There are various forms of acne, named according to how or why the acne started. 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 often found in Western teens, although it does occur in every country in the world, so there could be a genetic predisposition to it. It is possible that it could be an exceptional reaction to fairly average levels of testosterone. For most sufferers, the condition lasts only until adulthood, probably only a few years or at most ten. For others, however, it can be a life-long recurring affliction. It most often affects the face, upper-chest, upper-arms and back. However, an occasional spot does not constitute acne.

Acne vulgaris appears in various forms, which include: whiteheads, resulting from pores which are totally blocked, trapping sebum (oil), bacteria, and dead skin cells, resulting in a white appearance on the surface; blackheads, caused by 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 bumps with no head and pustules, which are similar to whiteheads, but are inflamed, and appear as red circles with a white or yellow centre.

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

A ‘cyst’ can appear similar to a nodule, but it is pus-filled, and has been described as having a diameter of at least 5mm and, again, can leave scars and cause pain. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which will last very much longer than if it had been left alone. Dermatologists have ways of lessening 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 false ‘cures’ on the market and many, many old wives’ tales. However, any good dermatologist would tell you that there is no sure-fire cure for acne and that the sufferer should follow a deliberate regimen of cleansing until the acne eventually ‘goes away’ on its own.

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