What Causes Acne and Pimples?
Pimples is the layman’s term for Acne Vulgaris, a medical condition of the skin. Pimples are caused by a sequence of events and can be simply explained to be due to a few main factors:
1. Skin that is TOO OILY
When a person is going through hormonal changes in their life, such as during puberty, the skin becomes too oily (with a substance called sebum). This excess oil mixes with the dead skin flakes on the skin to form a sticky paste that blocks the pores.
2. Too much DEAD SKIN FLAKES
Normal skin constantly sheds. When there is a lot of dead skin flakes around, and there is a lot of oil produced by the skin, these will become a sticky paste and block the pores of the oil glands.
3. BACTERIA Growth
Our skin has bacteria called Proprionebacterium Acnes, which infects the clogged pores and causes inflammation. This inflammation can range from small tiny spots called papules, to large, pus filled lumps called nodules.
What Are Blackheads and Whiteheads?
When pores are blocked, the pores can be either open, where a small blackish plug can be seen. These are called blackheads. In the other situation, the pores are completely blocked and the plugs are below the surface of the skin. In this situation, the blockage appears white, and are thus called whiteheads.
What are the Different Grades of Acne?
There is a medical classification of acne, which divides acne up into many different categories. However for most people, acne can be broadly categorised into 3 categories:
1. Comedonal Acne – Where there are just small whiteheads and blackheads on the face, and occasional red spots.
2. Papular Acne – Where there are small red spots and inflammed pimples (without pus or deep lumps)
3. Nodulo-pustular Acne – Where there are deep lumps which are collections of pus called nodules, and angry red spots which have pus forming on the tops, called pustules.
The differing grades of acne are treated differently and have different after effects in terms of scarring, obviously worst with severe nodulo-pustular acne.
Is Acne just a Skin Condition?
Aside from scarring, its main effects are psychological, such as reduced self esteem and in very extreme cases, depression or suicide. Acne usually appears during adolescence, when people already tend to be most socially insecure. Early and aggressive treatment is therefore advocated by some to lessen the overall long-term impact to individuals. It is important that the entire spectrum of acne and acne related conditions is appreciated and treated by the doctor seeing you.
What Causes Scars?
During the acute inflammatory phase of acne, the skin is damaged by the infection and results in fibrous tissue called scars being formed. In addition, the inflammation causes new blood vessels to be formed in the skin, making the scars purple. Also, scars tend to develop more brown pigment called melanin than the surrounding areas. This leads to darkening (also called hyperpigmentation) of the scars.
What are the Different Types of Scars?
The different types of scars can be divided into:
1. Pigmented Scars – these are brown in color due to the increased pigment called melanin produced after recovery of the pimple.
2. Vascular Scars – these are purplish in color due to the increased tiny blood vessels called capillaries running through the scar. This usually happens together with pigmentation.
3. Rolling Scars – these are depressed scars, which look like rolling hills.
4. Box-car Scars – these scars are punched-out and have steep walls.
5. Ice-pick Scars – these have a characteristic appearance of being pricked out by an ice pick. They are deep and narrow.
6. Hypertrophic Scars – these are raised and bumpy scars that are stable and not growing rapidly. They tend to be light colored.
7. Keloid Scars – these are raised, bumpy and growing rapidly. They are usually dark and may have obvious blood vessels running through them.
How is Acne Treated?
Acne treatment is very customised. There are a large number of treatments available on the market today. They range from:
6. Photodynamic Therapy
7. Antibiotic Pills
8. Oral Retinoids
The treatment of acne is a science which relies on accurate diagnosis of the problem, and instituting the appropriate treatment. These should only be prescribed by a doctor with appropriate experience in treating the problems.
How are Pimple Scars Treated?
Pimple scars have a variety of treatments. We will be covering this in more detail soon. Stay posted!