acne

acne

[ak-nee]
acne, common inflammatory disease of the hair follicles and sebaceous glands characterized by blackheads, whiteheads, pustules, nodules and, in the more severe forms, by cysts and scarring. The lesions appear on the face, neck, back, chest, and arms. There are several types of acne, including tropical acne, a condition of light-skinned people who are exposed to unaccustomed heat and humidity, and chloracne, a form resulting from exposure to chlorinated hydrocarbons.

The most common type is acne vulgaris, a form prevalent among adolescents. Although its exact cause is not known, it is undoubtedly related both to genetic predisposition and to the increased hormonal activity that occurs at puberty, which causes an overproduction of sebum, the oily secretion of the sebaceous glands. Exposure to external oils and grease (e.g., oil-based cosmetics or hair products, occupational use of cooking oils) can worsen the condition. There is no connection between diet and acne.

Washing the skin removes surface oils and can prevent acne from spreading. The contents of blackheads and pustular lesions should be evacuated only by a physician under proper aseptic conditions to lessen the possibility of scarring. Application of benzoyl peroxide, retinoic acid, azelaic acid, and antibiotics to the skin can clear many cases; exposure to ultraviolet light may also be used. More severe cases of acne may require oral antibiotic treatment. Treatment of the most resistant cases of acne includes the use of isotretinoin (Accutane), a drug that decreases sebaceous secretions. Isotretinoin is a well-established teratogen (i.e., it causes birth defects) and is not given to women who are pregnant. In the past dermabrasion (scraping off of the top layer of skin) was used to improve the appearance of skin scarred by acne, but such severe effects can now be avoided with proper treatment.

Inflammatory disease of the oil glands of the skin. Acne vulgaris, probably the most frequent chronic skin disorder, results from an interplay of hereditary factors, hormones, and bacteria, beginning in the teen years when overactive sebaceous glands are stimulated by high levels of androgens. Its primary lesion, the blackhead, may be open or closed; it consists of a plug of skin oil (sebum), cell debris, and microorganisms in a hair follicle. Acne has four grades of severity, with increasing degrees of spread, inflammation, pustule formation, and scarring. Methods of treatment vary from skin medication to antibiotics and hormones; many cases eventually resolve spontaneously.

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