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Symptoms of Acne: Zits, Pustules and Papules

What is acne? Acne vulgaris is simply the medical term for pimples or spots. It's the lucky few who get through life without zits or pimples. (Usually appearing on the eve of a big date, the disease has a cruel, but uncanny, sense of timing.)

Acne vulgaris usually appears on the face and shoulders, but infection of the back is also quite common. Whiteheads develop first, as the hair follicles become clogged and infected. A whitehead is a small, pinhead-sized spot. As the hair follicle expands from its internal pressure, the contents push upwards and turn a darker color, forming blackheads.

When a whitehead or blackhead ruptures, its infected contents come into contact with the skin, spreading the infection. This is when pustules form. Pustules are inflamed pus-filled areas of skin: classic zits. If zits become badly infected they can become cysts, an extreme form of pustule that is rooted deep in the skin, and can be quite painful. Cysts can lead to scars.

What are Papules?
Papules are any form of lump or swelling that appears on the skin. As such, you may hear zits or pimples referred to as papules from time to time. It's just a general medical term used to describe any abnormal swelling or skin lump.

Acne Information: Name that Zit!

Not all pimples are created equally and, sometimes, different skin care tips apply to different pimples. A nodule, for instance, often causes pain and usually requires treatment from a dermatologist. Whiteheads and blackheads, on the other hand, can often be controlled without medical intervention. Here are some of the more common members of the acne family:

whitehead: an infected hair follicle that remains under the skin
blackhead: that same hair follicle if it breaks through the skin's surface
nodule: a solid skin lesion that is often painful and buried deep in the skin
pustule: an inflamed, pus-filled area of skin infected by material from a ruptured whitehead (a.k.a. a "pimple")
cyst: like a pustule gone bad that goes deep into the skin and can lead to scarring.

Keloid and Acne Scars

Keloid is a common form of scarring. A keloid is an abundance of scar tissue that stands out from the rest of the facial skin. If exposed to excessive sunlight over the first year it forms, a keloid may take on a permanently darker color than the surrounding skin.

Severe scars can give a face a "cratered" appearance, such as the acne scars borne by actors James Woods and Tommy Lee Jones. Some treatments are designed to reduce the chances of scarring. Most mild to moderate acne does not result in scarring or keloids.

Hidden Scars

The disease is so often presumed to be simply physical that its mental effects are often overlooked. Teenagers with severe acne have a high incidence of depression, which can lead to relationship problems, low self-esteem, and, in extreme cases, even suicide. Acne can be mentally devastating, and its ability to cause emotional pain should not be overlooked.

It's Not Just the Face

Acne usually restricts itself to the face and shoulders, but back acne can occur, especially in severe cases. In extreme cases, the disease can spread to the trunk, buttocks and legs. Cystic acne is one of the more common severe types. With the cystic variety, multiple cysts develop, causing widespread scarring. To control and reduce scarring, cystic acne sufferers should seek treatment from a dermatologist.

Resources

American Academy of Dermatology. (1999). Acne. Retrieved March 19, 2002, from www.dermatologychannel.net/follicle/acne/.

American Academy of Dermatology. (1999). Patient information pamphlets. Retrieved March 19, 2002, from www.aad.org/pamphlets/.

National Skin Centre (Singapore). (nd). Information on common skin diseases. Retrieved March 19, 2002, from www.nsc.gov.sg/cgi-bin/WB_GroupGen.pl?id=33.

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