Acne usually starts in adolescence because of hormonal changes that happen as youth mature. The body begins to produce hormones called androgens, which are male hormones, but are found in both men and women. These hormones cause excess oil build up in the pores. When the oil clogs the pores, it leads to whiteheads or blackheads.
What causes acne?
When pores become clogged with oil and dead skin cells,
bacteria called acne that are already in the pores begin to increase. This leads to pimples and cysts. There are four classifications of acne. Some people may have more than one type.
Blackheads
The mildest form of acne is blackheads. While oil and bacteria are found in blackheads, it is the skin pigment keratin, not dirt, which caused the dark appearance. Because blackheads have an open pore, inflammation rarely occurs.
Whiteheads
With whiteheads, the trapped oil can rupture the hair follicle. Bacteria normally residing there may weaken the follicle wall. These same bacteria may produce special enzymes that make the oil more irritating to the skin once it escapes from the follicle.
Papules
The result of such inflammation may be papules. These raised, red, tender pimples can be as large as the blackheads. Unlike whiteheads or blackheads, pimples contain a small amount of pus. This pus is a byproduct of the body's attempt to ward off the infection responsible for the pimple in the first place.
Pustules, Nodules, and Cysts
Similar to papules, pustules contain more pus. Solid raised lesions, nodules are often bigger than half a centimeter in diameter. Unlike pustules, nodules are rooted deeper in the dermis layer of the skin. Movable, sometimes painful, pus-filled nodules are the hallmark of severe cystic acne. This type of acne is most likely to leave scars if not treated properly.
What warrants treatment?
Whiteheads and blackheads may be treated at home. Cystic acne generally warrants medical intervention.
Acne has a big effect on body image for teenagers. For some, this self-consciousness can turn into an obsessive preoccupation with their skin. Treatment will vary from person to person, depending on the severity of the acne and the psychological effect.
What treatments are available?
For some, mild acne may be controlled with over the counter preparations containing benzoil peroxide, sulfur or salicylic acid. These kill the inflammation inducing bacteria, which prevents new pimples from forming. They may also act as a drying agent to help control the oil, or as an exfoliating agent, allowing old skin to come off and open the pores.
These agents come in different concentrations and forms. Each form and concentration may affect individuals differently. Higher concentrations are not necessarily better, since these can also inflame the skin. A pharmacist can discuss possible side effects.
With any treatment, four to six weeks is generally needed for any improvement.
It takes four to six weeks for the average pimple to develop and since most treatment is aimed at stopping development, it will take at least that long to see results. It may take up to three months for acne to clear significantly.
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