Acne treatments

Acne is a skin condition where the sebaceous gland follicle becomes inflamed. It mainly occurs in areas with the most active sebaceous glands, such as the face's T-zone (forehead, nose, and chin), back, neck, throat, and shoulders.  

During puberty, the body produces more hormones, including androgens, which stimulate the sebaceous glands, leading to increased sebum production. Each sebaceous gland has a pore through which sebum is released. Sebum keeps the skin and hair supple, is water-resistant, protects against dehydration, and boosts the skin's resilience. 

However, thicker sebum combined with dead skin cells can block the pores, causing blackheads. A blackhead, or comedo, can appear as either a black or white spot. Those with a white spot are deeper and can block the entire pore. Additionally, scaling can occur over the gland's excretory duct, further clogging the pore. The sebaceous glands contain bacteria that convert sebum into fatty acids. As the sebum accumulates, the clogged follicle expands and can eventually burst. This allows irritants to enter the surrounding skin, causing inflammation and resulting in acne spots and pimples. 

Acne can be worsened by several factors, including: 

• Genetics (family history of acne) 
• Hormonal factors (menstruation and pregnancy) 
• Polycystic ovarian syndrome 
• Stress 
• Cosmetic use 
• Friction from clothing 
• Climate changes 

Acne presents in many forms, with common types including: 

• Acne vulgaris: The most frequent type, involving comedones, spots, and pustules in varying degrees. 
• Acne comedonica: Mild acne dominated by comedones rather than inflammation. 
• Acne conglobata: Severe acne featuring large and double comedones, nodules, and cysts, often resulting in scars. It mainly affects young men and may persist into adulthood. 
• Acne excoriée: Worsened by picking or squeezing pimples, leading to scarring. 
• Acne tarda: Similar to acne vulgaris but occurring in adults. 
• Acne ectopia (hidradenitis suppurativa): Caused by hair follicle inflammation, often in the groin or armpits. 
• Acne fulminans: A rare, severe outbreak with inflamed pustules that rapidly turn into open wounds, accompanied by fever, fatigue, blood disorders, and joint pain. 

Acne is usually found on the face's T-zone (forehead, nose, and chin), but also on the back, chest, shoulders, neck, and throat. It can appear as: 

• Blackheads (comedones): Open black comedones with a black plug or closed white comedones with a white spot. 
• Pimples or spots: Clearly defined raised areas on the skin. 
• Pustules: Visible skin cavities filled with pus. 
• Subcutaneous inflammation, nodules, and cysts: Nodules are firm, deep skin lumps that may leave scars, while cysts are closed fluid-filled cavities. 

Symptoms vary in combination and severity, and when acne is no longer active, scars and marks may still be visible. 

Proper treatment can reduce or eliminate acne. Cleanse the skin once or twice daily with lukewarm water, avoiding soap, scrubbing, or exfoliating. Do not squeeze blackheads, pimples, or spots, as this may worsen the condition and cause scarring. Avoid smoking, as it negatively impacts the skin. While healthy eating, adequate hydration, and moderate alcohol consumption do not directly influence acne, they certainly do not make it worse. Be cautious with makeup, as some products can clog sebaceous glands. Shower with lukewarm water after exercise, as sweat and friction can aggravate acne. Moisturising creams can also help.

Acne vital (z.d.). Acne fulminans and acne congoblata. Consulted on 23 April 2019 from https://acnevitaal.nl/acne/soorten- acne/acne-fulminans/

Apotheek.nl (Last updated KNMP: 29-09-2017). What medications are used for acne? Consulted on 23 April 2019 from https://www.apotheek.nl/klachten-ziektes/acne#welke-medicijnen-worden-gebruikt-bij-acne

Dr. Njoo D (z.d.). Acne. Consulted on 23 April 2019 from https://www.huidarts.com/huidaandoeningen/acne/

Ear skin therapists (z.d.). What does acne look like? What forms of acne are there? Consulted on 23 April 2019 from https://www.thoord.nl/aandoening/acne/

NHG (z.d.). Acne summary map. Consulted on 23 April 2019 from https://www.nhg.org/standaarden/samenvatting/acne

Pharmacotherapeutic compass (z.d.). Treatment plan Acne. Consulted on 23 April 2019 from https://www.farmacotherapeutischkompas.nl/bladeren/indicatieteksten/acne_vulgaris#acne_vulgaris_treatment plan

Skin care Royale (z.d.). Acne and quality of life. Consulted on 23 April 2019 from https://huidzorgroyale.nl/huidproblemen/acne/acne-vulgaris/

Skin care Royale (z.d.). Acne ectopia. Consulted on 23 April 2019 from https://huidzorgroyale.nl/huidproblemen/acne/acne- ectopica/

The Blaak outpatient clinic (z.d.). Acne treatment. Consulted on 23 April 2019 from https://www.polikliniekdeblaak.nl/huidziekten/acne-behandeling/