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Skin care: acne SKIN CARE: ACNE
Acne is a very common inflammatory disorder of the oil glands, or pilosebaceous follicles. The majority of these glands are confined to the face, chest and back, and they are most active during adolescence. The course of the disorder is variable, as is the age of onset. Usually it appears a little earlier in girls, but in either sex it is very uncommon before the age of 10. The duration of acne is as variable as the severity. In mild cases the condition may resolve itself spontaneously within a few months, but typically it will last for a year or two. If severe or if chronic, the condition warrants active treatment.
The precise reason why some people develop acne yet others do not, is unknown. However, hormonal factors appear to set the stage for the development of the condition. Except for in the first few months of life, the disease does not develop before puberty, nor does it occur in eunuchs unless they are treated with male hormones. Acne is aggravated by the administration of male hormones, and of course pre-menstrual exacerbations are common in women. Without the natural oils secreted in the skin, known as sebum, there would be no acne. Without male hormones there is little if any sebum. Genetic factors, however, have a definite influence, as do bacteria, which are involved in the development of inflammation. Dietary and emotional factors are sometimes implicated, but have not been completely proven.
The pathology in acne is that the sebaceous duct leading from the gland which produces the sebum becomes blocked. This blockage, if below the skin surface, is called a whitehead, or if above the surface, a blackhead. Following blockage of the duct, at whichever level, the duct, at whichever level, the duct or the gland may rupture, and the sebum escape underneath the skin, setting up an inflammatory reaction. This may be aggravated by the normal bacteria present on the skin.
Looked at objectively, it will be seen that the methods of treatment could include unblocking the duct; decreasing the amount of sebum secreted; changing its composition to make it less irritating; and reducing the amount of bacteria on the skin surface.
Acne occurs at an age when the adolescent is adjusting, sometimes with difficulty, to a major physical and emotional transition. The teenager is often self-conscious, and unduly embarrassed by even minor grades of the disease. To dismiss acne as unimportant demonstrates a considerable lack of understanding, particularly as the disease can be satisfactorily suppressed in the majority of patients, and scarring prevented or minimized.
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