Acne is a chronic inflammatory but also recurrent disease of the sebaceous unit.
It manifests itself with a multiform rash in specific areas, such as the face, neck, sternum, shoulders, and back. It is one of the most common skin diseases, from which 9.4% of the world’s population suffers, as it affects all races and both sexes.
The pathogenesis of acne includes the following 4 disorders:
• Intense activity of the sebaceous glands resulting in increased seborrhea (i.e. oiliness of the skin).
• Disruption of keratinization within the follicle, resulting in increased keratinization and formation of a keratin plug.
• Increased colonization of the sebaceous follicle by P.Acnes (specific acne microbe, Gram positive anaerobe).
• Inflammation and specific immune reaction of the patient (with release of inflammatory mediators in the skin).
An additional role is also played by:
• heredity
• menstrual disorders
• climatic factors (humid climate, UV radiation)
• drugs, such as anabolic steroids, etc.
8 myths associated with acne
1| Acne ONLY affects teenagers and women.
Acne is the most common dermatological problem in adolescents (70%-80% of adolescents have acne lesions). But it does not only concern them, but also many adults, men and women, who are very disturbed to see that their teenage acne has never left them or that they suddenly appear in their 30s with pimples on their face.
2| It is a contagious disease.
Based on the pathogenesis of the disease, no such opinion is substantiated.
3| It is due to poor hygiene.
If one believes this myth they will soon discover that persistent scrubbing of the face will further irritate the skin and worsen acne. The ideal approach to acne hygiene should include: washing the face morning and night with a mild cleanser, gently drying with a clean towel and applying the treatment recommended by the Dermatologist.
4| It is due to the absence of sex.
There is no scientific study that shows that intercourse causes, worsens, or improves acne.
5| It is due to diet.
To date various scientific studies have failed to link diet and acne. This practically means that diet cannot cause acne. Foods like pizza, french fries or even chocolate do not lead to acne. Of course, there are people who believe that certain foods affect them. If you belong to this category, simply avoid these foods. After all, maintaining a balanced diet generally helps one’s good physical condition!
6| It’s due to stress.
The daily stress of the modern lifestyle is not a factor in worsening acne. Persistent anxiety that requires medical treatment is often treated with medications that may cause acne as a side effect.
7| There is no cure, but it will go away on its own.
Like other skin diseases, acne should be treated. Some forms of acne, such as cystic acne, can cause ugly scars on the face or other parts of the body. It is certain that the earlier one starts the appropriate treatment, the sooner one will improve the image of one’s skin.
8| The sun heals acne.
Tanning after exposure to the sun can temporarily make irritated skin and pimples less visible but it cannot cure. In the summer, one should use a sunscreen (specifically for acne-prone faces) to avoid sun-induced discoloration of recent acne lesions.
It is true that:
• It can sometimes be due to cosmetics.
This can happen by using “unsuitable” products for the skin. So one should choose non-greasy cosmetics, non-caesogenic, and non-acneogenic.
• Sometimes a microbiological test may be needed, but not as a routine test, and this is because its result does not affect the treatment, and it is not a microbial infection. P.acnes simply acts as a trigger of inflammation.
• The dermatologist may request a hormone test, but not as a routine test (this only when there are manifestations or a history of hyperandrogenemia).
Clinically, in the beginning, a boil is created (closed-white small pimple, or open-black dot), followed by its swelling, inflammation (red pimples with pus) and sometimes cysts may be created but scars may remain (especially when the patient “teasing” his pimples).
Treatment of acne
Acne treatment includes general skin care guidelines, topical medications, and oral medications.
The goals of the treatment are to treat the blockage of the sebaceous duct, to reduce seborrhea, to reduce the bacterial population and at the same time to reduce the inflammatory products produced and finally to treat the inflammation.
Isotretinoin (vitamin A derivative) is perhaps the most effective drug in the Dermatologist’s quiver, since it can not only eliminate acne lesions, but also reduces (with its correct use) the possibility of recurrence, a particularly important fact. It requires good patient-doctor cooperation and avoiding “informing” patients from the internet!
Written by:
Dimitris Rigopoulos
shoulder Professor of Dermatology – Venereology
Director of Dermatology Department HYGEIA
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