In terms of what actually happens in the skin in Acne,there are four essential pathological components:
1. Sebum production.
Acne cannot happen without sebum. That is why babies do not suffer with it. Testosterone overproduction during puberty causes overproduction of sebum.
2. Blockage of Sebaceous ducts.
This happens because the keratin lining these ducts piles up and is shed in clumps, which block these ducts.
3. Infection.
As a result of this sebum & blockage, P. Acnes which is an Anaerobe (grows well without oxygen), multiplies.
4. Inflammation.
These bacteria now feed on the sebum, releasing irritating fatty acids that set up the redness, swelling causing papules, pustules, cysts & nodules. Other bacteria such as Staphylococcus aureus & Staphylococcus epidermidis can also get involved in this inflammation.
Acne was traditionally a problem of Puberty (high testosterone levels), however, it has recently become a problem during later years in life as well.
Some of these new causes are related to the modern life style.
One well known new cause is cosmetics.
The powders or chemicals in these cosmetics block the sebum draining ducts (sebaceous duct) in skin and cause retention of grease produced by skin.
In addition they set up irritation in these draining ducts and provoke infection. This cosmetics-induced acne is also sometimes referred to as Maturity onset acne.
In these cases, the hormonal cause should be excluded. This involves looking for high Testosterone levels in these cases. Only after high testosterone levels are not found can this be labelled “Adult onset acne”.
Chemical pollution in the air is also increasingly a cause of acne in urban environments, where vehicle pollution is on the increase.
A common & well known high-testosterone cause of acne in women is Polycystic ovary syndrome (PCOS). This can affect women between 15-40 years of age and is caused by the ovaries producing too much Testosterone. The ovaries sometimes, but not always show small cysts on their surface .These can be seen on Ultrasound examination of the Pelvis. Unfortunately these women also suffer from
- Irregular periods(always)
- Hairiness (Hirsutism)(not always))
- Acne (not always)
- Obesity (not always)
It is important to emphasise here, that the management of PCOS is essentially hormonal in that the Testosterone, which is being overproduced, needs to be addressed.
Drugs such as Metformin, Spironolactone & anti- testosterone drugs such as Cyproterone acetate are essential of its management.
Inorder to get rid of Acne pharmaclinix offers Acne Scar Cream Acnex® which has proven to be a big success with leading Dermatologists for the treatment of resistant Acne.
*Results may vary in every individual.*
Shashi Gossain
Skin care expert