Acne is a relatively common skin disease. It is the result of a set of processes related to the formation of comedones and blackheads, to hormonal stimulation in bacterial colonization skin to inflammation and an immune response more or less intense than the individual. There is acne induced by mechanical factors, chemicals, cosmetics sometimes difficult to identify. The role of stress has also been mentioned in acne.
Acne affects about 80 to 90% of people in their teens when the alarm hormonal causes a transient occurrence of the disease. The vast majority of adolescent acne back to normal in a few years, sometimes aided by women adequate contraception. A teenager out of 5 typically consults a doctor or dermatologist for severe or bothersome forms.
Adult, acne is rarer over 30 years. It affects around 2-3% of men and 10-15% of women. The occurrence of acne after 30 years requires a review of clinical and research predisposing cause.
Mechanism of occurrence of acne
The mechanism of formation of acne pimples, comedones and blackheads is now relatively well known. Under the stimulation of multiple factors, the upper channel hairs (follicular infundibulum) become narrower. Cells in this area (keratinocytes) become larger and wider than the other and have more filaments interconnection between there. This results in a decrease in the channel. This cell stimulation also produces hyper keratinization: This area becomes hard and resistant. It loses its elasticity. These changes favor the creation of a ‘reservoir’ narrow neck and resistant where secretions will struggle to flow naturally.
The steroid hormones from the ovaries, testes, but glands above kidneys produce stimulation to the sebaceous glands. Receptor stimulation of these glands by androgens causes increased synthesis of sebum in the gland.
This double phenomenon of accelerating the production of sebum and reduce volume of capacity ‘pipes’ to remove excess leads to congestion follicular structures of the skin. There are major changes, process of tension, stimulating inflammation. Stasis promotes colonization by bacteria (Staphylococcus or P. acnes) that weaken the area. Similarly, handling damage (popping the buttons for example) the process worsens inflammation / infection / immunity.
The occurrence of lesions in acne is the result of a cascade of complex physico-chemical phenomena leading to partial or complete obstruction of the follicle and in inflammatory and infectious destructive.
The evolution of damage can be done to channel formation, cysts, and skin infections worse. At this advanced stage, phenomena occur scar responsible permanent scarring. There are many variations of acne scars.
Signs and symptoms of acne (medical diagnosis)
Acne lesions (pimples, redness, cysts, blackheads, blackheads) are most often on the face (face) and to a lesser extent on the shoulders, neck and upper back and finally the thorax.
There are a variety of forms of acne and especially evolutionary stages and different severities. To guide and monitor acne, its evolution and treatment efficacy, general practitioners, dermatologists or Laser specialist use classifications, the most famous and classification of Burton.
In the early stages of acne, there is a tendency for poverty to be fat. It is a feeling related to the production of sebum in larger amounts than normal.
Doctors can make the diagnosis of acne in later stages such as comedonal phase. This is the form of non-inflammatory acne. The skin is produced and blackheads access sebum responsible oiliness.
At a later stage, we note the presence of papules, red areas (inflammation) or even pustules. At a later stage, the disintegration of the tissue resulted in nodules that can develop into cysts.
Blackheads: Changing keratinocytes cells, leaving the follicle, resulting in the production of a dark cap (black dot) and stasis of sebum in the follicle. There is still no inflammation at this stage.
Papules: it is already a stage where changes of the follicle and the sebaceous gland produces an inflammatory response and impaired skin relief.
Pustules: a stage a little more advanced. There has been an eruption of pustules.
Nodules and cysts: when the acne is severe, the deformation of follicles can be as deep cysts. These may eventually merge or communicate. This is an advanced stage of the disease. Inflammation, infection, immune phenomena and healing are at their maximum.
Scars: sequels of acne mainly reflect the appearance of scars usually final. They are embossed, indented, ice pick, tunneled fistulising, red (erythematous), hyperpigmented, atrophic keloids … depending on how they have evolved during the active phase of acne. Most of the time, there was no spontaneous improvement of these lesions. Different aesthetic techniques, however, can be used to attempt to erase or reduce: peels, laser surgical procedures (puncture / recovery), suture excision, and injection of fillers…