ACNE

Acne is an inflammatory condition of the hair follicle known as the pilosebaceous unit and its related sebaceous glands. It is especially common during adolescence (in girls, from the ages of 11-16, in boys from 14-18) but it can occur at any age. Liv Hospital's dermatologist Associate Professor GoncaGökdemir explains:

Why does acne occur?

There are 4 main factors: an elevated production of the oil in skin known as sebum, increased stickiness in the hair follicle, micro-organisms on the surface of the skin, and infection. Acne requires the active production of sebum. In adolescence, male hormones (androgens) stimulate the growth of the sebaceous glands and the production of sebum is increased. People with acne have an oilier skin type than other people. Some of the sebum-stimulant hormones can also lead to other problems in girls and women such as the growth of body hair and menstrual irregularities. Hair follicle cells increase in acne sufferers and can cause blockages. Spots form that are commonly called blackheads (clinically termed open comedones) and whiteheads (closed comedones).

Microbial effects on the skin

The accumulation of certain microbes in the hair follicles causes acne. These are the Propionibacterium acnes, Staphylococcus epidermidis and Pityrosporum ovale bacteria.

Inflammation

Certain substances released by the bacteria can lead to an inflammatory reaction.

How significant are genetic factors in the development of spots?

If either parent has suffered from acne, there is a more than 50% chance that the child will have the condition.

How do hormonal problems cause spots?

Before adolescence the sebaceous glands are very small in size and cannot cause spots. Hormonal factors that emerge in adolescence and afterwards (hormones secreted in the ovaries and testes) cause the growth of the sebaceous glands and the accumulation of excessive oil on the skin. Androgens (most importantly the androgenic hormone testosterone) are present in both males and females. The androgen level rises during adolescence. Androgens can cause the sebaceous glands to function excessively and this leads to the growth of spots.

What situations can trigger acne?

• Acne (adolescent spots)
• Some foods: chocolate, nuts, peanuts.
• Certain medications: steroids, body-building drugs.
• Menstrual cycle
• Sunlight
• Cosmetics
• Excessive sweating
• Psychological factors and stress
• Smoking
• Recent studies indicate that "hidden diabetes" (reactive hypoglycemia) can cause the formation of acne.

How does acne appear?

Acne appears mainly on the face, back, chest and upper arms. It can take the form of black spots, red swelling, inflamed wounds and cysts. Long-term and untreated spots can appear as raised or sunken marks on the skin.

Recommendations for the treatment of acne

Skin cleansers (pH-neutral soap), External treatments(creams, lotions), benzoyl peroxide medications, antibiotics (clindamycin, erythromycin, tetracycline), Retinoids (vitamin A derivatives), azelaic acid, salicylic acid, sulfur, resorcinol.

Systemic Treatments

Antibiotics (tetracycline, doxycycline, minocycline, erythromycin, clindamycin), Retinoids (vitamin A derivatives), hormonal medications (birth control pills)

Physical Treatments

Comedone (blackhead) removal, chemical peeling (scar removal by chemical peeling process), 'dermabrasion'skin peeling method using special equipment), derma-rollers, laser treatments, PRP (platelet rich plasma) therapy.