Acne Vulgaris – What Can You Do About It?

What is Acne Vulgaris?

Acne vulgaris also known simply as acne is a chronic disorder of the hair follicles and sebaceous glands. Some of the characteristics of acne include blackheads, pimples, cysts, infected abscesses, and rarely scarring.

Further, acne vulgaris usually occurs during adolescence in both men and women. To be more specific, acne starts during puberty and tends to get worse for people with oily skin. Additionally, acne badly affects teenage boys. Only mild to moderate forms of acne occur in middle-aged women.

Acne can be seen most commonly on the face. The other places where it can occur include the neck, chest, back, shoulders, scalp, and upper arms and legs. Most forms of acne vulgaris are the result of heredity and hormonal problems and have nothing to do with a harmful diet or poor hygiene.

The skin anatomy

To understand the acne vulgaris process, some knowledge about skin anatomy and physiology is essential:

The skin has three layers: The outer layer called epidermis consists of epithelial cells. Under this lies the dermis consisting of connective tissue. At the bottom there is a layer called the hypodermis consisting mostly of fat cells.

Your skin has narrow pores extending from the surface down to the top of the sub-dermis, called hair follicles. A hair extends from a growth zone in the bottom of each hair follicle and out at the skin surface.

Around the hair in the dermis, there are small glands called sebaceous glands. These glands produce a fatty substance, sebum, which empties through the follicle opening and lubricates the hair and the skin.

The acne vulgaris process

Acne starts by the glands in the hair follicles increasing their sebum production. This will in the beginning only cause greasy skin. Eventually the sebum in the entrance of the follicles mixes with dead epithelial cells. This mix reacts chemically to form hard comedones that close the pore entrances. According to the color of the comedones, they are called blackheads or whiteheads.

Then the closed hair follicle gets filled with sebum and swell. The swollen follicle then gets infected by bacteria. The bacteria and the accumulated sebum cause the follicle and the surrounding skin to get inflamed, forming a pimple.  At last the inflamed follicle bursts and empties its content.  Eventually the affected area heals.

Sometimes the inflammation reaches deep into the skin surrounding the follicle and destroys skin tissue. This will cause more or less distinct scars that may reside permanently. Typically, an affected person will have follicles in all these stages of the process at any given time.

The causes of acne vulgaris

The increased hormone production during puberty stimulates increased sebum production. The male hormone, testosterone, seems to contribute most. Also girls begin to produce more testosterone during puberty. In other periods, altered hormone production may also give acne. This occurs commonly in women approaching menopause.

Since not all teens get acne to a large extent, the increased hormone level cannot be the whole cause of the increased sebum production. The follicles of affected persons may for some reasons react stronger than the higher hormone level.

Dietary factors, like eating too much fat, too much sugar or the wrong kind of fat may aggravate acne for some individuals. Lack of vitamins, minerals and essential fatty acids may also contribute to the development of acne.

Poor digestion, lazy colon and constipation aggravate acne in some individuals, probably due to productions of toxins in the intestines. Lazy colon may be caused by dietary faults like lack of fiber.

Very frequent washing and use of strong soaps aggravate acne, and does not alleviate the condition as many think. Rubbing, scrubbing or squeezing the skin may also aggravate acne.

Here are some other factors that may contribute in causing acne vulgaris or aggravating the condition

• Stress
• Some contraceptive agents
• Environmental or domestic pollution.
• Humid environments.
• Some antidepressants.
• Testosterone and anabolic steroids used for treatment or for body-building.
• Use of some types of greasy cosmetic products.
• Some antiperspirant products.
• Exposing the skin to chlorine or other halogens, or medicines containing halogens.
• Women may get aggravated acne 2-7 days before menstruation.

Types of acne

Acne starts in a similar way for all but can take different forms and can react in a unique way according to the body conditions of the individual. A basic lesion called the comedo is the beginning of acne. The comedo is an enlarged hair follicle plugged with oil and bacteria residing under the surface of your skin, waiting for the right conditions to grow into an inflamed lesion. Whenever the skin produces more oil, the bacteria grows within the swollen follicle. The surrounding skin becomes increasingly inflamed as your white blood cells fight against the intruders.

Two main types of acne vulgaris include non-inflammatory acne and inflammatory acne.

Non-inflammatory acne vulgaris

Closed comedo:

If the plugged follicle stays below the surface of the skin, the lesion is called a closed comedo. This usually appears on the skin as a small, whitish bump. This condition is otherwise known as whitehead.

Open comedo:

If the plug enlarges and pushes through the surface of the skin, the lesion is called an open comedo. The dark appearance of the plug is not due to dirt, but due to the buildup of melanin, the pigmentation element of the skin. This condition is otherwise known as blackhead.

Inflammatory acne vulgaris

Papule:

This appears on the skin as a small, firm pink bump. The papules are tender in nature and are often considered an intermediary step between non-inflammatory and clearly inflammatory lesions.

Pustule:

These are small round lesions that are inflamed and contain visible pus, which appear red at the base with a yellowish or whitish center. Pustules do not contain a large amount of bacteria. The inflammation is caused by chemical irritation from sebum components such as free fatty acids.

Cysts:

These are large pus-filled lesions that are usually present deep within the skin. The cysts are very painful lesions, as they are inflamed. Cysts form as a result of the contents of a comedo spilling over the surrounding skin and due to the response of the local immune system in producing pus. The cysts often leave deep scars.

Acne conglobata:

This is a rare but serious form of inflammatory acne that develops primarily on the back, buttocks, and chest. In addition to the presence of pustules and cysts, there may be severe bacterial infection.

Symptoms of acne vulgaris

The common symptoms of acne include persistent, recurrent red spots or swellings on the skin known as pimples. The pimples become inflamed and get filled with pus. The pimples usually occur on the face, chest, shoulders, neck, or upper portion of the back.

Some of the other symptoms include dark spots with open pores at the center, which are known as blackheads, bulged spots under the skin without openings, which are known as whiteheads, and red swellings or lumps filled with pus, which are known as pustules.

The pustules can develop from blackheads or whiteheads. Inflamed fluid-filled lumps under the skin known as cysts are also a symptom of acne. These cysts can become as large as an inch across.

Acne vulgaris gives the combination of symptoms like greasy skin, whiteheads, blackheads, pimples, inflammation and scar formation. Acne mostly affects young people aged 14 – 25 years, but also sometimes older persons, like women in their menopause. Most teenagers experience outburst of acne, some only little, but for others acne may develop into a serious skin ailment with great cosmetic impact.

What can you do yourself to avoid or to treat acne vulgaris?

Sometimes acne vulgaris is so severe that special medical treatment is required, and sometimes the causes of acne necessitate medical treatment. But you can do much yourself also.

Here are listed things you can do yourself to prevent or treat acne:

1. Some advice about diet that may help prevent and cure acne:

• Do not consume a great amount of fat.
• The fat you add to the food should be natural oils. Olive oil is ideal, but use other types of oils too, like walnut oil, coconut oil, sunflower oil and soy oil. However, do not use only soy oil as many tend to do. Using only soy oil will give you too much of some fatty acids and too less of others.
• Eat much fish, seafood and not so much meat.
• Eat food with a high fiber content to regulate the digestion, like vegetables, whole cereals, full corn bread and fruit.

2. Here are some things you should avoid.

• Do not use greasy or heavy cosmetics that clog your skin and are difficult to wash away.
• Also, do not use strong irritating antiperspirants.
• Do not wash with strong soap or cleaners that dry up your skin and take away all the natural oily protection in your skin. This can also help prevent stretch marks.
• If you perform body-building, do not use anabolic steroids or other hormonal supplements.
• Use clothes that allow air to reach your body surface to avoid collection of humidity and overheating of your skin.

3. Use of rinsing milk or solutions

You can rinse your skin with mild products especially made to dissolve the plugs in your pores, and to make the environment in your skin unfriendly to bacteria causing infection. Some of these products are just products to wash your skin with one or more times a day; others should be on during the night and flushed away in the morning.

Salicylic acid is a mild ingredient often used in these products to dissolve the comedones. The products usually also contain ingredients that are antibacterial, and stimulate the skin’s own cleaning activities, like Tea tree oil or Echinacea extract.

4. Use of gels and creams to treat acne vulgaris and protect your skin

After the rinsing, you should apply some treatment gel, cream or lotion onto your skin to achieve these effects:

• To make your skin soft and elastic.
• Protect your skin against the environment.
• Act further to dissolve the clogging of your pores.
• To soothe and alleviate inflammation.
• Kill the bacteria causing infection or make the environment hostile to the bacteria.
• Stimulate the skin to clean itself.
• To stimulate the skin for proper healing.
• To be used as an isolating layer between the skin itself and cosmetics

In order to protect, make the skin soft, and further dissolve the comedones, many products contain natural plant oils that are easily absorbed into the epidermis, like Tea tree oil, Rose hip oil, Lavender oil and Olive oil.

Ingredients used in products to reduce inflammation and to stimulate healing may be: Aloe Vera extract, Viola Tricolour extract, Rose hip oil, Vitamin E and Vitamin A.

Tea tree oil and Grapefruit seed extract are natural antibacterial agents used in many of these products. In other products, artificial compounds like Benzoyl peroxide are used.

5. Oral supplements to fight the acne process and nourish the skin

Supplements taken by mouth to nourish your skin may be useful. The purpose of these supplements is more or less the same as that of nourishing creams.

• To make the sebum more fluid so it drains more easily
• Stimulate the substance exchange and cleaning processes in your skin
• To stimulate your skin to heal
• And give your skin building nutrients necessary to heal.

Ingredients often used in these supplements to stimulate the cleaning and healing processes in the skin are: Vitamins A, C, B1, B2, B3, B6, C, D, E, Folic acid,  Beta carotene, Bioflavonoids, Magnesium, Copper, Zinc, selenium, anti-oxidants from Green tea, Metylsulfonyl methane.

Nutrients found in these products used as materials to rebuild damaged skin and to give a sebum with better consistency are: Evening primrose oil, Olive oil, Flaxseed oil, Borage oil, Soy oil, Wheat germ oil and Lecithin.

Gum guggul extract used in oral products has an antibiotic effect; helps against spreading of the acne infection; and thus helps against scar formation.

Conclusion

You now better understand what acne means, the causes, symptoms and what you can do to alleviate your condition.

However, speak with your doctor for help. Your doctor may refer you to a dermatologist who will help make a full and accurate diagnosis of your condition.

In some cases, you may need an expert treatment to fully clear and control your acne.

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