Acne Vulgaris, Part One.

This week in classes, we've continued to learn a lot about skin in general, about skin lesions, and skin diseases. One topic we covered in great length was the dreaded Acne Vulgaris. Almost everyone has suffered from acne or at least knows about this very common skin condition of the face, torso, and back. Not the most glamorous subject to be discussed, but a very important health topic that needs to be better understood. Here are some notes:

- It (acne) involves skin follicles. Follicles are skin organs that make hair, however they contain pilosebaceous glands that secrete sebum. The acne vulgaris species likes to feed off of sebum, which is why it mainly affects follicle and gland-rich areas of the body, such as the face and upper body.
- It is highly associated with stress and hormones, which is why many women "break-out" during their period.
- It can either be open or closed. Open acne consists of black heads (flat, dark colored, undeveloped lesions), while closed consists of white heads (inflamed, red and white colored, pustular lesions).
- Black heads are NOT DIRT. They are oxidized melanin, which is the pigment that makes up our skin tone.
- If acne lesions are picked, a secondary infectious agent can be introduced, causing more inflammation and delaying the healing process. This can also cause scarring. Secondary infections are common in the jaw area.
- White heads are trapped keratin plugs (i.e. holes in the skin that have been infected). The white part of the lesion represents the "battle ground", where white blood cells have accumulated (and some have died) while fighting off the infection.
- Acne should not scar unless the lesions have been subject to extensive trauma, such as scratching or rough washing. Take home message: be gentle with your skin!

Today featured a discussion of the anatomy of acne, tomorrow I'll discuss the treatment and prevention options.