Description

Almost every teenager is affected by acne (including blemishes), boys usually more severely than girls. In addition to acne (acne vulgaris), which occurs during the hormonal changes of puberty, acne can also occur – much more rarely – as a result of hormone intake and in the context of diseases (see below). If acne occurs in adults over the age of 25, it is called acne tarda, late acne or adult acne. Blemished skin is usually recognised by its slightly greasy, shiny appearance. Open and closed blackheads appear mainly on the face, but often also on the neck, shoulders, chest and back. In moderate to severe cases, the skin is reddened and inflamed pimples, papules and pustules appear.

Causes

[+] Hormonal changes/disorders

 

[+] Medications (e.g. lithium, steroids, cortisone)

 

[+] Dietary style (high amount of carbohydrates, excessive consumption of cow’s milk and milk products etc.)

 

[+] Smoking and alcohol

 

[+] Unsuitable skin care products and make-up that have not been tested for their so-called comedogenicity

 

[+] Poor or insufficient cleansing of the skin

 

‍

 

Possible effects on your biomarkers

Micro-inflammations

Personal predispositions and hormonal changes create a pro-inflammatory micro-environment. This causes increased formation of micro-comedones, which eventually lead to skin blemishes.

 

Seborrhea

This is the term used to describe excessive sebum production. Normally, the sebaceous glands secrete an oily secretion that keeps the skin and hair supple. If certain changes occur in the hormone balance, impure skin can develop. The first visible sign is increased sebum production.

 

Hyperkeratosis

This refers to a thickening of the outer layer of the skin, the horny layer (stratum corneum). Due to excessive cell production and insufficient desquamation of dead, horny cells, the sebaceous gland excretory ducts are blocked and disturb or interrupt the outflow of sebum. As a result, the pores become clogged and impurities develop.

 

Microbial colonisation

There is a mixture of “good” and “bad” bacteria on the skin. Propionibacterium acnes, which is classified as “bad”, multiplies greatly when it finds optimal conditions – excessive sebum production – and leads to impurities.

 

Inflammation

The body reacts to this excess of bacteria and the bacterial degradation products with inflammation, which becomes visible as reddened papules and pustules. In severe cases, the follicle wall can break open in the late phase. Lipids, fatty acids, horny cells, bacteria and cell fragments are released and cause extensive and deep inflammation in the surrounding tissue.

 

Forms

There are several forms of acne (acne vulgaris), which are characterised by different skin changes:

 

Acne comedonica

This is characterised by the appearance of open and closed blackheads (impurities) which are not or hardly inflamed. The number of closed blackheads clearly exceeds the number of open blackheads, especially in women. In acne comedonica, the blackheads are mainly located on the face, especially on the sides of the nose, chin and forehead.

 

Acne papulo-pustulosa

In this form of acne, in addition to blackheads, there are inflammatory pustules (pus-filled protuberances of the excretory duct) and painful papules (up to five millimetres in size) and small nodules (five to ten millimetres in size) when touched. In addition to the face, the chest, back and upper arms can also be affected. Different types of scars can develop quickly or later from the inflammations.

 

Acne conglobata or cystic acne

Mainly men are affected by this severe form of acne that requires medical treatment. One to two centimetre large, highly inflammatory and painful nodules form, which in the course of time merge with each other to form ducts or encapsulate as deep abscesses. After the inflammations have healed, characteristic acne scars remain.

 

There are also various other forms of acne, some examples of which are listed below:

 

Acne fulminans

occurs as a complication of acne conglobata. It can lead to fever and the death of affected skin areas (skin necrosis), kidney inflammation and joint inflammation.

 

Acne neonatorum

occurs in newborns, but heals quickly after delivery. The cause is thought to be male sex hormones that are transferred from the mother to the embryo.

 

Acne infantum

means that the acne persists in infancy. A possible cause is congenital hormonal enzyme deficiency or locally over-oily skin.

 

Acne medicamentosa

Pimples and pustules caused by medication, for example cortisone preparations, vitamin B complex, iodine compounds, antidepressants or modern anti-tumour preparations.

 

Acne venenata (occupational acne/contact acne)

Affects people who work with oils or tar, for example, or who work in hot and humid environments (melting furnaces, mangles), or it is caused by blackhead-inducing ingredients in cosmetics.