A chronic skin disease, acne is due to overproduction of sebum, an oily substance, by the sebaceous glands of the forehead, nose, chin, chest, back of shoulders and outer side of the thighs. It is precipitated by production of testosterone. The condition of acne is associated with dyspepsia, constipation, lack of fresh air, lack of exercise, and in women it tends to worsen during menstruation.
Black spots or whiteheads on the skin indicate that the mouth of the small sebaceous ducts are clogged with dirt; little pustules, slightly inflamed, grow, burst and heal. In severe cases, pores rupture and the sebum carries bacteria into the skin tissue, causing hard red lumps up to half an inch across. These last for weeks or months, slowly suppurate, and leave a permanent hardness. Although not a serious health hazard, acne causes widespread psychological discomfort, especially among teen-agers.
Although there is no precise definition of acne, most authorities consider the presence of at least 5 to 10 comedones, or noninflammatory lesions, a requirement. Some further restrict the diagnosis of clinically significant acne to more widespread involvement or to the presence of at least several inflammatory elements, including papules, pustules and nodules.
Occurring in persons with sebarrhoea, acne is found in both sexes, usually in the age group 14-20. There is an individual predisposition to the disease, dependent upon the development of the sebaceous glands which takes place at puberty. In adolescence, acne affects more boys than girls; later, however, the sex prevalence is reversed. In all age-groups, males suffer a disproportionate incidence of severe involvement.
There are millions of acne sufferers all over the world. In France alone, it was recently estimated that 5 million people suffer from acne. An estimated 17 to 28 million Americans have some degree of acne; 7 million have at least moderately intense activity, and 750,000 have more severe inflammation.