Acne is an inflammatory disease of the sebaceous hair follicle. Each follicle contains a small hair and several sebaceous glands. Normally, sebum, an oily substance created by the sebaceous glands, travels up the hair follicle and exits onto the skin's surface. Its role is to lubricate and protect the skin. In acne, sebum is blocked in the follicle by certain surface cells, and a skin bacteria multiplies inside the blocked pores. Thus, the surrounding tissue becomes inflamed.
Acne can affect all teenagers (12-17 years old) at some point. It is estimated that over 90% of teenagers, 50% of adult women, and 25% of all adults have acne. Adults between 20 and even 40 years old can have acne. Some people may experience acne for the first time as adults. Acne affects young men and women equally. However, men are more prone to severe and long-lasting forms of acne. Adults can have different forms of acne, such as vulgar acne, cystic acne, or rosacea.
Acne can take many forms and can have different reactions in different people. In principle, acne is divided into two main categories: non-inflammatory acne (whiteheads and blackheads) and inflammatory acne (papules, pustules, nodules, or cysts).
Papule is a small solid lesion (up to 5 mm) slightly raised above the skin. A group of very small papules or microcomedones may be almost invisible but can be felt on touch. Papule is caused by a cellular reaction to acne. The lesion is a physical change in body tissue caused by a disease or injury/cut. A lesion can be external or internal.
Pustule is a fragile lesion containing a mixture of white cells, dead cells, and bacteria. A pustule forming over a sebaceous follicle usually has a hair in the center.
Comedone is a sebaceous follicle filled with sebum, dead cells from inside the follicle, small hairs, and bacteria. When a comedone is open, it is called a blackhead because it has a black appearance on the surface. A closed comedone is called a whitehead; it appears as a colored or slightly inflamed bump on the skin.
Macule is a temporary red spot that remains after a healed acne lesion. It is flat, usually red, with a well-defined border. It may persist for several days before disappearing.
Nodule, like a papule, is a raised lesion with an irregular shape. Unlike a papule, the nodule is characterized by deeper inflammation of the skin and can lead to tissue destruction and therefore scarring. Nodules are very painful and only respond to certain treatments.
Cyst is a sac-like lesion containing white cells, dead cells, and bacteria. It is larger than a pustule, can be very inflamed, and extends deep into the skin. Cysts and nodules often occur together in a form of acne called nodulocystic acne.
Rosacea represents the second evolutionary stage of rosacea, an inflammatory skin disease. This skin condition, rosacea, affects mostly women between 40 and 50 years old, before or after menopause. The most common locations for rosacea are the cheeks, nose, and chin. It starts as a blush, initially related to emotions, temperature changes, menstruation, alcohol consumption, which may disappear over time after the cessation of the aggressive factor. Later, the redness combines with telangiectasias (dilated vessels in the skin) that appear as red lines disappearing when pressure is applied to the cheek, nose, or chin.
After a period of time, pimples are added, which can become infected, turning into pustules. Untreated, this condition worsens, the redness becoming permanent, the telangiectasias giving an unsightly appearance to the skin, the pimples hypertrophy, become larger, and at the level of the nose, especially in men, there may be a thickening of the skin, with hypertrophy of the sebaceous glands on a red-purple background called rhinophyma.
Frequently, predisposition to rosacea is hereditary. Among the possible causes, exaggerated dilation of vessels in the skin, endocrine disorders (often occurs at menopause), various gastrointestinal conditions such as gastritis, irritable colon, transit disorders, avitaminosis, and some infections have been identified.
Climate plays a very important role in the appearance and worsening of rosacea. It is favored by the cold season, sudden temperature variations, strong sun, exposure to ultraviolet light, or other extreme weather conditions. Flares can also be triggered by alcohol consumption, hot drinks or food, consumption of highly spicy products, and tobacco.
Wrinkles are fine grooves found on the surface of the skin; they appear as we age because cells divide more slowly, and the inner layer of the skin, the dermis, thins. Elastin, which is the protein that gives the skin freshness, and collagen fibers (which are the proteins responsible for supporting the skin) become weaker and can rupture, causing wrinkles to appear. Factors influencing the appearance of wrinkles include: prolonged sun exposure (causing destruction of collagen in the skin), smoking, poor hydration of the skin, facial expressions (frowning, for example, leads to wrinkles appearing much faster), aging (the skin loses elasticity, failing to maintain good hydration, which leads to the appearance of wrinkles), wind, cold.
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