Acne vulgaris is a non-contagious disease that causes several factors, 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 greater amount of fatty secretion. This secretion cannot get beyond the opening of the pore and accumulates there forming open comedones (blackheads) that oxidize and darken in contact with the air, or closed comedones (whiteheads). The accumulation of this substance retained by the obstruction of hair follicles favors infection by bacteria, especially by Propionibacterium acnes .

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

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

  • Grade I acne (comedonic): open and closed comedones without inflammatory signs;
  • Grade II acne (papule-pustular): comedones, red and inflamed papules and pustules (pimples) with pus;
  •  Grade III acne (nodule-cystic): appearance of cysts, that is, deeper, inflamed and painful lesions;
  • Grade IV acne (conglobata): nodules, abscesses and purulent cysts, very inflamed and intercommunicating. This form of the disease can give the patient a disfiguring aspect;
  • Grade V acne (fulminans): a rare form that causes a fall in the patient’s general condition 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 the diet and the appearance of lesions, if the patient notices that certain fatty foods (chocolate, fried foods, nuts, peanuts, for example) worsen the crises, he should exclude them from the usual diet. People with oily skin should also avoid using makeup products, lotions and greasy moisturizers.

 

SYMPTOMS

 

The lesions of acne vulgaris 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 areas are symptoms of the disease. In addition to these, because of the appearance that injuries give to carriers, emotional problems, sociability and compromised self-esteem may arise.

More serious injuries and inadequate wound handling by patients themselves may be responsible for the appearance of scars that are difficult to correct.

 

DIAGNOSIS

 

The clinical diagnosis considers the presence of comedones, the appearance of the lesions and the patient’s 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 their complete disappearance. In the mildest cases, the local application of medications (tretinoin / retinoic acid, benzoyl peroxide) may be sufficient to unclog hair follicles, control oiliness and prevent the development of bacteria.

Antibiotics orally or topically or in the form of injections inside the lesions represent 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 are other therapeutic methods indicated for acne vulgaris.

 

RECOMMENDATIONS

 

It is always good to repeat that:

  • Washing your face several times a day does not prevent the appearance of acne vulgaris or improve the lesions already installed, but it is very important to clean the skin, especially at night, before sleeping;
  • Squeezing the pimples can result in the formation of permanent scars;
  • Exposing the face to sunlight does not have a curative effect on the lesions caused by acne;
  • Seeking psychological help can represent an important resource for acne sufferers with impaired self-esteem;
  • Following the advice of a dermatologist is the best, if not the only, way to treat skin diseases.