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Acne Scars

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Overview of Acne Scars

Acne Meaning in Urdu

ایکنی جِلد کی ایک عام بیماری ہے جس کی وجہ سے جِلد کے نیچے ہیئر فولیکلز آئل اور ختم شدہ سیلز کی وجہ سے بلاک ہو جاتے ہیں۔ ایکنی کی بنیادی علامات میں وائٹ ہیڈز، بلیک ہیڈز، اور پمپلز (مہاسے) شامل ہیں، اس کے علاوہ ایکنی کی وجہ سے جِلد پر چھوٹے چھوٹے سرخ دھبے یا مہاسے بھی ظاہر ہو سکتے ہیں۔ جِلد کی یہ بیماری زیادہ تر نوجوانوں کو متاثر کرتی ہے مگر یہ دوسری عمر کے لوگوں کو بھی متاثر کر سکتی ہے۔ جِلد میں بیکٹیریا کی افزائش کی وجہ سے ایکنی کا سامنا کرنا پڑ سکتا ہے۔ اس کے ساتھ ساتھ جِلد میں اگر بہت زیادہ تیل پیدا ہو رہا تو پھر بھی یہ بیماری لاحق ہو سکتی ہے۔

Few skin conditions act up when an individual reaches puberty, acne is one of them.

Acne (Mahasey /مہاسے) is a chronic, inflammatory skin condition. It occurs when the hair follicles become clogged with oil and dead skin cells. Its clinical name is Acne Vulgaris.

Once the body reaches puberty, acne appears on the face. The breakout of acne can range from mild to severe. Acne is very persistent and recurrent. The bumps swell, fill with fluid, and after a few days, deflate. It might or might not scar the skin permanently. Acne causes emotional distress and can be irritating.

Prevalence of Acne 

Acne affects 3 in every 4 people from ages 11 to 30. It affects 9.4 percent of the world’s population. Acne has a prevalence rate of 5% in Pakistan. It is the eighth most prevalent disease globally. It is more common in males than in females.

In Islamabad, the prevalence rate is 14.47% in females. Adult acne is rare but not uncommon.

Signs and Symptoms of Acne Scars

Acne can vary depending on the severity of the condition. The following symptoms correlate with the types of acne:

  • Closed clogged pores
  • Open clogged pores
  • Non-pus red, tender bumps
  • Pus-filled bumps
  • Large, hard painful lumps under the skin
  • Pus-filled, painful lumps under the skin

Types of Acne Scars

The appearance of acne is termed as ‘breakout’. The most usual area to be affected by acne is the face but sometimes other areas of the body might get affected as well.

Types of acne don’t look the same. It is essential to identify the type of acne to get the right treatment started.

Acne is categorized into two types:

  1. Non-inflammatory acne
  2. Inflammatory acne

Individuals can suffer from more than one type of acne at once. 

Non-inflammatory Acne

Non-inflammatory acne looks like tiny bumps on the skin. It does not swell nor cause any time of inflammation. It is present in clusters, especially around the nasal area.

It is further subdivided into blackheads and whiteheads. Over-the-counter medicine can be used to treat this type of acne.

  1. Blackheads

Blackheads are also known as open comedones. They are a mixture of dead skin cells and sebum. 

The pores are clogged with this mixture, the top of the pores remaining open, and appearing to be dark or black. They raise tiny bumps. Hence, the name blackheads. 

  1. Whiteheads

Whiteheads are also known as closed comedones. Like blackheads, whiteheads can also form from the clogged pores of sebum and dead skin cells.

The top of the pores, in this case, close up, showing the exterior of a small bump. Whiteheads are hard to identify and treat because they are already closed.

Inflammatory Acne

Red and swollen acne showcase inflammatory acne. This type of acne can be caused by sebum and dead skin cells and sometimes by some bacteria.

Bacterial acne causes painful acne that is harder to get rid of because the infection is deep beneath the skin's surface. This also means that the acne comes back.

Inflammatory acne is further sub-categorized into: 

  1. Papules

Inflammation breaks down the walls surrounding the pores, resulting in papules. They are not filled with pus and are tender to the touch. The skin around the pores is usually pink. The pores are hard and clogged.

  1. Pustules

Pustules are pus-filled bumps. These are also formed by the breakdown of the wall surrounding the pore. The skin surrounding the pore is read with a yellow or white head on top.

  1. Nodules

Clogged, swollen pores when irritated or trifled with, grow larger. This is when nodules are formed. Nodules are much deeper in the skin. The deep interior causes them to be treated professionally, rather than at home. 

  1. Cysts

Cysts are filled with dead skin cells, sebum, and bacteria. They form a sac underneath the skin and over time, grow in size. They are often painful to the touch.

Cysts form due to deep infection and are named the largest form of acne. It can leave a scar.

Severity of Acne

Acne can range from mild to severe depending upon the severity of the condition.

Severity

Region/ Type

Comedones/ Papules / Pustules

Mild

Localized

<10

Moderate

Lesions on trunk

10-40

Severe

Deeper nodules

40-100

Intense

Cysts

Numerous
  • Blackheads and whiteheads are the mildest forms of acne. They are easily cleared up by toners or spot treatments.
  • Papules and pustules are moderate forms of acne. They require an oral or topical prescription.
  • Nodules and cysts are the severest forms of acne. They cannot be treated at home.

Causes of Acne Scars

Causes of acne can be common or widespread. Known causes of acne are:

  • Clogged pores
  • Sebum and dead skin cells accumulate in the pores
  • Too much sebum production
  • Bacteria
  • Inflammation
  • Family history
  • Hormonal change
  • Puberty
  • Periods or menstruation 
  • Pregnancy
  • Polycystic Ovary Syndrome (PCOS)
  • Certain medications
  • Friction or pressure on the skin
  • Allergy to cosmetic products
  • Environmental factors
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Risk Factors of Acne Scars

Some of the common risk factors of acne are as follows:

  • Age-Acne can affect anyone at any age. But it is more common in teenagers.
  • Hormonal Issues-Most of acne outbreaks is common during menstrual cycles, pregnancy, and at the onset of puberty. This is mainly due to hormonal imbalance.
  • Family History-Genetics plays a primary role in the development of this condition. In case both of the parents have had acne, the child is highly likely to develop it. 
  • Oily Substances-The chances of an acne outbreak quadruple when the person comes in contact with oily or greasy substances such as lotions or creams. That is why you should make sure that you are consulting with your doctor before the application of such chemicals on your skin.
  • Pressure on the skin-This mainly happens because of the long term use of helmets, backpacks, cell phones or tight collars.

Health Complications of Acne 

These given below acne complications are more apparent in people who have darker skin tones:

  1. Scars

Even after the acne has healed, dark pits remain on the skin for a long time period. 

  1. Changes in Skin

The skin may appear a bit darker (hyperpigmented) or lighter (hypopigmented) after the successful treatment of acne.

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Prevention

Acne is not a chronic condition. With on-time treatment and useful preventive tips, one can fight this condition. Some of the useful preventive strategies are as follows:

  1. Make sure to properly wash your face
  2. Avoid dehydration
  3. Always remember to remove your makeup before bedtime
  4. Avoid prolonged UV exposures 
  5. Do not pop your pimples 
  6. Limit the consumption of oily or greasy foods 
  7.  Exercise daily 
  8. Remember to use moisturizer
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Diagnosis

A simple physical examination is enough for a diagnosis. The severity of the acne is determined to recommend the best treatment plan.

Treatment of Acne Scars | When to Consult a Doctor

Depending on the severity, acne can be treated at home and by a professional.

Home Remedies

Taking good care of the skin is the first step in treating acne. The following remedies can be used to prevent and treat acne:

  1. Use a gentle cleanser to open the clogged pores and wash off excess dirt and oil.
  2. Using benzoyl peroxide products to promote peeling. This will allow new skin to come forward.
  3. Using salicylic acid, glycolic acid, or alpha-hydroxy acid products.
  4. Topical creams for acne dry up the pustule.
  5. Avoid using products that irritate the skin.
  6. Using sunblock to protect your skin from sunburn and further irritation.
  7. Don’t put pressure on the skin. Let it breathe.
  8. Don’t irritate the acne by touching it or popping it.
  9. Wash off sweat and always shower after exercise.
  10. Create a stress-free environment, as stress can worsen acne.

Medications 

Your dermatologist will help you with medication. Avoid self-medication.

Topical treatments 

These are done to treat mild acne. They may be in the form of gels, lotions, or creams. These treatments include:

  • Benzoyl peroxide works as an antiseptic and kills the bacteria causing infection. It also slows down sebum production.
  • Topical retinoids exfoliate the skin and thus remove dead skin cells. 
  • Topical antibiotics kill the bacteria that infect the pores.
  • Azelaic acid exfoliates the skin and kills bacteria.
  • Salicylic acid reduces inflammation and swelling.

Oral Medication

  • Antibiotics are used in cases of moderate to severe acne. This includes tetracycline or a macrolide.
  • A combined oral contraceptive is used to treat acne in women. They can stabilize hormone levels.
  • Anti-androgen agents block the effect of androgen hormones on women and girls.
  • Isotretinoin treats moderate to severe acne.

Therapies

Sometimes therapies alone or in combination with medications are used.

  • Light therapy kills off the bacteria in the pores.
  • A chemical peel improves the appearance of the skin.
  • Cysts can be drained.
  • Whiteheads and blackheads extraction can ease up the skin's pores.
  • Corticosteroid injection is used to treat severe acne.

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