What is acne?
The medical definition of acne is "a chronic inflammatory disease of the sebaceous glands in hair follicles." Acne is a multifactorial disease of the upper body sebaceous glands, especially those of the face. Cutaneous Propionibacterium acnes (P.acnes) are slow-growing anaerobic bacteria and may be unable to multiply in follicles in which the sebum excretion rate is high as end products of bacterial metabolism escape with the out-flowing sebum. When a follicle becomes blocked, it behaves as a closed culture system from which bacteria cannot escape. From this point on the inflammatory response starts.
The effects from the hormones testosterone and dihydrotestosterone cause the sebaceous glands to increase oil (sebum) production, and acne develops on those areas of the skin where sebaceous glands are most numerous. This excess oil builds up in the inside the follicle walls and blocks the pores. If the blocked oil is not extracted from the pores, acne bacteria can grow and multiply. As the inflamed hair follicle and glands enlarge, the surrounding skin becomes more inflamed, and cysts may appear. Constant inflammation and presence of pimples, papules, pustules, cysts and painful, deep nodules can cause damage to the cells that create collagen, inducing acne scars. It's important to understand that treating acne in its earlier stages is the best way to prevent long-term scarring.
Who gets acne?
Acne is the most commonly diagnosed and treated skin condition in Canada, affecting an estimated 6 million Canadians. Most acne ( 80%) occurs between ages 12 and 25 years. However, it's common for acne to continue into the late 20s and 30s, with some people being affected into their 50s.
What determines the severity of acne?
Heredity can play a role in determining the severity of acne. Severity is measured (Burton Scale) by the type, grade and number of lesions (pimples) present, and their distribution on the face and body:
|Grade I||- sub clinical acne||- few open comedones and/or whiteheads|
|Grade II||- comedonal acne||- comedones with slight inflammation, papules (small, solid red bumps on the skin)|
|Grade III||- mild acne||- inflamed papule with Erythema, pustules (red bumps on the skin, containing pus)|
|Grade IV||- moderate acne||- many inflamed papules & pustules|
|Grade V||- severe nodular acne||- inflamed papules & pustules with several deep nodular lesion|
|Grade VI||- severe cystic acne||- many nodular cystic lesions and scaring|
Is acne contagious?
No. You cannot get acne from anyone or give it to anyone.
In our practice we discovered that often this condition is being misdiagnosed as acne and is treated like one. Please, note that this condition is caused by Staphylococcus aureus bacteria and requires referral to the doctor to be treated with a specific antibiotic.