Acne: The bane of existence

Acne, most commonly known as pimples, is the bane of almost every face and the worst nightmare for those too unfortunate to suffer.

It is the most common skin disease today.  In United States alone, nearly 60 million people are infected with acne, where 85 per cent of teenagers suffer from it.     

Acne is a disorder resulting from the action of hormones on the skin's oil glands (sebaceous glands), which leads to plugged pores and outbreaks of lesions commonly called pimples or zits. Acne lesions usually occur on the face, neck, back, chest, and shoulders.

Contrary to the popular belief, acne is not just teenagers’ diseases.  It is socially taboo, that can be upsetting and disfiguring.  It has a significant economic impact where people spend a lot of money on non-prescription and prescription treatments and therapies.

Acne cases vary from mild to severely disfiguring.  It ranges from comedones (blackheads and whiteheads) to nodules and cysts.  Here are several acne terms that can help you better understand acne.

Comedo or Comedones are simply a plugged and enlarged hair follicle.  When a comedo is open, it is usually called a blackhead.  When it is closed or deep into the skin, it is usually called whitehead. The whitehead differs in color from the blackhead because the opening of the plugged sebaceous follicle to the skin’s surface is closed or very narrow, in contrast to the distended follicular opening of the blackhead. Neither blackheads nor whiteheads should be squeezed or picked open, unless extracted by a dermatologist under sterile conditions. Tissue injured by squeezing or picking can become infected by staphylococci, streptococci and other skin bacteria.

Papules are inflamed lesions that usually appears as small, pink bumps on the skin and can be tender to the touch. A group of very small papules and microcomedones may be almost invisible but have a "sandpaper" feel to the touch. A papule is caused by localized cellular reaction to the process of acne.

Pustules are papules topped by pus-filled lesions that may be red at the base.  A pustule that forms over a sebaceous follicle usually has a hair in the center. Acne pustules that heal without progressing to cystic form usually leave no scars.

Nodules are solid, dome-shaped or irregularly- shaped lesions.  They are commonly characterized by inflammation, extend into deeper layers of the skin and may cause tissue destruction that result in scarring. A nodule may be very painful. Nodular acne is a severe form of acne that may not respond to therapies other than isotretinoin.

Cysts can appear similar to nodules but are pus-filled, very painful and can cause scarring.   They are usually described as having a diameter of 5 mm or more across.