Laserklinik DRes Steinert

Acne is a disease of sebaceous glands. In the adolescence, an increased sebum production and a hornification of sebaceous gland duct can occur. As result of that, hair gets greesy very quickly, the surface of the skin is shiny and later “famous” pimples appear. The disease begins with increased sebum production. The sebum cannot completely drain off from sebaceous glands; it is accumulated under skin surface. These are so called comedones (blackheads and whiteheads).

Because of bacterial colonisation, swelling can occur, so that papules become visible and sometimes turn into pustules. Very seldom, deep painfull papules appear that can heal up later.

Opposite to a common opinion, acne has nothing to do with insufficient hygiene or an allergy to certain foods. In the therapy, the causes of acne are treated: depending on findings, degreased, but at the same time skincare washing substance, peelings against sebum conjestion, external and internal medications combatting bacteria, hormones, and in difficult cases also a vitamin A-derivate can be applied. Light exposure to the sun, medical cosmetic acne treatment and healthy diet is a great addition to the treatment. Smoking deteriorates skin appearance and increases the risk of cysts formation. Acne is a skin disease and must be treated.

A common type of acne, which is called acne vulgaris, is one of the most common diseases among the young people. It develops not because of insuffient hygiene, but because of hormoneous stimulation of sebum glands, especially in the adolescence. Many girls observe a cycle-related fluctuation of the acne intensity. In the most cases, acne manifestation decreases approximately at the age of 25 by itself. Still acne is a real skin disease and must be treated accordingly.

Acne-type changes especially affect such skin parts, which have many sebum glands, such as face, back and breast. From time to time acne herds also appear on unusual places such as on the groin or on the armpits (acne inversa).

Acne can appear in different severity codes. Blackheads are referred to as easy acne or comedones. They appear when a sebaceous gland duct is congested. That can happen because of a microscopically small cornea particle of the upper skin layer. Now the produced sebum cannot get to the surface of the skin. A comedon has appeared.

The colour of a comedon has nothing to do with an unclean skin, or because someone does not wash himself. The black points on the skin appear because of the influence of skin lamellaes of the upper skin layer.

Later pustules/abscesses can often appear. They develop from blackheads because of bacterial imflammation of congested sebum.

In the case of difficult forms of acne vulgaris, inflamed nodules and acne scars often appear. Kligman und Plewig differentiate between three different grades of acne:

In the case, there are more pustules; a strongly anti-bacterial therapy must be performed, in the case there are more comedons, reduction of sebum production and elimination of an obstacle to sebum flow is more important. Special medical cremes can help as well as tablets and skin cleaning in addition to that (physical-manual acne-therapy). Furthermore, low doses of UV irradition and treatments with a pulsed dye laser can be successful. Girls after menarche can also be treated by antiandrogen in form of a pill, after a prior consultation with a gynecologist. Young men can take vitamin-A preparation as an internal treatment in severe cases. Light solar irradiation and healthy diet are a great addition of course. Smoking deteriorates skin appearance and increases the risk of cyst formation.