Acne (Acne Vulgaris)
Acne is a common inflammatory disease which affects the skin of the face and often the neck, shoulders, chest, and upper back. It appears in the early teens and often continues into the twenties. It has been described as the "scourge of adolescence." About 80 percent of teenagers have some acne, even if only "pimples." About one teen-ager in five is troubled with acne in its more severe forms which leave scars.
As a child reaches adolescence, the glands produce sex hormones which circulate throughout all the body tissues. One effect of these hormones are to stimulate the tiny sebaceous glands (oil glands) which are associated with the skin's hair follicles. The cells within the sebaceous glands multiply so rapidly that the gland's outlet may become plugged with impacted cells.
The gland continues to be active even though its secretion can no longer reach the skin surface. As the tiny gland bulges, it stretches the surroundings tissue and produces a white dot-a "whitehead." Some of the impacted secretion then undergoes chemical change which makes it look black. Thus a "blackhead" develops at the site of the hair follicle. As the sebaceous gland and its hair follicle stretch even more, they rupture, producing local inflammation. This produces a papule and then a pustule ('pimple"). In the more severe cases, the breakdown of the delicate tissues within the skin permits germs to enter so that infection develops.
Acne occurs at a time of life when the teen-ager is especially concerned over his appearance. The blemished skin causes the young person to be sensitive and embarrassed. Treatment for acne, then, should be prompt so as to avoid if possible the scaring that occurs in neglected cases.
There are two phases to treatment of acne. The patient himself should build up his general health so as to become more resistant to all kinds of illness, and he must avoid whatever may aggravate the skin condition.
The second part of the treatment is the doctor's part. He must evaluate each case as to whether it is a mild form of acne or a severe type. He must decide whether to use the newer medicines (Retin-A, benzoyl peroxide, and tetracycline or other antibiotics). He must advise the patient and encourage him to persist in the program of treatment. The powerful new medicines must be carefully supervised by the doctor. But they have made the treatment of severe acne much more successful.
WHAT TO DO
1. Cleanse the skin of the face and upper trunk twice daily, using warm water and a simple, non-irritating soap. Avoid medicated soaps and excessive washing.
2. Abstain from using cosmetics during the entire period of treatment except for simple foundation lotions.
3. Avoid mechanical pressure on the skin, such as resting chin in hands in wearing straps over the shoulders.
4. Obtain adequate rest; sleep at least eight hours each night.
5. Use a well-balanced, wholesome diet. Avoid between-meal snacks including sweetened drinks. Do not over-eat. Avoid chocolate and cola drinks.
6. Use no medicines or drugstore remedies except as a doctor directs.
7. Try to avoid anxiety and undue competition.
8. Keep in close touch with the doctor, particularly if he prescribes stronger medicines.
9. Faithfully follow the treatment the doctor prescribes. In many cases the strong medicine he uses will make the skin condition seem worse after three or four weeks. But the treatment must continue in order to derive real benefits. Discontinuing the medication without the doctor's knowledge, even though the acne seems improved, may make the condition as bad as before. The treatment may have to be continued for many months.
