Common forms of Acne

You have notices a cystic lesion over your face and you are thinking whether it can be acne. Well, let me tell you yes, most probably it is acne.

There are two major types of acne – Acne vulgaris and Acne rosasea. Acne vulgaris is the most common form of acne. It begins with a cystic lesion, and then it ruptures and ultimately gets infected. Although Acne vulgaris is a self limiting disease mainly of the adolescent and teenagers, 10-15% of the adults continue to suffer some form of this disorder. The primary cause of the disease in teenagers is increased production of sebum when they attain the age of puberty. Sebum is secreted from a specific type of gland, called the Sebaceous gland present in the epidermal layer of skin. Tiny cyst like lesion named – Comedones, emerges in the hair follicles as a result of blockage of the follicular opening due to retention of sebum and many other keratinous materials.

With favorable conditions, bacteria continue to infect these lesions. The most common bacterium responsible for the lesion is ‘Proprioniobacterium acnes’. The action of this organism inside the comedones releases some material from the sebum which is mainly acidic in nature – in fact these are different free fatty acids. All these materials lead to inflammation of the skin. When inflammation occurs within the cyst, there is rupture of the cyst wall. An inflammatory foreign body type reaction (type II hypersensitivity reaction) as a result of discharge of the oily and keratinous residues from the cyst. The cysts may be open, it is then called the blackheads; and sometimes closed – called the whiteheads. Blackheads are consists of easily expressible high colored oily debris. Whiteheads are tiny cystic lesions that are accentuated when the skin is stretched. This is the precursor of the inflammation in case of Acne vulgaris. Comedones generally exist with other types of inflammatory lesions – papules, nodules and pustules. The lesions seen in the adolescent and teenagers in the beginning are usually mildly inflamed whiteheads. There may not be presence of redness even. This is predominantly seen in the middle part of the forehead. As a result, more distinguishing inflammatory lesions develop on the nose, chin and the cheeks. Most common area affected by this cyst is face, however extensive lesion in the back, trunk and chest are also seen.

It is to be noted that acne is self limiting. In some cases which involves large area and becomes resistant to the different medications, scarring do occur leading to an ugly look.

There are some aspects that may change the end result of acne. External trauma and rubbing of the inflamed skin may rupture the existing benign cyst. Thus, the lesions which may not rupture at all in normal circumstances become exposed to the deleterious action of bacteria and deep scarring occurs. Application of irritable tropical creams, cosmetics and hair care preparations or constant contact to certain industrial compounds, which are comedogenic in nature may bring out or worsen the condition. Moreover, there are some medicines like lithium, glucocorticoid cream, isoniazide, halogens and phenytoins which may produce comedones or may exacerbate existing acne.

So, should you find any cyst like wound over your face or on the back, do not forget to pay attention and rush to your doctor for an expert opinion.