Types of acne lesions include nonscarring, noninflamed blackheads (e.g., comedomes) or whiteheads, or inflammatory lesions (such as pustules, papules, and nodules). As the lesions heal, scarring may occur Figure 02, Figure 03, Figure 04. Blackheads appear to have black debris within a dilated pore, while the whitehead is a lesion with a white top. The black of the blackhead is not due to dirt, but to a change in pigment in the blockage of the pore. Nodules are larger, often painful, and can become very inflamed deep under the surface of the skin. They take longer to heal, and have the potential to scar. Scars from acne lesions can be red and flat, and tend to not leave permanent marks on the face. Other kinds of scars, however, can be permanent, and leave the surface of the skin nicked or indented (depressed) where the lesion was.
Figure 02. Mild acne on forehead of young girl
Figure 03. A mixture of comedonal and inflammatory acne
Figure 04. Severe popular, pustular and nodular acne
Because of the increased hormone levels in the body, being a teenager between the ages of 12 and 17 increases your chances of having acne.
If your family members have certain types of acne, you may be predisposed to the condition also. Similarities exist among family members in the patterns of acne lesions, as well as the duration and severity of acne.
Wearing cosmetics or using toiletries or hair care products that contain ingredients that cause the pores to clog (such as oil or talc) can put you at greater risk of developing acne. Some cosmetics, including makeup, foundation, night cream, and moisturizers, are called "comedogenic" because they cause pores to clog and acne lesions to form. Individuals should look for cosmetics and toiletries labeled as "noncomedogenic."
If you are exposed repeatedly to an environment that promotes oil production and clogging of the pores, you are at risk for irritated acne-prone skin. Risky or comedogenic environments include places where you are exposed regularly to grease and oil (e.g., fast food restaurants, or a mechanic's shop). Rubbing and friction from clothing, hair, or sporting equipment may also irritate acne-prone skin. If you play sports, especially those that require a helmet, it is a good idea to wash your face before and after you play, and tie your hair back, because it contains oil. If possible, replace the pads on the inside of the helmet regularly and keep your hair clean, especially if you tend to break out on your forehead.
If you are sensitive to seasonal changes and stress and are on medication for it, you may be prone to acne. In some cases, acne may be related to a drug prescribed for depression, seizures, or other mental illness. Certain other drugs can also increase the likelihood of developing acne. These drugs include lithium, isoniazid, halogens, phenytoin, and corticosteroids Ordinary, day-to-day stress is not enough to cause acne.
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