Acne is a disorder of the skin’s sebaceous glands that results in plugged skin pores and skin lesions. Acne presents with blackheads, whiteheads, inflamed papules, pustules, cysts and nodules. Acne occurs on the face, as well as the neck, chest, back, shoulders, and upper arms. Although most teenagers get some form of acne, adults in their 20’s, 30’s, 40’s, or even older, can develop acne. Acne is not a serious health threat, but it can be disfiguring and upsetting to the patient. It may leave permanent scars. Nearly 17 million people in the United States have acne, making it one of our most common skin diseases.
Medically, acne is defined as a chronic inflammatory skin condition mostly occurring on the face in which the hair follicles of the skin become plugged with sebum. Signs and symptoms of acne include whiteheads and blackheads on the face, neck, shoulders, or back, as well as pimples and cysts. All hair follicles contain sebaceous glands that secrete fatty oil (sebum) to lubricate the hair and skin. When the body produces sebum and dead cells faster than they can exit from the pore, the two solidify as a white, cheesy plug. The acne plug may appear as a whitehead if it doesn’t protrude from the follicle and is covered by the epidermis or a blackhead if it does protrude and isn’t covered by the epidermis. Pimples are infections that develop when whiteheads rupture the follicle wall. A sebaceous cyst is a flat, pliable lump under the skin which forms when a sebaceous gland continues to secrete material that does not rupture through the skin. Although acne is a chronic concern from puberty through early adulthood, it primarily affects adolescents. Three out of four teenagers complain of acne.
Acne medication reduces the clumping of cells in the follicles and oil production, and diminishes bacteria and inflammation. In conventional Western medicine, topical medication includes topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics. Oral medication includes antibiotics, birth control pills, tretinoin or isotretinoin, corticosteroids, and anti-androgenic drugs.
In TCM theory, heat is nearly always involved in the etiology of acne: wind heat, damp heat in the intestines and stomach, or heat in the blood. Heat in the blood produces the most severe cases of acne. Strong emotions may result in stagnated heat and produce acne symptoms.