Acne vulgaris is a non-contagious disease that has several causes, including heredity, genetic predisposition, changes in the production of sex hormones, infection by bacteria, and even stress.

Acne vulgaris is a very common dermatological disease associated with the production of male sex hormones. It affects the pilosebaceous glands that start to produce a larger amount of greasy secretion. This secretion is unable to pass the pore opening and accumulates there, forming open comedones (blackheads), which oxidize and darken in contact with air, or closed comedones (whiteheads). The accumulation of this substance retained by the obstruction of the hair follicles favors infection by bacteria, especially by Propionibacterium acnes.

Acne vulgaris is not contagious. The disease manifests itself more in puberty, adolescence, and young adults. In women it can persist for longer and is called adult woman acne. In these cases, the lesions are installed especially in the jaw region and can be correlated with the menstrual cycle. In men, the conditions are usually more severe and, without treatment, can extend for decades.

CLASSIFICATION

 

According to the different types and severity of lesions, acne vulgaris can be classified into:

– Acne grade I (comedonic): open and closed comedones without inflammatory signs;

– Acne grade II (papulopustular): comedones, red and inflamed papules and pustules (pimples) with pus;

– Acne grade III (nodule-cystic): appearance of cysts, that is, deeper lesions, inflamed and painful;

– Acne grade IV (conglobata): nodules, abscesses, and purulent cysts, very inflamed and intercommunicating. This form of the disease can give the bearer a disfiguring aspect;

– Acne grade V (fulminans): a rare form that causes the patient’s general condition to deteriorate and requires hospitalization.

CAUSES AND RISK FACTORS

 

Acne is a multifactorial disease. Heredity, genetic predisposition, changes in the production of sex hormones, infection by bacteria, and even emotional stress are considered risk factors for the manifestation of the disease or worsening of the condition. Although there are no studies proving the correlation between diet and the appearance of lesions, if the patient notices that certain fatty foods (chocolate, fried food, nuts, peanuts, for example) worsen the crises, they should exclude them from their usual diet. People with oily skin should also avoid using make-up products, lotions, and greasy moisturizers.

SYMPTOMS

 

Acne vulgaris lesions appear more on the face, shoulders, chest, and back, and vary in intensity according to the type of skin and predisposition to the disease Pain, itching, and irritation in the affected area are symptoms of the disease. Besides these, because of the appearance that the lesions give to the carriers, emotional, sociability, and self-esteem problems may arise. More serious lesions and improper handling of the wounds by the patients themselves can be responsible for the appearance of scars that are difficult to correct.

DIAGNOSIS

 

The clinical diagnosis takes into account the presence of acne, the appearance of lesions, and the patient’s clinical history. It is always important to establish the differential diagnosis with other diseases that cause papules and pustules to guide the specific treatment for acne vulgaris.

 TREATMENT

 

The treatment is based on the type and severity of the lesions and must be maintained until they disappear completely. In milder cases it may be sufficient to apply local medication (tretinoin/retinoic acid, benzoyl peroxide) to clear the hair follicles, control oiliness and prevent the development of bacteria. Oral or topical antibiotics, or injections inside the lesions are a therapeutic option for cases of inflammatory and purulent acne. Cleaning the skin to remove open and closed comedones only makes sense if it is part of the acne treatment prescribed by a dermatologist. Chemical peels, microdermabrasion, and laser treatment are other treatments for acne vulgaris.

RECOMMENDATIONS

 

It is always good to repeat that:

– Washing the face several times a day does not prevent the appearance of acne vulgaris or improve lesions already installed, but it is very important to clean the skin, especially at night, before bedtime;

– Squeezing pimples can result in the formation of permanent scars;

– Exposing the face to the sun’s rays has no curative effect on the lesions caused by acne;

– Seeking psychological help may represent an important resource for acne sufferers with damaged self-esteem;

– Following the guidelines of a dermatologist is the best, if not the only, way to treat skin diseases.

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