Acne is Not the Same as Spots

There are several different types of acne, depending on how or why the acne arose. Some of the types 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 concentrate on acne vulgaris.

Acne vulgaris can 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’ (from Wikipedia).

Acne is most common in Western teenagers, although it does occur in every country in the world, so there may be a genetic weakness to it. It is possible that it could 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 affliction. It usually affects the face, upper-chest, upper-arms and back. However, an occasional spot does not constitute acne.

Acne vulgaris appears in various forms, which include: whiteheads, caused by pores which are totally blocked, trapping sebum (oil), bacteria, and dead skin cells, resulting in a white appearance on the top; blackheads, caused by 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 caused by 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 lumps with no head and pustules, which are like whiteheads, but are inflamed, and appear as red circles with a white or yellow centre.

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

A ‘cyst’ can look similar to a nodule, but it is pus-filled, and has been defined as having a diameter of at least 5mm and, again, can leave scars and cause pain. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which will last very much longer than if it had been left alone. Skin experts have ways of lessening swelling and preventing scarring with both nodules and cysts. It is not true that acne sufferers are not careful about cleanliness.

Indeed, it is a little-known fact that, excessive washing can irritate acne. There are many, many false ‘treatments’ in the shops and many, many old wives’ tales. However, any honest skin expert would advise you that there is no sure-fire remedy for acne and that the patient should follow a deliberate regimen of cleansing until the acne eventually ‘goes away’ on its own.