Acne
Acne is a condition caused by over activity, blockage and possibly infection of the tiny glands, called pilosebaceous glands, where hairs grow. Each hair follicle has an associated gland which produces a substance called sebum, which lubricates hair growth. Under the influence of testosterone the activity of these glands increases. At the same time there is blockage of the end of the follicle producing what is called a comedone (if it’s open it’s a blackhead, if it's closed it's a whitehead). The gland continues to secrete sebum, which may become infected and inflamed, forming first a papule, then a pustule, then a cyst. If this extends deep into the dermis then there is the risk of scarring during the healing process. Since this is a disease associated with hair it can affect any part of the body where there is hair-bearing skin (which essentially means everywhere apart from the palms and the soles) but it most commonly affects the face, the neck, the chest and the back, and while most people who suffer acne during adolescence find the disease has run its course by the early twenties, some five per cent of the population are lifelong sufferers.
Acne is worsened by stress and anxiety, but there is no convincing evidence it is related to particular foodstuffs. Mild cases may be managed by topical agents such as benzoyl peroxide which have an anti-bacterial action, or topical antibiotic agents together with treatments aimed at unplugging the blocked follicles. More severe cases may respond to antibiotics taken by mouth, though the treatment needs to be prolonged. For women there are treatments available which block the effects of testosterone (young men would find the side effects of this unacceptable). In severe cases where there is a risk of scarring the compound isoretinoin, which reduces sebum production and unblocks follicular cysts, may be effective, but can have adverse effects on the liver and lipid metabolism.
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