Acne

Comedones

The disruption to the natural cornification causes a plug of horny cells to form in the sebaceous follicle – a so-called blackhead or whitehead, or to give it its correct medical name, a comedo.
Closed comedones are skin-coloured knots the size of a pin, without any visible opening.
Open comedones have a central opening and are black on the surface. The black visible dot is not dirt, but rather a skin pigment, the colorant melanin.

Papules, pustules, and knots

As a result of inflammatory processes that also involve certain bacteria, reddened spots (papules), pus blisters (pustules), or – in severe cases – knots can develop from comedones or microcomedones.

Scars

Acne can also result in the formation of scars. Various scars can develop, e.g. pock or ice-pick like sunken scars and also those that protrude out of the normal skin appearance. To prevent scars, an early treatment of acne is necessary.

Forms of acne

Depending on the degree of severity, acne is frequently classified in a simplified form, into mild, moderate, and severe acne. The predominance of certain inflammatory lesions (e.g. papules or pustules), or non-inflammatory lesions (comedones), as well as the number of these lesions are assessed.

The most fundamental and "actual" form of acne is acne vulgaris. If there are predominantly comedones, the term acne comedonica is used. If there are predominantly spots and pus blisters, the acne is also called acne papulopustulosa. If these are joined by deep, inflammatory knots, or cysts, the term acne conglobata or acne cystica is used.

Special forms of acne

Acne vulgaris normally occurs temporarily and disappears around the age of 25. However, it is increasingly the case, particularly among women, that the acne appears for the first time or reappears from the age of 30 up until 40. In contrast to younger patients, the skin of patients with so-called late acne or acne tarda tends to be dry.

As a possible cause of acne tarda, it is often assumed, among other things, that discontinuing the anti-baby pill promotes the sensitivity of the sebaceous cells to male hormones (androgens). Another hypothesis is that everyday stress apparently strengthens the impact of the androgens on the receptor of the sebaceous gland. Being overweight also plays a role in late acne. Various biochemical processes that occur in the fatty tissue influence the hormonal balance and result in the increased formation of male hormones.

Another form of acne - acne excoriée des jeunes filles - develops through the 'compulsive' manipulation of existing or presumed skin impurities.

Acne-like diseases can also be caused by certain medicine (e.g. steroid acne), through constant contact with lubricants and/or tar products (so-called oil or tar acne), and through poisonous, chlorinated substances, e.g. dioxins (so-called chlorine or Seveso acne).
Mallorca acne is also a well-known form that can occur as a reaction after contact with cosmetics, or sunscreen products.
The long-term and excessive use of moisturising, facial, night and sunscreen creams can result in acne cosmetica.
Other special forms of acne include, among others, acne in women caused by androgens, and acne in infants (acne neonatorum), and young children (acne infantum).