The course of acne one particular individual / patient may unfortunately not be predicted. This is especially the fact that it deals mainly with the symptoms and not the cause. Only Roa and iso set there and reduce the production of the sebaceous glands, so that a "cure" can be achieved. But here is a definitive cure is not guaranteed. "Acne flare-ups" are possible.
Acne Stages and Phases
The skin can be divided into several stages of acne at one or phases. As a rule, before they accept a tripartite division, which later in all three stages are to be found more or less simultaneously. In the first phase to form the comedo, is known as the predominant primary noninflammatory (blackheads). Later in the comedones can become inflamed and lead to the second stage of secondary inflammatory lesions (papules, pustules). The third and final stage is characterized by inflammatory lesions not tertiary (scars) after healing of skin lesions.
Acne course dependent on the shape and characteristics
The possible course of acne is also directly related to the severity and type of skin disease. An example acne vulgaris has their main source of hormone changes will disappear after puberty alone. So they say that most acne patients with the common acne lesions in age from about 13/14 (possible with individual comedones, papules and pustules later) have until early 20s. The hormonal changes can last well until the beginning of the third decade of life. In women, such a change caused by hormonal changes in the last cycle or during pregnancy a little longer.
Correct severe forms of acne, and gradients are rare. In this it is often the case that there are spots remain and form at the end after healing scars. Exogenously induced acne forms can occur at any age!
In any case, the course of acne, however, with an appropriate and will be favored, especially early in therapy dermatologist. Symptoms are not so much out and the scarring can be reduced.
Acne Diagnosis
The diagnosis of acne is usually through the skin doctor (or GP) made simply on the basis of appearance. If the young people in puberty and shows an oily skin with pimples, blackheads (comedones), papules and / or pustules will be closed quickly on acne. Based on the spread (occurrence), level and number of inflammatory or non-inflammatory lesions can (special) form and severity can be determined.
Acne Smear and other tests
The dermatologist also has the option of pustules and papules to take a swab and then examined in the laboratory may be in order to detect bacteria. Besides the typical acne bacteria and staphylococci present, there is a super-infection. The staphylococcal aggravate the inflammation and contribute to a much worse skin. In female patients, the doctor may perform a blood test if he thinks that there may be a hormonal cause of acne. Other blood tests such as blood count, liver and kidney values are generally only performed when an internal treatment is planned.
Differential Diagnosis
The dermatologist will also rule out other skin diseases like, can be the cause for such typical acne lesions (eg, allergies to medications or cosmetics). Also important is the very physical examination to determine the general health is, and to any underlying medical conditions (especially hormonal or metabolic disorders) to exclude. In addition, show at first glance, not all affected skin areas.
Acne Anamnesis
Any self-care, medical history and previous treatments for the physician in the anamnesis of interest in order to get a picture. Also, life habits (alcohol, nicotine consumption), symptoms, sleep patterns, time of first occurrence of acne, development, nutrition, and details about the skin care help here to make a diagnosis. A prädispositionelle bias in the family is to be examined as well. Then forwarded to the skin doctor a consistent treatment of acne.
As a patient should be cleaned before such a visit to the doctor only mild skin and apply no make-up or camouflage, so that the actual disease can be determined.
Acne symptoms are a result of the multi-factorial interaction between the acne causes, depending on the acne, stage and severity in varying degrees. Once acne-typical skin manifestations occur, necessarily, a skin doctor (dermatologist) should be consulted.
Oily skin, blackheads, papules, pustules
Due to the positive influence of male sex hormones (androgens) on the production of sebum can clog pores. In consequence of which leads to the formation of comedones (blackheads). These can be open or closed comedones and appear therefore as a small black or yellow dots. The dark color is caused by melanin. Equally striking is that those affected have due to the increased production of sebum often have a very oily skin. Also, a combination skin with oily T-zone is often encountered. The above mentioned comedones are therefore the first sign of acne. Mild forms remain available at this point, we speak of a very mild acne vulgaris (common acne) and a non-inflammatory stage. However, it may then caused by the bacteria Propionibacterium acnes (the acne bacterium) and Staphylococcus epidermidis a danger of ignition and the emergence of papules and pustules (inflammatory stage). In particular, the severe forms of acne are highlighted even more by inflammatory nodules and cysts. Swelling, itching and pain to headaches, fever and sepsis can go hand in hand there.
Occurrence of acne lesions
Acne lesions may appear basically anywhere where sebaceous glands are sitting. Especially in areas with many of these glands, such as face, neck, back, shoulder and neckline are blackheads, pustules and papules found. However, the armpits, groin, buttocks and genital area may be involved in certain forms. Quite often it is more inflammation in the game that hurt.
Acne scars
Another typical appearance of acne scars are (defect state), but not occur in mild forms of acne. Acne comedo example resolves completely without scarring. It takes but a few days, sometimes weeks. The interested party in this case must necessarily forego their own skin experiments, especially an improper expression or squeezing of pimples or blackheads. This can lead to bacterial infection and subsequent scarring. For cleansing, a beautician are visited, from the skin manifestations such professionally.
For acne sufferers are the three described stages or phases, ie
- predominant primary noninflammatory (blackheads),
- secondary inflammatory lesions (pimples) and
- not more inflammatory lesions tertiary (scar)
Leaders of the different skin regions more or less simultaneously.
Acne Causes
The causes of acne are very complex, it is called a multifactorial process in the pathogenesis of acne. Unfortunately, all these factors, and chemical reactions which take place in connection with acne on the body, still not fully understood. In particular, the influence of diet makes for controversial discussions. But environmental influences, stress and poor hygiene are mentioned again and again at this point. Moreover, there is no specific criterion whose presence or absence of the acne patients stands.
Development of Acne
What is certain is the actual development process of acne. Increased sebum production, in the jargon Seborrhea (or hyperseborrhoea), together with a keratinization in the output of the sebaceous gland follicle Selbiger by example, multiplication of horny cells (hyperkeratosis) and impaired desquamation lead to the formation of comedones (blackheads, open or closed), because the sebaceous no longer able to drain (formation of a Hornpfropfs). This inflates the sebaceous gland to the mass of fat, skin cells, white blood cells and bacteria and creates the blackheads. Should the comedones in the course, ignite develop papules or pustules. Endogenous acne, to the well-known acne vulgaris is one, has a strong genetic predisposition, ie that there is less "aknevorbelastendes" genetic material for the tendency to keratinization and seborrhea or should be. Found out it also has that are missing in acne patients sebaceous unsaturated fatty acids, but unfortunately is no significant improvement in growth of such unsaturated fatty acids have been found.
Acne Bacteria
In the context of new research results could find one that the "famous" acne bacterium Propionibacterium plays acnes is not a necessary role in the pathogenesis of acne inflammation process, but certainly in the course by making lipases that cleave the sebum into free fatty acids and strong pro-inflammatory are. Inflammatory cells (leukocytes) are attracted, sebum, free fatty acids, bacteria and hairs enter the tissue, thereby contributing to the inflammatory acne lesions (papules and pustules). It requires, however, no excessive colonization of Propionibacterium acnes aknetypische for any skin changes. Rather, it appears to be involved also the body's own immune inflammatory mediators such as interleukin-1 alpha in the inflammatory processes to. Many do not contain propionibacteria blackheads, but high concentrations of interleukin-1 alpha that induce non-specific inflammatory reaction.
Hormonal Influence
Hormonal factors play an important role in any case. Fluctuations in hormone levels are present especially during puberty, pregnancy or menstruation. It is in these phases aknetypische lesions are encountered very often. The pituitary gland, the pituitary gland, controls and monitors the process of hormones throughout the body. This leads to the increase in male sex hormones (androgens), by the way in male and female alike, to an increase in sebaceous gland volume of keratinocyte proliferation and the formation of a proliferation hyperkeratosis in the excretory duct of the affected follicle and thus initiates the creation process of acne. In particular, the female sex is therefore a special oral contraceptives with elevated levels of estrogens and antiandrogens an effective measure to combat acne. Besides the well-known male sex hormone testosterone also plays the so-called Dihydoepiandrosteron shortly DHEA, a role. This is produced in the adrenal cortex and is a precursor of androgens. Not everyone gets, however due to the increased testosterone levels acne. It depends on the ratio in which male and female hormones in the blood are present in the sebaceous glands and the extent of the individual against the receptors of testosterone are susceptible.
Definition
Acne can give rise to a multi-factorial skin disease caused mainly of the sebaceous gland follicle, the first non-inflammatory comedones produces ("blackheads"), but also later in inflammatory lesions such as papules, pustules and nodules. The most important criterion is the presence of acne comedones.
Acne is usually harmless and occurs mainly in adolescents. An estimated 70 to 90 percent of teenage acne lesions indicate, however, develops only in about 10-30 percent of clinical acne that requires treatment. With more than 70 percent of the disease is mild. Acne occurs mainly between the 15th and 18 Age on (mostly in boys than in girls and later) and is considered a "social disease".
The term acne comes originally from the Greek "akme" of ("peak ripeness, bloom"). By a faulty transcription of it was the Latin term "acnas". In English, the acne as "rosy-drop" was called, which means something like "flower". This designation is due to the pointed shape of the pustules. The translation from English into German occurred in the nineteenth century.
Acne forms on the extent and severity
On the extent and severity of acne comedones the distinction is that acne papulo-pustulosa and acne conglobata. In light of acne comedones occur mainly comedones and a maximum of only very few, mild inflammation (papules) in the T-zone (forehead, nose and chin) on. The skin is coarse and slightly shiny and greasy. They usually heals without a scar from forming. Acne Papulopustulosa characterized by papules and pustules, which can lead to scarring. You are not only the face, but also in the range of cleavage, upper arms, chest and back. The most severe form is acne conglobata. In their form also called, sometimes painful, and Fistelkomedonen nodes, a strong scarring is possible.
Acne forms on the cause
On the basis of their skin disease can cause acne in an endogenous, exogenous, which sometimes run extra, drug-induced and physically induced acne can be divided, where different forms of acne and special shapes can be assigned.
Endogenous Acne
For acne include endogenous forms that have their origins in changes in body metabolism.
Acne Vulgaris
Acne vulgaris ("common acne", "puberty acne") is the most common endogenous form of acne and is therefore represented here in some detail. It is caused by hormonal changes in the body. During puberty, the concentration of male sex hormones (androgens) in the blood, but boys are more frequent and more affected by the impacts (girls especially during the menstrual cycle and during pregnancy). The hormones cause an increase or increased production of sebum, which can lead to a disorder of keratinization in the output of the sebaceous gland follicle when the sebaceous glands become clogged by skin cells and sebum can not flow out of. As a result, form comedones (dark-colored by the skin pigment melanin) to the case of a possible inflammatory papules, pustules or nodules lead. Mainly affects skin areas with many sebaceous glands, such as face, shoulders, neck, back, neck, shoulders less frequently, genital, buttocks and groin. In today's medicine can be the often harmless and mild acne vulgaris running pretty good deal, unless it is started early enough therapy in the dermatologist. Stakeholders can assist with an appropriate cleansing and skin care treatment. A small consolation is that the acne will disappear by the end of puberty alone, usually at the very latest by the beginning of the third decade of life.
What exactly is acne? Why it just hits me? As long as you have them? What can you do about it? How is the disease? These are just a few questions, the answers for an acne-affected and usually are of interest. As an interested party should be as much as possible about the acne basics, to understand the reasons behind why this happens and that, acting as certain medications, etc.
For the basic acne include particular knowledge about forms, causes, symptoms, diagnosis and course. This know-how to be conveyed in the following pages to learn about the disease.
- Acne Definition, Types, Classification
- Acne Causes
- Acne Symptoms
- Acne Diagnosis
- Acne Course
The course of acne one particular individual / patient may unfortunately not be predicted. This is especially the fact that it deals mainly with the symptoms and not the cause. Only Roa and iso set there and reduce the production of the sebaceous glands, so that a "cure" can be achieved. But here is a definitive cure is not guaranteed. "Acne flare-ups" are possible.
