There are several different forms of acne, depending on how or why the acne developed. Some of the forms of acne are: acne conglobata (chronic boils); acne fulminans (an extreme form of conglobata); acne cosmetica (caused by cosmetics); acne keloidalis nuchae (from shaving); acne medicamentosa (caused by starting or stopping a medication); acne rosacea (redness on the face); baby acne; hormonal acne; cloracne and the common variety, acne vulgaris (also known as ‘puberty spots’). In this article, we will concentrate on acne vulgaris.

Acne vulgaris can be defined as: ‘an inflammatory disease of the skin, caused by changes in the pilosebaceous units (skin structures consisting of a hair follicle and its associated sebaceous gland). Acne lesions are commonly referred to as pimples, spots or zits’ (according to Wikipedia).

Acne is most common in white Western teenagers, although it does occur in every country in the world, so there could be a genetic weakness to it. It is possible that it could be an exceptional reaction to quite average levels of testosterone. For most sufferers, outbreaks of acne last only until adulthood, probably only a few years or at the most ten. For other people, however, it may be a life-long problem. It usually affects the face, upper-chest, upper-arms and back. However, an occasional spot does not constitute acne.

Acne vulgaris appears in various ways, which include: whiteheads, resulting from pores that are totally blocked, trapping sebum (oil), bacteria, and dead skin cells, causing a white appearance on the surface; blackheads, resulting from pores which are only partially blocked, allowing some of the trapped sebum, bacteria, and dead skin cells to slowly drain to the surface (the black colour is not caused by dirt, but is a reaction of the skin’s own pigment, called melanin, with the oxygen in the air); papules, which are inflamed, red, tender lumps with no head and pustules, which are like whiteheads, but are inflamed, and appear as red circles with a white or yellow centre.

Whiteheads do not often last long; blackheads can last a long time and pustules are what people call spots. Severe acne vulgaris is characterized by nodules and cysts. A ‘nodule’ is a much larger and more painful kind of pustule and can sometimes last for months. Nodules are large, hard bumps under the skin’s surface. They frequently result in scarring and should never be squeezed, which could cause them to last for months longer still.

A ‘cyst’ can look like a nodule, but it is full of pus and has been defined as having a diameter of at least 5mm and, again, can cause scars and cause irritation. Squeezing an acne cyst can cause a deeper infection and more painful inflammation which may last very much longer than if it had not been squeezed. Dermatologists have methods of reducing the swelling and preventing scarring with both nodules and cysts. It is a myth that acne sufferers are not meticulous about cleanliness.

In fact, excessive washing can exacerbate acne. There are many, many useless ‘cures’ on the market and many, many old wives’ remedies, but any good skin expert would tell you that there is no known cure for acne and that the patient should follow a deliberate regimen of cleansing until the acne just ‘disappears’ of its own accord.

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