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 Propionibacterium acnes 

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Acne can affect people from ages 9 through to middle-age. Acne can show up as any of the following; congested pores, whiteheads, blackheads, pimples, pustules, or cysts - deep pimples, spots. These blemishes occur wherever there are many oil or sebaceous glands, mainly on the face, chest, and back. Acne is commonly referred to in slang as zits.

ACNE - acne occurs when sebaceous glands under the skin begin to secrete superfluous oil during puberty. The sebum oil production glands are stimulated by male hormones that are produced in the adrenal glands, of both boys and girls. 

The oil generally lubricates and protects the skin, but this acute secretion, gives millions of us many problems, especially as young adults. Inadvertently, cells that are close to the openings of the sebaceous glands sometimes block the openings. This causes a build up of oil underneath the skin, and as part of general decay, bacteria go to work on this organic material. Other bacteria, which live in our skin but are generally benign, devour this oil and multiply, and cause the surrounding tissues to become inflamed, as a mild infection.

When the infection is right near the surface, a pustule is formed; if it is deeper, a papule or pimple is formed. Deeper still and it becomes a cyst. If the oil breaks though to the surface, the result is a whitehead. If the oil becomes oxidized, acted on by oxygen in the air, the oil changes from white to black, and the result is a blackhead. This is how the two types of comedones develop.

ACNE - any inflammatory disease of the sebaceous, and or oil glands of the skin. There are around 50 different types of acne. In common usage, the term acne is frequently used alone to designate acne vulgaris, or common acne, probably the most prevalent of all chronic skin disorders, especially in teenagers.

Acne vulgaris results from an interplay of heredity factors, hormones, and bacteria. In susceptible individuals, it begins in the teen years, being caused by overactive sebaceous glands, which are stimulated by the upsurge in the circulating level of male sex hormones that accompanies the onset of puberty. 

The primary lesion of acne vulgaris is the comedo, or blackhead, which consists of a plug of sebum -  the fatty substance secreted by a sebaceous gland, cell debris, and microorganisms, especially the bacterium Propionibacterium acnes, filling up a hair follicle. Comedones may be open, their upper or visible portion being darkened by oxidative changes; or they may be closed (i.e., not reaching the surface to be extruded), in which case, they may be starting points for pustules and deep inflammatory lesions.

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Comedo: The primary sign of acne consisting of a dilated or widened hair follicle filled with keratin squamae - skin debris, bacteria, and sebum oil. A comedo may be closed or open. A closed comedo has an obstructed opening to the skin and may rupture to cause a low-grade skin inflammatory reaction in the area. The common name for a closed comedo is a whitehead. An open comedo has a wide opening to the skin and is capped with a blackened mass of skin debris. It is commonly known as a blackhead.

Comedo is the Latin word for glutton. The ancients believed that the contents of a comedo were the remains of a gluttonous worm. Note that the preferred plural form of comedo is comedones.

The severity of acne is divided generally into four grades. In grade I, comedones may be sparse or profuse but there is little or no inflammation. 

In grade II, comedones are intermingled with superficial pustules and papules - small, solid, usually conical elevations. The lesions are ordinarily confined to the face and do not produce significant scarring, unless there has been continued scratching and picking. At this stage, topical - locally applied medication is reasonably effective. Complete spontaneous remission is ordinarily seen within one to two years. 

In grades III and IV, the acne is characterized by comedones and pustules and deeper inflamed nodules, which are thought to result from the rupture of the sebaceous duct, with extrusion of sebum and bacterial products into the skin tissue. The lesions are likely to extend from the face to the neck and upper trunk and to produce a permanent scarring of the skin.

The course of acne vulgaris is variable, persistence being ordinarily directly related to the severity of the lesions, although changes of climate and emotional stress may markedly improve or exacerbate the acne lesions. 

Methods of treatment vary from topical medication to sunlight and ultraviolet light, antibiotics, and hormones. In a high proportion of cases, however, the tendency is toward spontaneous cure over several months.

How To Reduce An Acne Problem

It is sometimes hard to come to terms with Acne, for the majority of people it will be no bother, some may not have any spots at all. However, most will have at least a few, with other people having many spots, pimples or zits. Some that will go deep and produce horrific scars that will last a lifetime.

Points to Watch

• You should never squeeze, pick, scratch, or rub your skin where you suspect there is a zit, as it makes the problem worse; it might even cause scarring.

• Methodically shampoo your hair, pick the shampoo that suits your hair. Try to keep hair away from your face if possible - especially at night.

• Keep a diary on what you eat, to work out if you are a particularly prone person whose acne gets worse if they eat certain things. Take advise on what to eat, though foods do not generally cause acne, but you should eat sensibly and in moderation.

• Exercise regularly to obtain a much healthy demeanor, increase blood-flow and general health. Always shower after a good work out of any kind, and use a soap for greasy skin.

• Drink plenty of clean fresh water.

• Try not to touch your face to often as this will encorage the introduction of dirt and bacteria. 

• Stress can make the production of superfluous oils higher, If possible, try to minimize your stress levels.

• Avoid sunburn.

• Always use a new / clean face-flannel every time you wash. Bacteria will multiply on a used damp face cloth. Never use a face-flannel anyone else has used. Wash your face twice a day with a gentle soap. Always rinse really well with lots of clean water.

• There are products that you can buy that will, over time, reduce scarring.

    

In serious cases where you have to see a doctor

You may be given an oral antibiotic, this will decrease inflammation and decrease bacteria from inside the body, it will help your body's immune system fight the problem. These antibiotics are most successful for acne sufferers with lots of papules, pustules and cysts.

The most common application are topical antibiotics, as they are useful to destroy skin bacteria by being directly applied to the surface of the face. Topical antibiotics can be used unaided or in combination with other agents.

Benzoyl Peroxide is a peeling agent that dries the skin, and helps to prevent the growth of bacteria.

Topical Vitamin A derivatives, including tretinoin, adapalene, or tazorac, are peeling agents that loosen the blockages of the skin pores / follicles. They are most supportive in the reduction of blackheads and whiteheads.

 

Bacteria  - Microscopic single-celled organisms found wherever life is possible. Generally 0.0001–0.005 mm long, they may be spherical (coccus), rodlike (bacillus), or spiral-shaped (spirillum) and often occur in chains or clusters of cells. True bacteria have a rigid cell wall, which may be surrounded by a slimy capsule, and they often have long whip-like flagella for locomotion and short hair-like pili used in a form of sexual reproduction. A few bacteria can use simple chemical substances, including carbon dioxide from the atmosphere, to manufacture their own nutrients, but most require a source of carbon derived from living organisms (i.e. organic carbon) plus other nutrients for growth. Some bacteria can reproduce every 15 minutes, leading to rapid population growth.

 

The most important role of bacteria is in decomposing dead plant and animal tissues and releasing their constituents to the soil (see carbon cycle). Nitrogen-fixing bacteria in the soil or sea convert atmospheric nitrogen gas to nitrites and nitrates, which can then be used by plants (see nitrogen cycle). Cheese making and fermentation reactions depend on bacteria. Bacteria also play an important part in animal digestion, especially in ruminants. However, certain (pathogenic) species may cause disease while others, such as Salmonella, can cause food poisoning.

 

 

A narrative verdict has been recorded at the inquest into the death of a "fit and healthy" 14-year boy who died 12 hours after taking tablets for acne.

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