Acne is a general term for pimples and deeper pustules that are clogged pores. If severe enough acne can leave permanent scars.
Acne is an inflammatory skin disorder of the skin’s sebaceous glands and hair follicles that affects about 80% of people between the ages of 12 and 24. During puberty high levels of hormones are produced in both girls and boys. This leads to the production of large quantities of sebum. Sebum is an irritant that can clog the pores and form a pimple which may become infected and form a pustule. Hormones don’t go away after adolescence. Many women still get premenstrual acne from of the release of progesterone after ovulation.
Acne is a disease that affects the skin’s oil glands. The small holes in your skin (pores) connect to the oil glands under the skin. These glands make an oily substance called sebum. The pores connect to the glands by a canal called a follicle. Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows through the follicle and out to the skin. When the follicle of a skin gland clogs up, a pimple grows. Most pimples are found on the face, neck, back, chest, and shoulders. Acne is not a serious health threat but it can cause scars.
Causes of Acne
The exact cause of acne is unknown, several related factors are:
§ Hormonal activity supposed to be responsible, such as menstrual cycles and puberty.
§ Increase in hormones called androgens (male sex hormones), which causes sebaceous glands to enlarge and make more sebum.
§ Hormonal changes related to pregnancy can also cause acne.
§ Another factor is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many school-age boys with acne have a family history of the disorder.
§ Accumulation of dead skin cell.
§ Bacteria in the pores, to which body becomes allergic.
§ Skin irritation or scratching of any sort will active the inflammation.
§ Starting or stopping birth control pills.
§ Heredity (if your parents had acne, you might get it too).
§ Some types of medicine.
§ Greasy makeup.
In some patients, contributing factors may be:
Pressure: In some patients, pressure from helmets, chinstraps, collars, and the like can aggravate acne.
Drugs: Some medications may cause or worsen acne, such as those containing iodides, bromides, or oral or injected steroids (either the medically prescribed prednisone or the steroids bodybuilders or athletes take.) Most cases of acne, however, are not drug-related.
Occupations: In some jobs, exposure to industrial products like cutting oils may produce acne.
Pathophysiology of Acne
§ Excessive secretion of oils from the sebaceous glands accompanies the plugging of the pores with naturally occurring dead skin cells (corneocytes) blocking hair follicles.
§ The accumulation of these corneocytes in the duct appears to be due to a failure of the normal keratinization process in the skin which usually leads to shedding of skin cells lining the pores.
§ Oil secretions are said to build up beneath the blocked pore, providing a perfect environment for the skin bacteria Propionibacterium acnes and the lipophilic (oil/lipid-loving) yeast Malassezia to multiply uncontrollably.
§ Under the microscope, however there is no evidence of pooled trapped sebum. Indeed the oil perolates through the plugged duct onto the surface.
§ In response to the bacterial and yeast populations, the skin inflames, producing the vision lesion.
§ The face, chest, back, shoulders and upper arms are especially affected.
Acne is a group of skin rashes with different causes named as:-
It is most commonly experienced around puberty, typically of the face and shoulders / chest.
A red rash predominantly on the face.
Acne keloidalis nuchae (pseudofolliculitis nuchae)
A rash caused by shaving.
Acne conglobata (Hidradenitis suppurativa)
Chronic abscesses or boils of sweat gland and hair follicle; in the underarms, groin, buttocks and under the breasts in women.
Acne caused by use of cosmetics.
An extreme form of acne conglobata.
Acne cause by starting or stopping medicine.
A rash seen on the cheeks, chin, and forehead of infants.
Acne caused by exposure to chlorinated hydrocarbons such as dioxins or PCBs.
Acne vulgaris is an inflammatory disease of the skin, which is caused by changes in the pilosebaceous units.
It is the most common form of acne. Large number of teenagers suffers from this, during the period of puberty. In most of the cases it tends to disappear or atleast decreases after one reaches early twenties. There is no fix prediction how long time it will take to disappear entirely,
Signs and Symptoms of Acne
Acne typically appears on face, neck, chest, back, shoulders and the areas of skin with the largest number of functional oil glands. People with acne frequently have a variety of lesions, some of which are shown in the diagrams below. The basic acne lesion, called the comedo, is simply an enlarged and plugged hair follicle. Acne can take the following forms;
Whiteheads: These are created when the openings of hair follicles become clogged and blocked with oil secretions and dead skin.
If the plugged follicle, or comedo, stays beneath the skin, it is called a closed comedo and produceswhite bump called a whitehead.
Blackheads: These are similar to whiteheads, but are open to the skin surface and darken.
A comedo that reaches the surface of the skin and opens up is called an open comedo or blackhead because it looks black on the skin’s surface. This black discoloration is due to changes in sebum as it is exposed to air. It is not due to dirt. Both whiteheads and blackheads may stay in the skin for a long time.
Other troublesome acne lesions can develop, including the following:
§ Papules – inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch
§ Macule – A macule is the temporary red spot left by a healed acne lesion. It is flat, usually red or red-pink, with a well defined border.
A macule may persist for days to weeks before disappearing. When a number of macules are present at one time they can contribute to the “inflamed face” appearance of acne. It shows the “red face” appearance.
§ Pustules (pimples) – These are raised; reddish spots that signal inflammation or infection in the hair follicles. Papules topped by white or yellow pus-filled lesions that may be red at the base
§ Nodules – large, painful, solid lesions that are lodged deep within the skin
§ Cysts – These are thick lumps beneath the surface of the skin, which are formed by the buildup of secretions deep within hair follicles. Deep, painful, pus-filled lesions that can cause scarring.
After resolution of acne lesions their may be prominent unsightly scars
Acne rosacea is a skin disorder leading to redness and pimples on the nose, forehead, cheekbones, and chin. The inflamed pimples and redness of rosacea can look a great deal like acne, but blackheads are almost never present. Fair-skinned individuals and people who flush easily seem to be more susceptible to this condition.
Rosacea becomes progressively worse in many of those affected. The real cause of rosacea is now thought to be a tendency to flush and blush in a person with sun damage. Sun damages the supporting fibers of the small blood vessels just under the surface of the skin, allowing the vessels to stretch out (become permanently dilated). The damaged blood vessels leak fluid when flushing occurs, resulting in blotchy red areas. Swelling occurs, but is not usually so prominent to be very visible. The first sign most people see are small red pimples and pustules (pus-filled whiteheads). The redness can come and go and may be tender, inflamed and sensitive to the touch. Later, the skin tissue can swell and thicken. Eventually the redness and swelling can become permanent.
Symptoms of Acne rosacea
It may vary according to the severity of the case.
Facial flushing is the classic symptom of rosacea. Flushing is the result of increased blood flow through dilated facial blood vessels. During a flush, face can turn various shades of red depending on the amount of blood flowing through the skin. A sufferer may experience a fire-red face during intense flushes, a mildly-red face during moderate flushes, or a barely noticeable pinkish-hue during mild flushes; it may be transient or long-standing.
Facial redness is caused by hundreds of tiny dilated blood vessels near the surface of the facial skin
Facial Telangiectasia; tiny broken blood vessels which are permanently fixed in the dilated state and take appearance of fine red lines coursing through the surface of the facial skin.
Facial Skin Hyper-Reactivity: These blood vessels dilate very easily to topical triggers and physical insults
Uneven skin texture, caused by dilated blood vessels,
Papules on the face
Facial Burning Sensations
Rhinophyma is a form of rosacea that is characterized by chronic redness, inflammation, and increased tissue growth of the nose.
What causes Acne Rosacea?
It is believe that rosacea is a disorder where the blood vessels become damaged when repeatedly dilated by stimuli.
Triggers that cause episodes of flushing and blushing.
Exposure to temperature extremes can cause the face to become flushed
Heat from sunlight,
Moving to a warm or hot environment from a cold environment
Some foods and drinks that can trig the condition include alcohol, foods high in histamine and spicy food.
Acne keloidalis nuchae
It refers to the occurrence of keloidlike papules and plaques on the occipital scalp and the posterior part of the neck, almost exclusively in African American men. Initially, patients usually develop a chronic folliculitis and perifolliculitis of the occipital part of the scalp and the posterior part of the neck, which heal with keloidlike lesions, sometimes with discharging sinuses. The lesions are often painful and cosmetica.lly disfiguring
Causes are still speculative; it is supposed to be caused by-
§ Injury produced by short haircuts, where hairline is shaved with a razor and curved hair follicles may be precipitating factors
§ Constant irritation from shirt collars
§ Chronic low-grade bacterial infections
§ An autoimmune process (AKN usually responds to systemic steroid therapy.)
§ Use of antiepileptic drugs
§ An increased number of mast cells in the occipital region
Sign and Symptoms
§ Large lesions are often painful.
§ Older lesions with abscesses and sinuses may emit an odorous discharge.
§ Hats, shirts, jackets, and sweaters may irritate the involved area, thereby causing patients to alter their preferred style of dress.
§ Even if large lesions are asymptomatic, they are often a cause of great cosmetic concern.
§ Acne starts after puberty as firm, dome-shaped, follicular papules that are 2-4 mm in diameter.
§ The papules develop on the nape of the neck and/or on the occipital part of the scalp.
§ Pustules may be present in the same areas.
§ Comedones are not present (in contradistinction to acne).
§ More papules may appear and enlarge as the disease progresses.
§ Some papules coalesce to form keloid like plaques, which are usually arranged in a band like distribution at or below the posterior part of the hairline.
§ Hair is usually lost in large lesions.
§ Scarring alopecia and subcutaneous abscesses with draining sinuses may also be present.
It is an uncommon and unusually severe form of acne characterized by burrowing and interconnecting abscesses and irregular scars (both keloidal and atrophic), often producing pronounced disfigurement. It is an uncommon disease.
The primary cause of it remains unknown.
Changes in reactivity to Propionibacterium acnes may play an important role in the etiology of the disease.
Exposure to halogenated aromatic hydrocarbons (eg, dioxins) or ingestion of halogens (eg, thyroid medication, hypnotic agents) may trigger AC in an individual who is predisposed.
Other factors that can provoke AC include androgens (eg, androgen-producing tumors) and anabolic steroids.
AC and AF may appear after cessation of testosterone therapy.
Signs and symptoms
§ The nodules associated with AC are succulent, tender, and dome shaped.
§ Characteristic nodules increase in size; break down to discharge pus; and often fuse, forming unusual shapes of several centimeters.
§ The formation of nodules begins in early puberty; the severity increases until late adolescence and often beyond. Active nodule formation may persist for years and usually continues until the fourth decade of life.
§ Isolation of coagulase-positive staphylococci is common in the lesions.
§ As the nodules break down, crusts may form over a deep ulcer, which extends centrifugally but tends to heal centrally. This process is persistent, and slow healing is characteristic.
§ A conspicuous feature of the disease is the blackheads that appear in pairs or groups on the neck or the trunk; sometimes, blackheads involve the upper arms or the buttocks.
Persistent, low grade usually affecting the chin and cheek of a woman who uses cosmetics. People may not contribute their reactions to their reactions to their cosmetics at first, but may notice when get worsening symptoms after using certain face makeup or lip products. Certain chemicals in liquid foundation; it may cause allergic reaction.
Acne fulminans is a rare and very severe form of acne conglobata associated with systemic symptoms. It nearly always affects males.
It demonstrates numerous inflammatory nodules on the trunk. The large nodules tend to become painful ulcers with overhanging borders surrounding exudative necrotic plaques that become confluent; however, polyporous comedones and non inflammatory cysts are not evident. Erythematous neovascular nodules may also be seen
Inflammatory and ulcerated nodular acne on chest and back
Severe acne scarring
Loss of appetite and weight loss
Raised white blood cell count.
Acne caused or exacerbated by several types of drugs, such as antiepileptic, halogens, and steroids. As acne is generally a disorder of the pilosebaceous units caused by hormones, the medications that trigger acne medicamentosa most frequently are hormones.
What causes baby acne?
Baby Acne (acne neonatorum) is a common condition that affects roughly 20 percent of newborn babies. Infants usually develop neonatal acne because of stimulation of the baby’s sebaceous glands by lingering maternal hormones after delivery. These hormones cross the placenta into your baby and after delivery they cause the oil glands on the skin to form bumps that look like pimples. Face present with red pimples on the cheeks, forehead and chin; whiteheads may present.
Baby acne often clears up quickly [generally within 3 weeks]; in some cases, however, baby acne lingers for months or even longer. Male babies are more often affected than female babies. It is best to wash your baby’s face with warm water two or three times a day and pat it dry. Don’t use lotions, oils or other treatments. Never pinch or scrub baby acne. You may cause more irritation or an infection.
Chloracne is acne like eruption of blackheads, cysts and pustules associated with over- exposure to certain halogenic aromatic hydrocarbons, such as chlorinated dioxins and dibenzofurans. The lesions are most frequently found on cheeks, behind the ears, in the armpits and the groin region
Chloracne normally results from direct skin contact with chloracnegens, although ingestion and inhalation are also possible causative routes.
The following provides information about conventional acne treatments and homeopathic treatment of acne.
Conventional acne treatments
§ Topical bactericidals. Acne lotions may dry up the oil, kill bacteria and promote sloughing of dead skin cells.
§ Antibiotics. For moderate to severe acne, prescription oral antibiotics may be needed to reduce bacteria and fight inflammation.
§ Isotretinoin. For deep cysts, antibiotics may not be enough. Isotretinoin (Accutane) is a powerful medication available for scarring cystic acne or acne that doesn’t respond to other treatments. Isotretinoin can cause birth defects in the developing fetus of a pregnant woman. Some people with acne become depressed by the changes in the appearance of their skin. Changes in mood may be intensified during treatment or soon after completing a course of medicines like isotretinoin. Other side effects include; dry eyes, mouth, lips, nose, or skin (very common), itching, nosebleeds, muscle aches, sensitivity to the sun, poor night vision, changes in the blood, such as an increase in fats in the blood (triglycerides and cholesterol), change in liver function. Side effects usually go away after the medicine is stopped.
§ Oral contraceptives. Oral contraceptives, including a combination of norgestimate and ethinyl estradiol (Ortho-Cyclen, Ortho Tri-Cyclen), have been shown to improve acne in women. However, oral contraceptives may cause other side effects that you’ll want to discuss with your doctor.
§ Antiandrogen drugs such as spironolactone (Aldactone) – to reduce the excessive oil production. Side effects of antiandrogen drugs may include irregular menstruation, tender breasts, headaches, and fatigue.
§ Cosmetic surgery to diminish scar left by acne
§ Heat therapy- zeno product uses heat at a specific temperature to kill bacteria and to treat mild moderate acne.
§ Laser treatment
Homeopathy for Acne
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathic treatment of acne. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit our Materia Medica section. None of these medicines should be taken without professional advice.
[Kent] skin, Eruptions, Pimples
[Murphy] skin, Acne
[Boericke] skin, Face, Eruption on face, Acne rosacea/Acne simplex
[Boennighausen’s] Face, Acne
Homeopathic Remedies for Acne
Sulphur, Sanguinaria, Kali bromatum, Antimonium crudum, Asterias Rubens, Belladonna, Hepar Sulphur, Calcarea Silicata, Nux vomica, Arsenicum iodatum, Causticum, Chelidonium majus, Graphites, Psorinum, Sabina, Calcarea phosphoricum, Thuja occidentalis, Ledum palustre, Nitricum acidum, Bovista, Tuberculinum.
Is perhaps the remedy most often indicated in this affection, especially if chronic. The skin is rough and hard and the acne is associated with comedones and constipation; great aggravation from water is the characteristic leading to Sulphur in skin affections. Face is Pale, sickly color. Heat and spotted redness of face. Black pores. Itching intensely in evening and from warmth. The acne punctata is the variety corresponding most nearly to Sulphur. Simple forms yield to Belladonna or Pulsatilla. Acne rosacea yields to Arsenicum iodatum or Sulphur iodide.
It is another useful remedy in acne, especially in women with scanty menses and irregular circulation of blood. Other remedies for acne dependent on sexual disturbances of women are Calcarea carbonica and Aurum muriaticum natronatrum.
Acne on the face, neck and shoulders. We frequently find acne in Epileptics who have been maltreated by bromides. This remedy is especially adapted to the acne simplex and the acne indurata, especially in hyperaesthetic, nervous females. Face flushed. Acne of face, pustules. General failure of mental power, loss of memory, melancholia, anesthesia of the mucous membranes. Suicidal mania with tremulousness. Itching of skin worse on chest, shoulders, and face. Anesthesia of skin. This remedy may be given if Asterias Rubens fails. Dr. J.H.Clarke says, “I know of no remedy of such universal usefulness in cases of simple acne as Kali bromatum 30,” and the late Dr.A.M. Cushing recommended Arsenicum bromatum 4x as very efficacious.Thuja is one of our best remedies for acne facialis. Calcarea picrata is also a useful remedy for acne; clinically it has been found one of the good remedies. Calcarea sulphurica is indicated where the pimples suppurate.
Small red pimples on face, acne in drunkards with gastric derangements, thirst and white-coated tongue. Face with sad expression Fat, fretful, cross and peevish; cries if looked at, touched or washed. Ecstatic, dreamy, sentimental. Pustules.
Obstinate cases, with tendency to pustulation, are curable with this remedy.
It is useful where the skin is rough and the acne persistent.
It acts especially on the sebaceous glands, and is a very helpful remedy in acne. In this affection attention must be directed especially to the patient’s type, temperament and tendencies and the general symptoms are far mores important than the local ones.
Pimples on the face at the age of puberty. A remedy for the sycotic diathesis; flabby, lymphatic constitution, flabby with red face. Nervous disturbances. Pimples on side of nose chin and mouth.
Acne rosacea. Alternate redness and paleness of the skin. Skin dry, hot and swollen, pustules on face. Face is red, bluish-red, hot, swollen, and shining. Patient is restless and talks fast. Acuteness of all senses.
Papules prone to suppurate and extend. Acne in youth. Suppurate with prickly pain. Easily bleed. Unhealthy skin; every little injury suppurates. Cannot bear to be uncovered; wants to be wrapped up warmly. Sticking or pricking in afflicted parts. Great sensitiveness to slightest touch. Constant offensive exhalation from the body Face, Yellowish complexion. Suits especially scrofulous and lymphatic constitutions that are inclined to have eruptions and glandular swellings. Unhealthy skin. Great sensitiveness to all impressions. The lesions spread by the formation of small papules around the side of the old lesion. Chilliness, hypersensitiveness, splinter-like pains, craving for sour and strong things are very characteristic.
Pimples, comedones. A deep, long acting medicine for complaints which come on slowly and reach their final development after long periods. Hydrogenoid constitution. Skin Itching, burning, cold and blue, very sensitive. very sensitive to cold. Patient is weak, emaciated, cold and chilly, but worse from being overheated; sensitive generally.
Acne; skin red and blotchy. Body burning hot, especially face; yet cannot move or uncover without feeling chilly. The typical Nux patient is rather thin, spare, quick, active, nervous, and irritable. Nux patients are easily chilled, avoid open air. Very irritable: sensitive to all impressions. Ugly, malicious. Does not want to be touched. Face Pale, yellowish, earthy or livid countenance. Yellow about nose, mouth or eyes. Red, swollen.
Acne hard, shotty, indurated base with pustule at apex. It will be indicated by a profound prostration, rapid, irritable pulse and severe cases of acne vulgaris. Great emaciation. Skin is Dry, scaly, itching. Debilitating night-sweats.
Acne rosacea. Acne in groups, aggravated by heat. Acne especially on nose Adapted to persons with dark hair and rigid fibre; weakly, psoric, with excessively yellow, sallow complexion; Ailments from suppressed eruptions. Burning pimple with itching.
Painful red pimples and pustules; especially on nose and cheeks. Wilted skin. Dry heat of skin with itching. Painful red pimples and pustules. Face red, without heat. Itching over entire face and forehead. Depression and sadness, even to weeping. Restlessness and solicitude concerning the present and future.
Pimples and acne; itching. Skin is Rough, hard, persistent dryness of portions of skin. Unhealthy skin; every little injury suppurates. Patients who are rather stout, of fair complexion, with tendency to skin affections and constipation, fat, chilly, and costive, with delayed menstrual history, take cold easily. Has a particular tendency to develop the skin phase of internal disorders. Anemia with redness of face. Tendency to obesity. Timid. Unable to decide.
Acne rosacea. Greasy face. Pale, sickly look. Skin is yellow, dirty, and greasy. Roughness of knuckles. Pimples with black points in center. Small numerous pustules, itching unhealthy. Itching, after scratching vesicles arise, when touched. Acne worse during menses, from fats, sugar, coffee, meat.
Hypochondriacal dejection. Low spirited and joyless, with a feeling of general exhaustion. Acne. Face is pale, with lusterless eyes encircled by blue ring. Black pores on nose and face.
Acne in anaemic girls at puberty, with vertex headache and flatulent dyspepsia, relieved by eating. Skin is dark – brown, yellowish. Red, with prickling like nettles after a bath.
Pimples on face. Face glowing redness of whole face, with a fine network of blood vessels, as if it were marbled. oily skin. Burning heat and redness of. Flushes of heat in. Sweat on, especially on side on which he does not lie. Pimples on upper lip and chin. Lips, etc. All eruptions burn violently after cold washing. Corrosive itching. Better scratching, but then followed by burning. Painful sensitiveness of affected part. The skin symptoms better by touch.
Angry mood. Love for solitude. Great seriousness. Face, Alternatively pale and red. Dry pimples like millet seed on forehead. Red nodules Boils on forehead. Skin Dry, want of natural perspiration.
Anxious about his complaints, with fear of death. Sadness and despondency. Face yellow. Sunken eyes encircled by yellow. Dark yellow, almost brownish complexion. Pimples on forehead and temples. Skin with Black pores.
Acne from the use of cosmetics; especially during summer. Pale swelling of cheeks. Skin itching, especially when getting warm, better not scratching. Sadness, with restlessness. Easily offended: takes everything in bad part.
Acne simplex in the tubercular children. Rapid breakdown . Takes cold easily; ends in diarrhœa. Fits of violent temper. Craves cold milk, or sweets. Drum belly. Skin dry, harsh, sensitive, easily tanned; itching in cool air. Chilly; yet wants fresh air. Flushes of heat.
Skin care to prevent acne
§ Clean skin gently- Gently wash your face with a mild cleanser [according to the type of your skin], once in the morning and once in the evening, as well as after heavy exercise. It is also important to shampoo your hair regularly. If you have oily hair, you may want to wash it every day. Wash your face with plain water frequently.
§ Avoid frequent handling of the skin. Avoid rubbing and touching skin lesions. Squeezing, pinching or picking blemishes can lead to the development of scars or dark blotches.
§ Shave carefully- Shave gently and only when necessary to reduce the risk of nicking blemishes.
§ Choose cosmetics carefully.
§ Self-care measures and over-the-counter medicine have not helped after several months; Your acne is severe or getting worse; then contact your dermatologist.
§ Products such as facial scrubs, astringents and masks generally aren’t recommended because they tend to irritate skin, which can aggravate acne. Excessive washing and scrubbing also can irritate skin. If you tend to develop acne around your hairline, shampoo your hair frequently.
§ Try over-the-counter acne lotion to dry excess oil and promote peeling. Look for products containing benzoyl peroxide, resorcinol or salicylic acid as the active ingredient.
§ Avoid irritants. You may want to avoid oily or greasy cosmetics, sunscreens, hair-styling products or acne concealers. Use products labeled “water-based” or “noncomedogenic.”
§ Protect yourself from sun. For some people, the sun worsens acne.