A cross-sectional, community-based study was conducted in Egypt between October 2010 and January 2011 to determine the prevalence, beliefs, patients' attitudes, severity, and impact of acne on quality of life.
The prevalence of acne amongst the sample was found to be 54.2 percent, with no difference between urban and rural areas.
Prevalence was found to be slightly higher amongst females (56 percent) than males (52 percent).
Eighty-three percent of the participants believed that acne is a serious disease. Other misconceptions included the belief that acne is incurable (45 percent of participants) and that it is contagious (58 percent).
Acne is the most common skin disease of adolescence, with approximately 85 percent of teenagers in the US experiencing this condition each year.
The prevalence of acne varies between countries, as was highlighted by the Journal of Investigative Dermatology in 2009. Reported rates vary between 49.8 percent and 93.2 percent.
Acne may occur as early as age 8 and persist until approximately age 72, but, on average, acne affects individuals from 15 to 42 years of age. Accordingly, most of us have either had acne or know at least someone who did. Although it is common, available information about acne can be misleading.
So what is acne?
Acne is an inflammation of special units in the skin, known as pilosebaceous units (PSUs). PSUs contain special glands, which are connected to hair follicles. These glands produce an oily substance (sebum) that empties onto the skin via the hair follicle.
Simply put, acne occurs when these glands cannot empty the sebum. Propionibacterium acnes, a specific type of bacteria, then grows inside those glands and causes inflammation. No one really knows why one person develops acne and another person doesn't.
Nevertheless, some contributing factors have been identified by dermatologists. These include:
Hormonal factors: Increased levels of hormones, known as androgens, that occurs in both boys and girls during puberty, increased sensitivity of these glands to the effect of these hormones, and hormonal changes related to pregnancy or to starting or stopping use of birth control pills may also cause acne.
Genetic factors.
Some medications like steroids, lithium, and oral contraceptives.
Emotional stress can definitely cause exacerbations.
Occlusion and pressure on the skin is often an unrecognised exacerbating factor. This occurs by leaning the face on hands or from pressure by e.g. a helmet.
Diet: The role of diet in acne is controversial as the result of research is contradicting. Acne is definitely not caused by diet. Nevertheless, if you have acne, it is best to avoid milk and food with a high glycemic index as they may increase acne by increasing insulin-like growth factor, which has a role in the formation of acne.
But what exactly is acne?
Acne can present as blackheads (an open clogged hair follicle opening), whiteheads (a closed clogged hair follicle opening), papules (inflamed lesions that usually appear as small, pink bumps on the skin and can be tender to the touch), pustules (white or yellow pus-filled lesions that may be red at the base), cysts (deep, painful, pus-filled lesions that can cause scarring), and/or nodules (large, painful, solid lesions lodged deep within the skin).
Because there are more PSUs on the face, upper back, and chest, these areas are more commonly affected by acne.
Acne may lead to low self-esteem and depression. Without treatment, dark spots and permanent scars can appear on the skin as acne clears.
The American Academy of Dermatology recommends the following tips to reduce your acne:
Wash your skin at least two times every day and especially after sweating.
Clean your skin using a gentle, non-abrasive cleanser.
Use alcohol-free facial products. Do not use products that irritate your skin, which may include astringents, toners and exfoliates.
Do not scrub your skin.
Rinse with lukewarm water.
Wash your hair frequently to avoid oils getting from your hair onto your skin.
Do not pick, pop or squeeze the acne.
Do not touch your face.
Apply a non-comedogenic sunscreen whenever you are exposed to the sun.
Consult a dermatologist if one of your parents or siblings has acne that has left scars, if you have a lot of acne lesions, cysts, or nodules, and if your acne is leaving scars or darkening your skin.
Dermatologists can help treat existing acne, prevent new breakouts, and reduce your chance of developing scars by prescribing topical treatments (such as retinoid, benzyl peroxide, or antibiotics) and/or oral treatments (such as antibiotics, isotretinoin, or hormonal treatment).
Moreover, there are many available procedures that can help treat the acne and/or the scars (such as comedone extractions, chemical peels, light therapies, or LASERs).
Dr Dina El Disouki is a Fellow of Dermatology at the Egyptian Fellowship Program, and Dermatologist at Cutis "The Skin Clinic".
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