Every young person develops pimples , blackheads and an impure complexion during puberty . Acne is the aggravated form of this natural formation. It is primarily an inflammation of the sebaceous follicle.

First of all, it produces non-inflammatory comedones that are only a nuisance for aesthetic reasons. Over time, however, inflammatory efflorescences such as pustules or nodules develop. Acne occurs particularly frequently in young people, occasionally even in newborns and rarely in adults.

Typical signs of severe acne are pimples , pustules, blackheads , inflamed sebaceous glands and sometimes purulent blisters .

causes

Natural acne occurs when the sebum follicle produces too much sebum. This initially develops into a comedo. Psychological factors such as stressful situations , but also physical stress , for example from smoking , can greatly promote the development of acne. As soon as the first comedones have formed, the bacterium Propionibacterium acnes comes into play. It promotes the inflammation of the blackheads and in this way leads to the typical appearance of the disease.

Acne can also be caused by external influences. These forms occur more frequently in adults and newborns, since naturally occurring acne occurs more quickly in adolescents and external influences only further promote it. Excessive UV radiation causes the lipids contained in sun cream, for example, to react with free radicals in the skin and can lead to acne-like skin. Other cosmetics can also cause it if they don’t leave enough room for the skin to breathe.

In other cases, chemical substances are to blame. Drugs containing lithium or corticosteroids, as well as direct contact with chlorine or tar, can provoke a skin reaction.

Symptoms, Ailments & Signs

The symptoms that appear depend on the type of acne a patient is suffering from. With acne comedonica, which is mainly observed in women, open and closed blackheads form, which are visible as small black dots. Blackheads are particularly common on the nose and chin and are often associated with greasy skin.

Inflammation rarely occurs with this form of acne. In contrast, inflamed, pus-filled pimples and reddish papules are typical for acne papulo-pustulosa. Sometimes small knots form, which can become painful. The pimples and pustules primarily affect the forehead, chin and cheeks.

They also often spread to the neck, chest, and back. Inflamed, pus-filled pimples can leave scars after they heal. This risk is particularly great when patients express the pus pimples, which also usually aggravates the inflammation or spreads it to other skin areas.

In rare cases, acne conglobata occurs, which affects men more often than women. In this form of the skin disease, patients suffer from highly inflammatory nodules that can grow up to two centimeters in size and often mutate into deep abscesses .

Course

Adolescent acne usually occurs in girls at the beginning of the 12th to 13th year of life, in boys the acne usually occurs one to two years later, but then lasts longer accordingly.

The first signs are typically severe with purulent pimples and blackheads. But generally oily skin and oily hair also indicate acne.

As a rule, pubertal acne does not have to be treated by a doctor, but can be favorably influenced by cleanliness and facial hygiene.

Sometimes, however, severe forms of acne occur, whereby not only the face, but also the back, chest and buttocks can be severely affected by pimples and blackheads. It is beneficial to have this extreme form of acne treated by a dermatologist in order to prevent scars as much as possible .

complications

Acne occurs primarily in adolescents who are just reaching the age of puberty. At this age, acne can be relatively widespread. This disease does not necessarily need to be treated as it does not represent a harmful situation. However, if the patient feels uncomfortable with it, the acne can also be treated with medication.

In most cases, acne will go away on its own. Here, however, the period of healing can be relatively long. In other cases, acne can worsen, leaving severe scars on the skin. If the acne is treated by a doctor, it is usually treated with medication or with a cream or ointment.

Drugs have some side effects, such as headaches or general dry skin. Anyone who uses ointments and creams against acne will also often suffer from dry and cracked skin, as they remove the fat from the skin. In the case of very severe acne, the disease can also lead to psychological problems.

This includes a general malaise or depression caused by bad and impure skin. These can be further aggravated by incidents at work or school. In most cases, acne has a positive course of the disease.

When should you go to the doctor?

Acne during puberty is normal. However, this common skin condition can take different forms and go through several stages. Even newborns and small children can be affected by certain forms of acne.

In the case of milder forms of acne, visits to the dermatologist are not absolutely necessary. However, these should be done if those affected are suffering from acne. In some people, acne persists into adulthood. This is another reason to see a dermatologist.

The dermatologist first determines how severely the skin is affected and what form of acne it is. Without this determination, the treatment cannot take effect. Acne can be work-related or triggered by medication. Acne inversa, chloracne or alcohol-related acne must be treated differently than normal puberty acne. In addition, acne can have hormonal causes that may also require treatment. Gynecologists or andrologists are responsible for this .

Physiological acne, which frequently occurs in adolescents, can be treated with commercially available creams, lotions and cleansing fluids. However, if there are pronounced forms with purulent inflammation and furuncle formation, a doctor’s visit is advisable. This makes sense against the background of possible scarring. Each form of acne requires different treatment strategies.

Treatment & Therapy

All cases of acne that go beyond the mild form must be treated by a dermatologist (skin specialist). The drug treatment aims to prevent the formation of new blackheads , to heal the inflammation and to have a positive effect on the keratinization process in the sebum follicle.

First, a cream is prescribed, which is infused with alpha hydroxy acids. These have a comedolytic effect and dissolve the first blackheads. They also act against the formation of new ones. As a rule, at least three months must be treated with the cream.

At the same time, antibiotics can be given to fight the bacteria on the skin that are responsible for acne. They are either applied as a cream or taken in tablet form.

There are many other treatments that work in a similar way.

In women, it can help to administer additional hormones . Affected women usually produce too many androgens, which can promote acne. Therefore, she receives targeted therapy with female hormones to gradually resolve the acne.

Outlook & Forecast

In most cases, acne is mild, ie the symptoms are not particularly pronounced. In these cases, the acne goes away on its own after puberty is over and the hormonal balance has stabilized, leaving no scars.

If the acne persists into adulthood, the prognosis is less favourable. Visible, deep scars usually remain. Although the scars can be reduced, the skin will not appear completely free of scars, which can sometimes cause psychological problems for those affected. Otherwise, the patient does not have to fear physical impairments. Rarely does acne persist beyond the age of forty – the prognosis is therefore always favorable.

In acne inversa (a particularly severe form of acne), the skin changes can promote the development of skin cancer. Those affected should have their acne treated by a dermatologist at regular intervals . With regular check-ups and treatments, the prognosis for acne inversa is also good.

prevention

Acne can only be prevented to a limited extent. Since it results from an interplay of internal physical relationships over which the human being has little influence, he can only avoid external causes as far as possible. Cigarette smoking should always be avoided, and a balanced diet can help to keep the skin healthy. Cosmetics should always be thoroughly removed after wearing to allow the skin to breathe. Pimples should never be squeezed, otherwise the acne will spread.

aftercare

After acne has been treated, various circumstances can make follow-up care necessary. Many of those affected retain scars that they find unaesthetic or that even cause them serious problems. The discoloration of the scars (usually reddish in light complexion) disappears on its own after a few months. However, heavier scars also form depressions or elevations.

Depending on the severity and level of suffering, there are various treatment options to reduce or even eliminate such scars. The gentle therapy methods in particular can be used by those affected themselves with the help of home remedies or over-the-counter products. Dermatologists and professional beauticians have tools available that can be used to achieve clear results more quickly.

However, these initially attack the skin tissue more strongly, making it susceptible to undesirable effects such as inflammation or discoloration. Therefore, methods such as abrasion, laser therapy or TCA peelings should only be carried out by specialist staff and under medical supervision.

Since acne can in principle appear at any age, a recurrence is possible even after successful therapy. Sufferers should continue to follow the same dietary and personal hygiene principles that help prevent and treat acne.

You can do that yourself

Acne does not necessarily have to be treated by a doctor. In most cases, the pimples can be reduced independently with the right skin care and some home remedies .

First of all, it is advisable to clean the affected parts of the body several times a day with a fresh washcloth. Before using creams, we recommend a nourishing steam bath with additives of rosemary , chamomile or sea salt. Honey and quark also help with acne and provide the skin with moisture and minerals. To prevent the acne from spreading further, the pimples should not be touched or squeezed out if possible. Inflamed or burst blackheads are best disinfected with alcoholic facial tonic. In addition, high-fat creams and peelings should be avoided in order to avoid further skin irritation.

If these measures have no effect, the pill may also help. The preparation can help to improve the appearance of the skin, but as a remedy for acne it should only be used in consultation with a gynecologist .

Finally, a healthy lifestyle helps. A balanced diet , exercise and enough sleep reduce acne and contribute to a clear complexion in the long term.