What is Acne ?

This skin disease affects a large number of individuals (mostly adolescents and young adults, but in some cases also adults in old age), of whom however only a small part develops the serious form. The onset of the disease and its evolutionary severity would seem to be to some extent also linked to genetic factors.

Usually acne occurs first in girls, often already in pre-pubertal age (before the appearance of menstrual flow), with the characteristic sign of greasy skin. As they grow older, it is more common in men (especially in the 16-18 age group); moreover, boys are more often subject to more prolonged and severe forms of acne than boys of the same age.

Acne is characterized by the presence of lesions of different appearance (papules, pustules, cysts), which are sometimes characterized by local accumulation of pus (abscesses) and manifest themselves in a rather painful and aesthetically invasive.

The disease usually appears on the face, in particular on the nose, cheeks and forehead, but it can also affect the skin of the back, in particular its upper part; more specifically, it affects the follicle-sebaceous unit and the sebaceous glands, which produce a higher amount of sebum (the so-called seborrhea). The retention of sebum, together with that of keratin, leads to a progressive occlusion, partial (open or black black blackhead) or complete (closed or white blackhead), of the sebaceous follicle.

Signs and symptoms

Acne manifestations can vary from very mild forms, characterized by a few white spots or a few small furuncles, to extremely serious situations, with pustules, nodules, cysts and consequent possibility of not definitive healings or residues of unsightly scars.

Usually the onset is represented by the fact that the skin becomes greasy and shiny: this sign is typical in young adolescents (especially in girls), and expresses a hormonal change related to puberty.

Then comedones may appear, which are the first actual manifestation of acne: better known as white spots or black spots, these occlusions are easily visible to the naked eye and are formed on the surface of the skin, which can also appear completely normal. It is never advisable to “squeeze” them: in this case, a white filament emerges from the blackhead with a dark end (the upper one). The blackheads generally tend to heal themselves (a phenomenon of self-resolution); more rarely there is a real inflammation, especially if they are manipulated with operations, in fact, of “squeezing”.

In its most severe form, however, acne typically manifests itself with inflammatory lesions such as pustules, nodules and cysts, commonly known as pimples: these lesions are accompanied by the presence of pus, with reddening of the surrounding skin, an unequivocal sign of inflammation. Inflammatory lesions can be little or even very painful and, in cases where the amount of pus contained in them is particularly significant, can give rise to the formation of large abscesses under the skin. If the lesions are not “teased” and the patient follows the doctor’s advice precisely, the acne heals without leaving any kind of result. Unfortunately, the skin is often treated in an exaggerated way: blackheads and furuncles are squeezed, and there is a general inflammatory state that leads to an evolution towards forms of acne, even very severe; the disease then becomes rather annoying and problematic also from a psychological point of view, as it greatly increases the probability of having permanent scars.