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There are several different kinds of acne, depending on 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 take a closer look at acne vulgaris.

Acne vulgaris could 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’ (see article on “Acne” in Wikipedia).

Acne is most usually found in white Western teenagers, although it is to be found in every country in the world, so there could be a genetic weakness to it. It is possible that it may be an exceptional reaction to fairly normal levels of testosterone. For most afflicted, outbreaks of acne last only until the age of twenty or so, probably only a few years or at the most ten. For other people, however, it can be a life-long affliction. It usually appears on the face, upper-chest, upper-arms and back. However, an occasional spot is not the same as acne.

Acne vulgaris manifests itself in many forms, including: whiteheads, resulting from pores which are completely blocked, trapping sebum (oil), bacteria, and dead skin cells, causing a white appearance on the top; 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, 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 look like red circles with a white or yellow centre.

Whiteheads do not often last for a long time; blackheads do 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 result in scarring and should never for any reason be squeezed, since this could cause them to last for months longer.

A ‘cyst’ can look similar to a nodule, but it is full of pus and has been described as having a diameter of at least 5mm and, again, can cause scars and cause irritation. Squeezing an acne cyst may cause a more severe infection and more acute inflammation which can last quite a lot longer than if it had not been squeezed. Skin experts have methods of reducing the swelling and avoiding scarring with both nodules and cysts. It is just not true that acne sufferers are not meticulous about their hygiene.

In fact, excessive washing can exacerbate acne. There are many, many false ‘treatments’ on the market and many, many old wives’ tales. However, any good skin expert would tell you that there is no sure-fire cure for acne and that the sufferer has to follow a religious regimen of cleaning until the acne just ‘goes away’ of its own accord.

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