Acne dysmorphia

Acne dysmorphia is a rare but debilitating mental illness, linked to body dysmorphic disorder, which manifests itself as a total preoccupation with a deformity of some kind, and is similar in psychiatric terms to Anorexia Nervosa.

Obsessive behaviour

Acne dysmorphia, put simply, is the obsessive thought that the sufferer's skin is irregular or disgusting. In most cases they do have acne, but even when the acne is very mild or even non-apparent, the person will believe that they have "horrible skin" or "terrible acne". A sufferer is usually not far from a mirror, and may obsessively and relentlessly check for imperfections.

Instead of seeking psychiatric help, the patient will often look to other avenues of recourse, sometimes self-inflicted and harmful. For instance, a person might pick at their imperfections until they tear away the skin and bleed. The extent of this disorder should not be underestimated. It can take over a person's life and ruin their chances for normal social interaction. Understandably, patients are often shy in telling their physician about their obsessive thoughts and behaviors. It is therefore important that the physician ask questions if acne dysmorphia is suspected. Left untreated, the disorder may manifest itself in the patient causing harm.

Not surprisingly, people with acne dysmorphia can be depressed. It is important that a person who suspects that he or she has acne dysmorphia consult a psychiatrist for possible treatment options. Some of the serotonin reuptake inhibitors (SRIs) may help. Cognitive-behavioral therapy is often helpful as well.

Causes of acne

The cause of pimples is unknown. The process by which a pimple develops is highly intricate. While we do know that a pore collapses on itself and blocks sebum (oil) from escaping, we do not fully understand why this process takes place in one sebaceous gland versus another.

Causes of adult acne and teen acne may include hormones, diet, evolutionary biology, vitamin deficiency, stress, and more. The real explanation may be a complex mix of many of these factors.

Since we do not know what causes pimples, our time is better spent finding a tested and effective treatment.

Helpful links:

• Hormones and acne - See this page of Acne.org for more on hormones and acne.

Cure Acne in 3 days! Herbal Acne Cures! The Acne Cure!

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The market is littered with "cures for acne". However, if you ask any dermatologist or medical researcher, they will tell you a cure does not exist. While Accutane does provide long term remission for some patients and an argument could be made that it approaches an "acne cure" in these cases, you will not find a cure on the Internet or in the back of a magazine.

Since there is no cure for acne, your time is better spent looking at how to treat and prevent acne. In my experience, benzoyl peroxide is the best over-the-counter medication for preventing acne. But with benzoyl peroxide, as with any other acne medication aside from Accutane, you must be deliberate and steady and follow an acne treatment regimen until you grow out of acne naturally. Prevention is the key.

For a free, non-commercial acne prevention regimen, visit the Regimen pages of Acne.org.

Hormones and acne

Acne - a hormonal disease

Acne by its very nature can be considered a hormonal disease. Hormones are responsible for the maturation of the oil glands in our skin. This is why children do not experience acne.

There are several times in our lives when our hormones can become unbalanced and wreak havoc, including puberty, pregnancy, menopause, and, well, any other time they feel like it. More specifically, acne may be precipitated by androgens, male hormones present in both men and women. The oil surplus created by these hormones may be instrumental in clogging hair follicles where bacteria grows and causes acne pimples and blemishes. Hormonal acne is seen mostly in women due to the natural cycles a woman goes through, such as menstruation, pregnancy and menopause. Because of this, some birth control pills, in small doses and with other topical remedies, can be used to reduce blemishes by keeping androgens steady. Anyone considering using this type of treatment should consult a physician first.

I have received many e-mails from women in their late 20s and older who are experiencing an acne flare-up or even acne for the first time in their lives. These women have also reported that the Regimen helps clear up their adult onset hormone induced acne, so the Regimen is definitely worth a shot.

Female acne

Premenstrual adult acne

Premenstrual adult acne may be caused by over-stimulated androgens (hormones that stimulate sebaceous glands and hair follicles in the skin). During this time a woman’s oil-producing glands can go into overdrive. Women may also see acne throughout their cycle, the cause of which we do not fully understand.

Acne and pregnancy

Pregnant women and women undergoing menopause and post-menopause may also experience hormonal acne. During pregnancy in particular, it is important that an expectant mother speak closely with her physician regarding appropriate acne treatments, topical or oral.

There are a few treatment options available for adult female acne. For women who have found that antibiotics or topical treatments have not been helpful, there are still alternatives. After consulting a physician, many women have turned to birth control. As an acne treatment, birth-control pills, when used in low-dosages, can decrease the amount of extra androgens, therefore limiting breakouts. Before resorting to this type of treatment, women should be aware of other side effects related to birth control and consult a gynecologist.

In my experience, men and women do not differ much in terms of effective acne treatment, and simple topical treatment is often the best option. I have personally coached many men and women through the Regimen with equal success.

Adult acne

Statistics

Adult acne affects 25% of all adult men and 50% of adult women at some time in their adult lives. These are the official statistics, but I personally don't know many adults who have not had a zit or two in their adult lives. People can develop unpleasant acne or have an acne recurrence in their 20s, 30s, 40s and beyond. It can be difficult to cope with no matter your age, and can cause depression and social anxiety in an adult the same way it can in a teen.

Causes of adult acne

Although the causes of adult acne are unknown, it is thought that adult acne may sometimes have hormonal roots. The appropriate adult pimple treatment may involve getting your hormones in check which requires a trip to your doctor.

Treatment of adult acne

There are many adult acne products, however, in my experience, the overall best treatment for adult acne is identical to the best treatment for teen acne, benzoyl peroxide. See the Regimen for a step-by-step program you can use to clear your skin using benzoyl peroxide. Thousands of adults have used the Regimen to treat their acne with great results.

Not so uncommon

It is important to realize that adult acne is more common than people may think, and adult sufferers are not alone. If you are troubled by adult onset acne, promptly consult your doctor. She or he may have a hormonal adult acne treatment that can help, or read the Regimen and give it a go.

You can find further tips to stop adult acne on the adult acne message boards. Many adults frequent the boards and are happy to answer questions.

Types of acne

There are many variations of acne, ranging in severity from mild to severely disfiguring. The Regimen works well to combat moderate to light acne. Severe acne may require more aggressive treatment. Visit the Types of acne message boards to seek further help from other members.

Acne Vulgaris - mild/moderate

Acne Vulgaris is the most common form of acne which includes several types of pimples. These acne lesions include blackheads, whiteheads, papules, pustules, nodules and cysts.

Mild to Moderate acne vulgaris consists of the following types of acne spots:

Whiteheads: Whiteheads result when a pore is completely blocked, trapping sebum (oil), bacteria, and dead skin cells, causing a white appearance on the surface. These types of acne lesions sometimes seem to be begging to be popped. Make sure you read about how to pop a pimple before you attempt this. Whiteheads are normally quicker in life cycle than blackheads. You can view a diagram of a whitehead on the what is acne page. The Regimen provides a step-by-step program on how to treat a whitehead.

Blackheads: Blackheads result when a pore is only partially blocked, allowing some of the trapped sebum (oil), bacteria, and dead skin cells to slowly drain to the surface. The black color is not caused by dirt. Rather, it is a reaction of the skin's own pigment, melanin, reacting with the oxygen in the air. A blackhead tends to be a stable structure, and can often take a long time to clear. You can view a diagram of a blackhead on the what is acne page. The Regimen provides a step-by-step program on how to treat blackheads.

Papules: Papules are inflamed, red, tender bumps with no head. Do not squeeze a papule. It will do no good, and may exacerbate scarring. The Regimen provides a step-by-step program on how to treat papules.

Pustules: A pustule is similar to a whitehead, but is inflamed, and appears as a red circle with a white or yellow center. Pustules are your garden variety zit. Before you pop or squeeze such a lesion, be sure to read about how to pop a pimple. The Regimen provides a step-by-step program on how to treat pustules.

Acne Vulgaris - Severe

Severe acne vulgaris is characterized by nodules and cysts:

Nodules: As opposed to the lesions mentioned above, nodular acne consists of acne spots which are much larger, can be quite painful and can sometimes last for months. Nodules are large, hard bumps under the skin's surface. Scarring is common. Absolutely do not attempt to squeeze such a lesion. You may cause severe trauma to the skin and the lesion may last for months longer than it normally would. Dermatologists often have ways of lessening swelling and preventing scarring.

Cysts: An acne cyst can appear similar to a nodule, but is pus-filled, and has been described as having a diameter of 5mm or more across. They can be painful. Again, scarring is common with cystic acne. Squeezing an acne cyst may cause a deeper infection and more painful inflammation which will last much longer than if you had left it alone. Dermatologists often have ways of lessening swelling and preventing scarring.

Acne Rosacea

Acne Rosacea can look similar to the aforementioned acne vulgaris, and the two types of acne are sometimes confused for one another. Acne Rosacea message board

Rosacea affects millions of people, most of whom are over the age of 30. It appears as a red rash which is normally confined to the cheeks, nose, forehead and chin. The redness is often accompanied by bumps, pimples, and skin blemishes. Blood vessels may also become more visible on the skin. Blackheads are not a part of rosacea. It is more prevalent in women, but often more severe when found in men. Left untreated, it can cause swelling of the nose and the growth of excess tissue, a condition called rhinophyma. Treatment is often different for rosacea than for acne, and it is important that you consult a doctor can determine if what you are experiencing is acne vulgaris or rosacea.

Severe forms of acne

Severe forms of acne are rare, but they are a great hardship to the people who experience them, and can be disfiguring--and, like all forms of acne, can have psychological effects on the sufferer.

Acne Conglobata: This is the most severe form of acne vulgaris and is more common in males. It is characterized by numerous large lesions, which are sometimes interconnected, along with widespread blackheads. It can cause severe, irrevocable damage to the skin, and disfiguring scarring. It is found on the face, chest, back, buttocks, upper arms, and thighs. The age of onset for acne conglobata is usually between 18 and 30 years, and the condition can stay active for many years. As with all forms of acne, the cause of acne conglobata is unknown. Treatment usually includes isotretinoin (Accutane), and although acne conglobata is sometimes resistant to treatment, it can often be controlled through aggressive treatment over time.

Acne Fulminans: This is an abrupt onset of acne conglobata which normally afflicts young men. Symptoms of severe nodulocystic, often ulcerating acne are apparent. As with acne conglobata, extreme, disfiguring scarring is common. Acne fulminans is unique in that it also includes a fever and aching of the joints. Acne fulminans does not respond well to antibiotics. Isotretinoin (Accutane) and oral steroids are normally prescribed.

Gram-Negative Folliculitis: This condition is a bacterial infection characterized by pustules and cysts, possibly occurring as a complication resulting from a long term antibiotic treatment of acne vulgaris. It is a rare condition, and we do not know if it is more common in males or females at this time. Fortunately, isotretinoin (Accutane) is often effective in combating gram-negative folliculitis.

Pyoderma Faciale: This type of severe facial acne affects only females, usually between the ages of 20 to 40 years old, and is characterized by painful large nodules, pustules and sores which may leave scarring. It begins abruptly, and may occur on the skin of a woman who has never had acne before. It is confined to the face, and usually does not last longer than one year, but can wreak havoc in a very short time.