Acne is Not Spots

by Frank Williams

There are several different types of acne, depending on how or why the acne developed. Some of the forms of acne are: acne conglobata (chronic boils); acne fulminans (an extreme form of conglobata); acne cosmetica (caused by cosmetics); acne keloidalis nuchae (from shaving); acne medicamentosa (caused by starting or stopping a medication); acne rosacea (redness on the face); baby acne; hormonal acne; cloracne and the common variety: acne vulgaris (better known as ‘puberty spots’). We will take a closer look at acne vulgaris.
Acne vulgaris may be defined as: ‘an inflammatory disease of the skin, caused by changes in the pilosebaceous units (skin structures consisting of a hair follicle and its associated sebaceous gland). Acne lesions are commonly referred to as pimples, spots or zits’ (see article on “Acne” in Wikipedia).

Acne is most often found in Western teenagers, although it does occur in every country in the world, so there could be a genetic weakness to it. It is possible that it may be an abnormal reaction to quite average levels of testosterone. For most sufferers, the condition lasts only until adulthood, probably only a few years or at most ten. For others, however, it can be a life-long recurring problem. It usually affects the face, upper-chest, upper-arms and back. However, an occasional spot is not the same as acne.

Acne vulgaris appears in various forms, which include: whiteheads, resulting from pores that are totally blocked, trapping sebum (oil), bacteria, and dead skin cells, causing a white appearance on the top; blackheads, resulting from pores which are only partially blocked, allowing some of the trapped sebum, bacteria, and dead skin cells to slowly drain to the surface (the black colour is not a result of dirt, but is a reaction of the skin’s own pigment, called melanin, with the oxygen in the air); papules, which are inflamed, red, tender bumps with no head and pustules, which are similar to whiteheads, but are inflamed, and look like red circles with a white or yellow centre.

Whiteheads do not usually last for a long time; blackheads do last a long time and pustules are what people usually refer to as spots or zits. Severe acne vulgaris is distinguished by nodules and cysts. A ‘nodule’ is a rather larger and much more painful type of pustule and can often last for months. Nodules are large, hard lumps just under the skin. They frequently result in scarring and should never for any reason be squeezed, since this could make them last for months longer.

A ‘cyst’ may appear similar to a nodule, but it is full of pus and has been defined as having a diameter of at least 5mm and, again, can cause scars and cause pain. Squeezing an acne cyst can cause a more severe infection and more acute inflammation which can last quite a bit longer than if it had not been squeezed. Skin experts have ways of lessening the swelling and preventing scarring with both nodules and cysts. It is just a myth that acne sufferers are not meticulous about their hygiene.

In fact, excessive washing can exacerbate acne. There are many, many false ‘cures’ on the market and many, many old wives’ tales. However, any good skin expert would tell you that there is no sure-fire remedy for acne and that the sufferer should follow a deliberate regimen of cleansing until the acne just ‘goes away’ of its own accord.

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