar to chickenpox scars. Rolling Scars : That give the skin a wave-like appearance. Hypertrophic Scars : Thickened, or keloid scars. Pigmentation Postinflammatory hyperpigmentation is usually the result of nodular or cystic acne (the painful ?bumps? lying under the skin). They often leave behind an inflamed red mark after the original acne lesion has resolved. Pigmented scars is a common but misleading term, as it suggests the color change is permanent. Often, the pigmentation scars can be avoided by avoiding aggravation of the nodule or cyst. Daily use of SPF 15 or higher sunscreen can minimize pigmentation associated with acne. Cause
1) Hormonal : Hormonal activity, such as menstrual cycles and puberty, may contribute to the formation of acne. During puberty, an increase in sex hormones called androgens cause the follicular glands to grow larger and make more sebum; A similar increase in androgens occurs during pregnancy, also leading to increased sebum production. Use of anabolic steroids may have a similar effect. Development of acne vulgaris in later years is uncommon. True acne vulgaris in adult women may be a feature of an underlying condition such as pregnancy or disorders such as polycystic ovary syndrome, hirsutism or Cushing?s syndrome. Menopause-associated acne occurs as production of the natural anti-acne ovarian hormones.
2) Genetic : The predisposition for specific individuals to acne is likely explained by a genetic component.
3) Psychological : While the connection between acne and stress has been debated, scientific research indicates that ?increased acne severity? is ?associated with increased stress levels.
4) Infectious : Propionibacterium acnes (P. Acnes) is widely concluded to cause acne, though Staphylococcus aureus has been universally discovered to play some role
5) Diet : The relationship between diet and acne is unclear as there is no good quality evidence. However, a high glycemic load diet is associated with worsening acne. There is also a positive association between the consumption of milk and a greater rate and severity of acne.