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Dermatology

Dermatology Dermatology

Acne

Acne is one of the most common skin diseases. It generally starts in adolescence and affects both men and women equally, varying in severity. It usually disappears spontaneously at around 20 years of age, but can persist for considerably longer. It is estimated that it affects 85% of the adolescent population, mainly on the face, and sometimes also on the chest, back and shoulders, areas where there are a high number of sebaceous glands. Typical acne lesions occur in the pilosebaceous follicle. They are initially comedones (closed or open “blackheads”) which can develop into papules and pustules (“spots”), nodules and cysts (the latter in the most severe cases).

How does it occur?

The following processes must occur for the \"spot\" to be formed:

 

  • Sebaceous glands produce more oil, which builds up in the pore or pilosebaceous follicle.

 

  • The skin cells forming the follicle canal present a disorder in their growth and they become more rigid and also build up in the pore. The accumulation of oil and cells blocking the pore causes dilation and blocking thereof (comedogenesis). The result of this stage are the so-called comedones, which may be open (“blackheads or pimples”) or closed (“whiteheads”).

 

  • The microorganisms forming part of the normal skin flora present in the bottom of the follicle or pore get trapped in the comedo together with the dead skin cells and oil. This provides the ideal microenvironment for bacterial growth, particularly of Propionibacterium acnes, which causes the body to produce an inflammatory reaction (reddening, swelling and pain). The results are the so-called papules and pustules (“pus-filled spots”) which may form deeper lesions such as cysts and nodules that can leave hypertrophic scars and even keloids.

Why is it suffered?

As it is a multifactorial disease, it can be enhanced or triggered for several reasons, such as:

 

  • Genetic susceptibility.
  • Hormonal disorders, (puberty, menstruation, pregnancy, polycystic ovarian syndrome, etc.)
  • The use of unsuitable products in the area. (creams and/or occlusive cosmetics, some medicinal products, such as corticosteroids)
  • The emotional status, (environmental changes or stress).

 

Although it has been popularly believed that diet (chocolate, fats, etc.) contributes to the formation of acne, there is no scientific evidence to support this causal relationship.

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