UNDERSTANDING ACNE: CAUSES, SYMPTOMS & EFFECTIVE TREATMENT OPTIONS

Acne is a common condition that affects the population around the world. It refers to a chronic inflammation of sebaceous hair follicles. These follicles are androgen-dependent and connected to big sebaceous (oily) glands. This type of follicle is present on the face, chest, shoulders, and back, explaining the distribution of the acne lesions. 

It is common during puberty with the activation of the sebaceous glands, but it can occur at any age.  While this is not a dangerous condition, it does leave scars on the skin. 

In this blog, you will know more about the acne problem, its root cause, symptoms, how to diagnose it, and the proper treatment options.

Causes of Acne (Pimples)

Our skin has pores that are connected to the oil glands present under the skin. The glands produce Sebum, which is an oily liquid. It is the carrier of dead skin cells from hair follicles to the skin. Through every follicle, hair grows out of the skin.
There is an underlying genetic predisposition. Accordingly, acne affects some families more than others.

Acne results from:

• Excessive sebum production, which can block the pores, leading to an excessive sebum build-up under the skin.
• Increased the thickness of the sebaceous duct (pilosebaceous cornification)
• Bacteria: When hair sebum and skin cells clump together into a plug, it increases the chances of colonization of the sebaceous ducts by bacteria.
• Release of certain inflammatory mediators can lead to acne formation.

Steps of Acne Formation:

At puberty, androgen-sensitive hair follicles show a hyper-responsiveness that results in increased abnormal sebum secretion. This abnormal sebum leads to increased thickness of the canal between the sebaceous gland and the outside. A process called hyperkeratosis of the pathway of sebum. These result in the formation of the primary lesion, the comedones. They are either open black heads or closed white heads. 

The bacteria increase abruptly at puberty due to increased sebum secretions. They secrete many chemicals (inflammatory mediators) leading to inflammatory lesions of acne, such as inflamed papules, pustules (pimples with pus inside the product of interaction between bacteria and immune cells), nodules (raised pimples), or cysts (with clear fluid inside). 

Acne (Pimples) Symptoms

Acne generally appears on the face, chest, back, and shoulders at the age of puberty. It can affect males and females equally. Symptoms may include: 

• Pleomorphic comedones (Blackheads or whiteheads) 
• Cysts 
• Papules 
• Pustules  
• Post-acne scars can also occur 

Acne (Pimples) Diagnosis 

It is often easy for the dermatologist to look at your skin and diagnose acne. It involves examination of your chest, back, face and other places for sore nodules or blackheads.

Acne (Pimples) Treatment & types of pimples

The type of treatment suggested to any patient depends on the severity of their acne: 

It can be categorized into: 

• Mild – These mostly include blackheads and whiteheads with a few pustules and papules. These usually don’t hurt much, and there isn’t a lot of swelling around the lumps. 
• Moderate – These have a higher number and more widespread blackheads, whiteheads, and pustules. Topical treatment is needed here, such as topical retinoids, benzoyl peroxide, antibiotics, and azelaic acid.  Additionally, oral antibiotics can be added. 
• Severe – This includes a large number of pustules and papules. Furthermore, these can be painful and, in most cases, leave scars on the skin.

Only topical treatment is needed:

1. Topical retinoids: act by decreasing the thickness of the ducts and have anti-inflammatory action as well. The most common side effect of this cream is facial irritation. It should be used at night only.
2. Topical benzoyl peroxide: acts by changing the medium that helps the bacteria to grow. Hence, inhibiting the activity of bacteria and aborting infection.
3. Topical antibiotic: acts by killing the bacteria.
4. Topical azelaic acid: acts by decreasing the thickness of the ducts and has an anti-inflammatory effect as well.

The proper treatment in these cases is only systemic treatment, given by the dermatologist only under monitoring with certain precautions.

Precautionary guidance for acne treatment

1. Systemic isotretinoin: It has multiple side effects, which is why it should be taken under the close guidance of your dermatologist. It leads to cracked lips, dry skin, eyes, and nose.
   
   Additionally, it leads to a transient increase in the triglyceride level and liver enzymes. So, adhere to your dermatologist’s advice on going for serial blood tests.
   
   For married females in the childbearing period, they need to use two methods of contraception. Isotretinoin can lead to a child’s malformation if taken by a pregnant female.
2. Systemic antibiotic: It should be taken for 2 to 4 months with follow-ups with your dermatologist.
3. Oral Contraceptives: If acne is linked to hormonal changes in women, oral contraceptives may be recommended as anti-androgen to suppress overactive glands and are commonly used as long-term treatments for acne in women.

Conclusion

Effective acne treatment works by reducing oil production, boosting skin cell turnover, and combating bacteria to reduce inflammation, which helps prevent scarring. Achieving complete clearance and healthier skin may take a long time. You need to be patient and adhere to your follow-up appointments with your dermatologist to get the proper results of acne treatment. 

Acne can significantly impact your life in more ways than one. Beyond discomfort and pain, it can leave permanent scars, affecting your confidence and self-esteem. This makes it essential to visit a top dermatologist in Abu Dhabi at Reem Hospital to choose the best treatment available.