What is causing my cystic acne
Acne is the most common skin disease worldwide. It occurs predominantly in adolescents during puberty. When asked, "What exactly is acne?" there is no exact answer, as the disease occurs in various forms. Most of those affected develop pustules, pimples and blackheads on the face, mainly on the forehead and chin. Acne on the back and cleavage also occurs, but is less common.
Slight forms of expression can usually be treated yourself with washing and care series from the drugstore or pharmacy. Severe acne must be treated by a dermatologist.
Almost every young person is more or less affected by acne. Acne in adults (late-onset acne or acne tarda) is less common - according to a study, it occurs in around 54 percent of women and 40 percent of men over the age of 25 and only gets better after the age of 45. Medical treatment is necessary for around a third of all those affected.
Acne vulgaris: the most common type
Acne vulgaris is the best known form of acne and is also called "common acne". It is triggered by the hormonal changes during puberty. Boys are usually more affected by puberty acne than girls.
With good treatment, acne vulgaris usually heals quickly. If left untreated, it usually resolves on its own by the age of 25. In individual cases, however, symptoms can persist up to the age of 40 and beyond.
Depending on the severity, Acne vulgaris is divided into three subtypes:
- Acne comedonica: It is the mildest form of the disease and only affects the face (forehead, nose and cheeks), less often the back. Acne comedonica is characterized by blackheads, which can become infected when they are squeezed out.
- Papulopustular acne: This moderate form of the disease is characterized by blackheads and inflamed pimples. Often papulopustular acne affects the face and back.
- Acne conglobata: Acne conglobata is the most severe form of the disease. Here, the pimples form real nodules that are easily inflamed and leave visible scars as they heal.
Other forms of acne
Other forms of disease can develop if the skin does not tolerate certain substances that are found in care products, medicines or food. This includes:
- Contact, cosmetics or Chlorine acne
- Drug acne (Acne medicamentosa)
- Doping acne
These forms of acne are special forms of an allergic reaction and can be combated in a targeted manner by removing the substance to which the skin reacts. To determine the cause of the disease, allergy tests at the doctor can help.
Other forms of acne are the Newborn acne, the Infant acne, the Mallorca acne and Acne inversa (Acne inversa). In colloquial language, newborn and infant acne are often referred to together as infant acne or baby acne. However, this is not medically correct.
In newborn acne ("baby acne", acne neonatorum), small blackheads are mainly found on the cheeks. They can exist before birth or form in the course of the first few weeks of life. Therapy is not necessary, as newborn acne will resolve on its own within a few weeks. This skin disease affects around 20 percent of all babies - boys more often than girls.
Infant acne ("infant acne", Acne infantum) occurs between the third and twelfth month of life, and more often in boys than in girls. It is characterized by small yellowish pimples that mainly form on the forehead and cheeks. This can result in scars. Infant acne should therefore always be treated by a doctor.
Most people with infant acne develop acne vulgaris later in life.
Another special form is the so-called Mallorca acne (Acne aestivalis). It is not a typical acne disease, but actually a light allergy or a special form of sun eczema (polymorphic light dermatosis).
In Mallorca acne, small pustules form mainly in the décolleté and on the arms and legs, very rarely also on the face. Itching and severe reddening are unpleasant side effects, but these only occur in some cases. Mallorca acne is caused by a reaction of sunlight or UV radiation with the sebum of the skin or with the fats in sun protection creams, which produce substances that are harmful to the skin. Scientists also suspect a genetic predisposition. Young people (women more often than men) with oily skin are particularly at risk.
Mallorca acne usually forms at the beginning of a holiday or in the first few days of summer, as the skin is then not yet used to the sun's rays. There is little that can be done about them. It usually heals on its own within a few days. It is important to avoid re-exposure to the sun during these days. A corneal dissolving (keratolytic) therapy can support healing in people who have a tendency to acne.
In the case of Mallorca acne, pay particular attention to the precautionary measures: You should slowly get your skin used to the sun. Also, avoid oily lotions or sunscreens. There are also special sun protection products for allergic skin that help prevent Mallorca acne.
Acne inversa is a severe form of acne and usually occurs in the armpit and genital area. You can read more about this in the article Acne inversa.
In acne, a small red point or nodule forms in the skin. This feels like a thickening of the skin. Such a blackhead (comedo) occurs when the duct of a sebum gland in the skin becomes blocked by cornification. The sebum builds up, the blackhead is visible as a small white dot. If such a blackhead tears open, air gets into the sebum, causing the blackhead to turn black. If bacteria (propioni bacteria) are added, inflammation develops - a "blooming" pimple develops.
The pimples and blackheads form mainly on the face, preferably in the so-called T-zone, i.e. on the forehead, chin and bridge of the nose. Depending on predisposition and skin type, severe acne can also show up on the cheeks. The back and chest are less commonly affected.
You should consult a dermatologist if you have the following symptoms:
- large, sore pimples
- sudden deterioration in the appearance of the skin
- severe psychological stress from the pimples
- Acne scars
How exactly acne scars develop and how they can be removed can be read in the article Acne scars.
Acne: causes and risk factors
Acne can be caused by a number of factors.
The most common form, acne vulgaris, is mostly hormone-related. The cause here are the male sex hormones, called androgens (main representatives: testosterone). These are not only produced to a greater extent in men, but also to a lesser extent in women (especially during puberty). But since they occur in larger quantities in men, men are also more affected by the skin disease.
The androgens stimulate the skin's sebum glands to produce more sebum. Normally this sebum is released to the outside through the pores. During the hormonal change in puberty, however, the production of horny material in the skin, which closes the ducts, also increases. The sebum builds up under the surface of the skin and so-called closed blackheads are created. The whitish-looking sebum can pour into this.
At some point the skin on the duct tears open. The blackhead turns black when it comes into contact with atmospheric oxygen. That means: Blackheads are open blackheads.
The sebum in the blackheads “attracts” bacteria. These break down the sebum and produce breakdown products that promote inflammatory reactions ("blooming pimples") and stimulate the formation of new blackheads.
Hormone fluctuations occur not only during puberty, but also during pregnancy, during the menopause (menopause) and when the contraceptive pill is discontinued. At these times, as well as during menstruation, when the skin is increasingly oily, women often have a new outbreak of acne.
Other risk factors
But not only the hormones are responsible for the development of acne. Studies also show that a hereditary predisposition as well as a strong one mental strain and stress can support the development of the skin disease.
In addition, fats can be found in Cosmetic products, Ingredients of Medication and certain foods stimulate sebum production or clog the ducts. Medications that can cause acne include:
- Corticosteroid (cortisone)
- Anabolic steroids
- Adrenocorticotropin (ACTH)
- Psychiatric drugs
- Sleeping pills and sedatives that contain bromine
- Neuroleptics (drugs for various mental illnesses)
- Halogens as disinfectants
- Vitamins B2, B6, B12
- certain medicines used to treat cancer (EGF receptor agonists)
For some people, the nutrition promote the development of acne. For example, very high-fat foods and chocolate have a bad reputation in this regard. However, this relationship has not yet been proven in studies.
Various factors such as moisture, cigarette smoke, and scratching the pimples can make symptoms worse.
Acne: examinations and diagnosis
Acne is easy to diagnose because of its external appearance. The pustules, blackheads and pimples are usually a clear symptom.
However, before you start treatment on your own, you should still consult a specialist in skin diseases (dermatologist) in order to rule out another skin disease. In addition, only the specialist can determine which form of acne it is and which is the best therapy.
If the doctor suspects that there is an infection, he can take some secretion from the blackheads in order to have it analyzed. This shows whether and, if so, which bacteria are causing the infection. The treatment is then based on this.
You can read everything you need to know about therapy in the article on acne treatment.
Read more about the therapies
Read more about therapies that can help here:
Acne: disease course and prognosis
In most cases, acne will heal on its own by the age of 25. In some cases, however, the disease persists longer. Stress and psychological stress can have a strong influence on the course of the disease. In acute stressful situations, it can lead to a renewed outbreak of the disease into old age acne come (acne tarda).
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