Acne

Acne is a pustular infection of the skin, due to changes in the sebaceous glands. Excessive secretion of oils from the glands can cause the hair follicles to become blocked, and they suffer from bacterial infections which causes a pimple. The face, chest, back and upper arms are especially exposed. It is common in puberty as a result of an abnormal response to normal levels of male hormone, testosterone. For the acne sufferer this has a profound effect on the skin. The response for most people goes over time and the acne decreases continually. But there is no way to predict how long that will take, from years to up to decades for some individuals.

Causes for acne

Exactly why some people get acne and some do not is not fully known. It appears that children whose parents suffered from acne have a larger probability to develop acne than others, but the connection is not verified. Four factors are known to cause acne:

• Hormonial activity
• Hyperactive sebaceous glands
• Accumulation of dead skin cells
• Bacteria in the pores
• Anabolic steroids
• Birthcontrol pills, however many women have reported reduced acne while on the pill
• Those exposed to high levels of chlorine compounds, particularly chlorinated dioxins, often develop severe, long-lasting acne, known as Chloracne

Not causes for acne

Since the medical knowledge about acne is still relatively small, many misconceptions and rumours about what causes acne exits:

• Diet. It is not impossible that a changed diet can help clear acne for a certain individual. But no general correlation has been found. Chocolate, chips, sugar, milk and seafood among others have not been shown to effect acne.
• Deficient personal hygiene. Acne is not caused by dirt. This misconception probably comes from the fact that blackheads by their nature are black and the acne infected skin, therefore, looks dirty.
• Sex. Rumours have had it that both celibacy and masturbation are causes for acne. This is not the case.

Treatments

There is a myriad of products sold for the treatment of acne, many of them without any scientifically proven effects. Generally there are two types of treatments that have been proven effective:

Killing the bacteria that is caused by the blocked follicles. Either by the intake of antibiotics like tetracyclines or treating the affected areas externally with bactericidal substances like benzoyl peroxide. Since the bacteria isn't the cause of acne but rather the effect of it acne will generally reappear months after finished treatment.

Reducing the secretion of oils from the glands. This is done by a great daily intake of Vitamin A derivates like isotretinoin over a period over a few months. Isotretinoin has been shown to be very effective in treating severe acne and is effective in up to 80% of the patients. The drug has a much longer effect than anti-bacterial treatments and will often cure acne for good. The treatment requires close medical examination by a dermatologist since the drug has many known side effects. The most common are dry skin and nosebleed. It can also permanently damage the liver. The product is sold by Roche under the names Accutane in USA and Roaccutane in Europe.

Acne scars

Severe acne often leaves nasty scars where the skin gets a "volcanic" shape. Acne scars are very hard (and expensive) to treat and it is unusual for the scars to be successfully removed completely. In those cases, scar treatment may be appropriate. The most commonly used forms of scar treatments are:

• Dermabrasion. The top layer of the skin is removed to make the scar look less pitted. It makes the scar less visible but does not remove it completely. Multiple treatments may be necessary to get the desired results.
• Laser resurfacing. A laser is used to burn off the top layer of the skin.
• Punch excision. The scar is excised with a punch tool and the edges are sutured together.
• Chemical peels. Different types of acid are applied to the skin so that a smoother layer can surface.
• Subcision. The scar is detached from deeper tissue, allowing a pool of blood to form under the scar which helps form a connective tissue under the scar, levelling it with the surface.

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