The scourge of adolescence, acne appears in young adults very frequently and is the cause of much concern, anxiety and even behavioral disorders that can lead to forced changes in life style. It has a wide range of presentations from tiny black dots (black heads) to large cystic reddened lesions that can lead to lifelong disfigurement. This article is to explain, at least partially, the cause, course and treatment of this common problem in an effort to ease the pain that your adolescent might go through.
At a certain time in a child’s life, usually between 12 and 16 years of age, there is an outpouring of hormones into the system as puberty begins to show itself. These hormones, along with other bodily changes, cause very small glands in the skin to increase production of a thick gooey material that then tries to make its way through tiny ducts to the skin surface. When it does, this substance becomes oxidized by the oxygen in the air and can turn a dark or black color. It also becomes more thick and tends to further block that duct. This is what is referred to as a “black head”. In this stage it is not infected and if that plug could be removed the thick material might very well ooze out and the “problem” is over.
In a certain amount of cases, however, that plug remains and skin bacteria (everyone has bacteria growing on their skin) get into the duct and begin to grow. As it grows, “pus” is produced and the duct becomes filled with white material replacing the black outer plug. This is now a small pimple or “white head”. If the situation remains unchanged and the bacteria continue to grow this can cause an inflammatory reaction and the skin around the lesion will turn red and become sore. At this point it will usually open and drain by itself. In even a smaller number of cases the pimple can grow quite large (especially if it is manipulated- attempts to “squeeze the pimple”) and cause cystic lesions which, when healed, can leave scars.
The process of pimple formation is not affected by anything your adolescent does, such as eating sweets or fatty foods, and he/she must be made aware of this. After a certain amount of time, the initial bombardment of hormones decreases in intensity as the body acclimates to its new level of maturation and in most cases the acne spontaneously resolves.
In my next post I will address the treatment options of acne.