ISKRA HEALTH SYSTEM

Acne Vulgaris

Acne vulgaris is called "common acne" as nearly everyone suffers from outbreaks of pimples at some point in life. It is an inflamatory skin disease that affects the sebaceus (oil) glands of the skin. Acne is hormonal related overproduction of oil by the sebaceus glands. A greasy skin could be the first indication of predisposition to acne. The oil that normally lubricates the skin gets trapped in blocked oil ducts within the hair folicules on the face, outer ear canal, back, chest and groin. In severe cases acne may spread as far as the legs. It results in what we know as pimples, blackheads, and whiteheads on the surface of skin. Sometimes it also includes cysts -  deeper skin lesions. 

Blockage of the duct leading from the sebaceus gland to the skin openings (pores) traps secretions inside the duct and forms dark formations called blackheads. If the openings are large, the clogs take the form of blackheads: small, flat spots with centers darkened by exposure to air. They contain mixture of oil and cells.

If the openings are small, the clogs take the form of whiteheads: small, closed, flesh-or white colored bumps.

Both types of plugged pores can develop into swollen, tender inflammations or pimples or deeper lumps or nodules. Pimples sometimes contain pus.

Bacteria on the skin can be trapped inside the blocked ducts. Bacterial enzymes break down skin oil and trigger inflamation.

Cystic acne is assosiated with severe cases of acne. Cysts are closed sacs beneath the skin or deeper that contain fluid, semisolid or solid substances. They may become inflamed and sometimes infected.

The condition usually starts at puberty and peaks at 17 - 21 although the acne is not restricted to the youth age. Older adults and children can also have acne. In most people, acne will last for about three to four years and in 15% of the cases, acne can continue for 8 - 12 years. In a smaller percentage (5%), acne will last beyond age 25 and can continue up to age 40.

In women particularly, acne may not occur until age 25. In 70% of the cases, women will notice a flare-up in the acne condition prior their menstrual period, perhaps due to an increase of androgens. Androgens are steroid hormones responsible for the development and maintenance of male physical characteristics.The more severe cases of acne tend to occur most often in men, because they produce more of the male hormones that stimulate acne formation. Teenage boys tend to have the most severe cases.

Women with a lot of body or facial hair, and those who have irregular periods, may be at increased risk of acne. These women may want to have their hormone levels evaluated by a physician.

What causes acne? 

Acne isn't caused by a harmful diet, poor hygiene, or an uncontrolled sex drive. The simple truth is that heredity and hormones are behind most forms of acne. Stress can aggravate acne, but it clearly does not cause it.

Hormones. Common acne in teenagers starts with an increase in hormone production. During puberty, both boys and girls produce high levels of androgens, the male sex hormones that include testosterone. Testosterone signals the body to make more sebum, a waxy substance that helps the skin retain moisture.

Bacteria. Excess sebum clogs the openings to hair follicles -- especially those on the face, neck, chest, and back. Bacteria grow in these clogged follicles. This makes blackheads or whiteheads form on the skin's surface -- a condition called non-inflammatory acne. Sometimes the follicle wall breaks under the pressure of this buildup. When this happens, sebum leaks into nearby tissues and forms a pustule -- this is called inflammatory acne. This can create cysts. Ruptured cysts can leave temporary or permanent scars.

Depending on the type of pill, oral contraceptives may trigger acne in some women but suppress it in others. Steroids taken by some bodybuilders and other athletes can also lead to severe outbreaks.

Acne has many subtypes. Acne neonatorum and acne infantum occasionally affect newborns and infants, usually boys. A pimply rash appears on the face but usually clears within weeks with no lasting effect. People who escaped their teen years almost pimple free may develop persistent adult-onset acne as they get older.

How a person's skin responds to an increase in sebum production has to be taken into account as well.

The bacteria Propionibacterium acnes and Staphylococcus epidermidis occur naturally in healthy hair follicles. If too many of them accumulate in plugged follicles, they may secrete enzymes that break down sebum and cause inflammation. Some people are simply more sensitive than others to this reaction. Sebum levels that might cause a pimple or two in one person may result in widespread outbreaks -- or even acute cystic acne -- in another person.

Rosacea

Rosacea, also referred to as acne rosacea, is different from acne vulgaris. Unlike Acne vulgaris, Rosacea isn't common problem for teenagers. Rosacea affects mostly adults between the ages of 30 to 50 years. People with fair skin are more often affected, although darker skin types may also experience symptoms. Recent study shown that 75 percent of the Rosacea sufferers are women and 58 percent of them are Europeans, the study also shown that Rosacea is more severe in men than in women. Rosacea is fairly common. It affects over 50 million people worldwide and 75 percent of sufferers are women and while its symptoms may wax and wane, it is most often referred to as a chronic condition. Rosacea is usually a progressive disease, and without treatment may continue to worsen over time. Rosacea can also cause emotional repercussions.

Acne Rosacea is a chronic skin condition affecting commonly both the skin and the eyes and less commonly the chest, neck and shoulders. If affects mostly the central part of the face, especially the central forehead, nose, chin and cheeks. It begins as  frequent or sustained redness on the skin, blushing or flushing. In women, this is not to be confused with monthly flushing before menstruation.

The skin appears red and inflamed. Rosacea is a facial eruption and if not treated properly it can cause more serious problems later in time like telangiectasias / broken capillaries/, erythematous papules, pustules, gritty eyes, rhynophyma. If Acne Rosacea isn't treated in time the affected areas may become more inflamed with swelling, pus spots and broken capillaries.