Acne - Rash

• Why does acne start and why is it most common during adolescence?
• What is acne?
• There are two types of acne
• Acne comes in various forms
• Causes of acne
• Stress and acne
• Taking care of your skin in puberty
• Professional treatment for acne
• Can I do acne treatment on my own?

Rashes and various other forms of acne are so prevalent during adolescence that they are considered a normal part of growing up.  Eight out of ten teenagers experience a rash on the face. Various forms of back acne are also a normal occurrence as well as different types of rash appearing on other parts of the body. It goes without saying that you will want to get rid of acne as soon as possible. The good news is we can tell you how to achieve this!  First, try to get as much information as you can about different types of rash, how to recognize acne, and what it actually is. Find out answers to basic questions about acne, such as what its origins are, what precipitates its occurrence, also what works for acne and what prevents it. Secondly, proper acne treatment at home is crucial. Learn how to give yourself an effective acne treatment at home. You will find more details on how to achieve this in this article.

Basic manifestations of acne are comedones (blackheads) and an inflamed rash. Depending on the   severity of the condition, several forms of acne can be distinguished. Do you realize that if you suffer from serious acne it is, in most cases, your own fault? Why is this? Well if, every time you look in the mirror, you touch or squeeze the rash, this aggravates the problem.  Therefore, you should remember that although it is extremely tempting, do not unnecessarily touch any rash or acne and never squeeze it, as by doing so you could seriously damage your skin.

In severe cases, acne treatment is definitely necessary and requires not just self-help but also help by a health care professional. You should be seen by a dermatologist.

Why does acne start and why is it most common during adolescence?

What do we consider as acne? It is one of the most common skin diseases. During puberty it occurs in almost everyone, with differing intensity. In late adolescence it disappears of its own accord. In some cases it stays with the sufferer till he/she is 30, and sometimes this can be even longer. The sooner acne appears the more serious its spread. It occurs slightly more often in boys and has a rather remarkable progression with them. Why is this?

During childhood the body secretes a minimum of sex hormones, but at around the age of eleven there is a veritable eruption of hormones. The “awakened” androgenic hormones (male sex hormones):

• cause the transformation of fine hair on certain body parts into longer and coarser hair.


• activate sweat and activity in the sebaceous glands. The sebum (oil) produced by sebaceous glands lubricates the surface of the skin and hair and protects it from damage.  

However, the sebaceous glands overproduce in the majority of young people during pubescence. It shows as oily and shiny skin, particularly on the face – the forehead, nose, chin, the temples and cheeks. It can also affect the arms, chest and the upper part of the back where the concentration of the sebaceous glands is the highest. Around the orifice of the hair follicle a sort of funnel is formed where the sebum (oil) accumulates. It continuously irritates the skin and encourages it to accelerated keratinisation. The walls of the funnel gradually thicken, the pores permanently widen and the skin resembles a perforated orange peel. In a lesser form the increased production of sebaceous glands is called seborrhoea (from Latin sebum = oil, rhoe = to flow). As almost all young people suffer from some symptoms of seborrhoea it is considered a physiological disease at this particular age.

What is acne?

Acne is a chronic inflammatory disease of the hair follicle and the sebaceous gland. Therefore it is quite natural for acne to target skin areas rich in sebaceous glands. This is why we find some form of rash on the face, on the chest, or back acne, particularly on the upper part of the back.

Generally, a certain amount of sebum (oil) is secreted onto the surface of the skin through the opening in the hair follicle, without any problems. With acne not only an excessive amount of sebum (oil) is produced but there is also an impaired keratinisation of the upper part of the follicle. This defect is inherited in most cases. The cells which form the walls of the follicle are shedding rapidly; they accumulate and plug the exit. The sebum (oil) is able to accumulate under a sort of “plug”. Moreover, the plugged follicles are a fertile environment in which the Propionibacterium acnes bacteria can multiply. Under normal conditions, these types of bacteria live, in small numbers, on our skin. However, their overabundance produces chemical substances and enzymes that cause inflammation. In time the blocked opening of the follicle cannot keep its contents and ruptures. The oil, shed skin cells and bacteria reach the surface of the skin and its surrounding. This is how the infection spreads.

There are two types of acne

The main manifestations of acne are comedones (blackheads) and an inflamed rash. The simplest form of acne is acne comedonica, occurring during puberty predominantly in the area of the nose, forehead and cheeks. Newly formed comedones (called closed comedones or white comedones/whiteheads) look like tiny white bulges on the top of the skin.  Older comedones reach the surface of the skin and  open. These are called open comedones or black comedones/blackheads due to their colour (a result of the melanin in the closure of the follicle orifice). This is the oxidized sebum (oil). It appears as a wormlike shape with a black head - known by its common name blackhead; the scientific name is comedo (plural comedones). Black comedones may last for a long time as their contents are secreted to the surface of the skin very slowly. Do not squeeze or scratch the black or the white comedones. They should be removed only by a cosmetician or dermatologist under sterile conditions. The skin tissue harmed by squeezing or scratching can become infected by staphylococci, streptococci or other skin bacteria. Once they are squeezed out the comedones can re-emerge after a few weeks.

Some skin comedones do not present a real problem and are not considered to be a disease. They may not look pleasant  but with proper,  regular care a young person can live through puberty without any negative impact to his/her skin or self-esteem.

Because the oil produced by the sebaceous gland cannot freely leave the sebaceous pore it can become a ‘fertile ground’ for some puss producing bacteria, and the comedo may become infected. If the individual infected comedones turn into a purulent rash, this needs to be treated by a dermatologist. Untreated the comedones (blackheads) may turn into acne. 

Acne comes in various forms

• Papules – start in the area of the closed and open comedones when the wall of the follicle is damaged. White blood cells hasten to the rescue and the pores become inflamed. This brings about the reddish colouring of the papules.


• Pustules – are formed from papules a few days later when the white blood cells reach the surface of the skin. These are usually called pimples. If they are small they only last a short period of time.  Larger ones can endure for more than seven days and it takes a long time for them to be absorbed and finally to disappear altogether.


• Cysts – are formed in severe cases of acne. The pimples and their surrounding skin become inflamed and the inflammation spreads into the neighbouring follicles. 


• Lesions/scars – After acne is successfully treated, the healing process of severe cases of inflammation leave unsightly scars that may last and thus remind the sufferer of the disease forever. 

Important note: Despite being hugely tempted, do not squeeze pimples every time you look into the mirror. Keep your fingers off them.  Using an improper angle of pressure or irritating the skin with your nails may create a deep inflammation which heals by leaving scars.

Causes of acne

Clinical tests do not confirm that oily skin and acne are the immediate result of improper nutrition (e.g. consuming lots of chocolate). On the other hand it is indisputable that a healthy diet and lifestyle support the immune system and lower the occurrence of inflammations in the body.  This is supported by the fact that up to 75 % of population in developed countries suffers from acne, while in the developing countries the disease is not known.

It can be caused or fostered by various factors:

• Impaired keratinisation of cells in the hair follicle and the plugging-up of   the follicle.


• Increased oil production due to androgenic sex hormones.


• Overgrowth of Propionibacterium acnes bacteria and yeasts, which are normally found on the surface of the skin in small numbers.


• Hidden or latent foci of inflammation inside the body  –  e.g. inflammation of the tooth root or inflammation of the tonsils.


• Excessive acidity in the body and its consequences (or other diseases of the stomach, liver, kidneys, or yeast infections, etc.).


• Heredity – you can expect to get acne if one or both of your parents suffered from it during their adolescence.

Stress and acne

Is there a connection between the two? The answer is a resounding YES. Stress may aggravate symptoms. But the effects of moderate or light stress can usually be tackled without major problems if a proper treatment for acne is chosen. The second question is: “How does stress influence acne?” The explanation is that the skin of acne sufferers has blocked pores that are, however, invisible. Stress brings about an inflammatory reaction in the body and may cause damage to the walls of these pores. When this happens the body reacts by reddening the area around the damaged pores and creating pimples. At the same time, during periods of stress the adrenal glands increase their function. The level of androgens (male hormones) produced by the glands is higher. This occurrence is particular to women who produce a higher percentage of androgens in their adrenal glands than men. This probably explains why women are more affected by acne than men when under stress.

Taking care of your skin in puberty

Stress, smoking, pollution, lack of fluids and insufficient fibre in the diet foster the formation of toxins in the body. Therefore, first and foremost, change your eating habits. If you are suffering from various types of rash or if you have a propensity to acne, it is necessary to undertake regular courses of treatment which detoxify the intestinal and blood systems and adjust metabolism. A big help is the Colonix Program. Moreover, taking nutritional supplements containing zinc, silicon, vitamin B, and also sea algae or the fresh-water green algae chlorella is also helpful.

Professional treatment for acne

The treatment for acne depends on the severity of the damage to the skin. Three stages are recognized, and each of them requires a different procedure for acne:

1.) The light stage of acne is shown as white spots on the face; there is no inflammation present. The treatment is not drastic and does not require antibiotics. It is sufficient to use cosmetic or pharmaceutical products containing benzoyl peroxide or retinoid.

2.) This stage is called inflammatory acne, presenting itself with small red and purulent pustules. It is treated similarly to light acne, but the treatment also includes antibiotics, which are applied topically.  Simultaneously, the treatment for acne is complemented with other, oral antibiotics for acne (belonging into the erythromycin, tetracycline, doxycycline, etc. group). Doctors usually combine all approaches, i.e. cleaning the skin with cosmetic topical antibiotics and taking antibiotics for acne.

3.) The most severe stage of acne produces purulent knots and cysts. This definitely requires the assistance of a doctor or dermatologist, who needs to proceed with great care and circumspection in order not to increase the damage.

Can I do acne treatment on my own?

Remembering the three basic causes of acne will make you appreciate why acne treatment at home, as well as professional treatment for acne focuses on:
(1) pore cleansing,
(2) killing of bacteria and
(3) minimising the production of oil.

It is important to maintain three rules of skin care while fighting acne:

• Active hygiene (regulating the keratinisation of skin and flow of sebum).


• Actively  fighting against inflammation and infection.


• Regular care  with hydrating products.

Proper acne treatment is very important. Below, I will give you an effective method of cleansing and afterwards disinfecting the skin. If you adhere to the given advice you’ll realize that it is possible perform your acne treatment successfully. You can avoid complications; it is all up to you – in fact, it is in your hands. 

a) Cleansing the skin:

• If the comedones (blackheads) are only on the surface, and are not inflamed and open, you can carefully remove them, in the evening, under strict hygienic conditions, i.e. with clean short nails covered in tissue. Squeeze them from the centre outwards so as not to cause red spots from accumulated blood; never towards the centre! Stripping the skin of oil using alcohol and coarse, uncaring methods destroys it; it becomes more sensitive and the condition deteriorates.


• Steam the skin before cleansing, or at least apply cotton pads soaked in a hot herbal infusion to the affected spots for a short while. You may also apply warm used camomile or lemon balm tea bags.


• After steaming cleansing can be complemented by squeezing the comedones that are not inflamed into the openings of an extractor. The extractor is a special metal spoon with an eyelet (obtainable from a health appliance store or on the internet). It is advisable to ask a cosmetician for usage instructions in order not to cause small scars by using the extractor improperly. You can also use a glass eye dropper; there is less risk involved, but it is also less effective.


• After steaming, individual comedones that are inflamed on the surface can be opened up with a disinfected needle (it is sufficient to disinfect the needle in a gas flame) and the puss soaked up with a cotton pad. Other self-help measures are not suitable and it is best to avoid them.


• Visit a cosmetician or dermatologist if you have painful pimples with a more pronounced and deeper inflammation.

b) Disinfection:

• After the local cleaning of comedones the skin should be disinfected (toners, containing less alcohol than previously, are in vogue) using disinfectant, astringent and calming substances. Extracts of agrimony, sage, tea-tree oil, manuka oil, dibenzoyl peroxide, camphor, menthol etc. have all been used successfully. After cleansing, astringent and antibacterial masks are beneficial. 


• Do not forget to disinfect your mobile phone, which is a scourge for the skin. It harbours many bacteria which are a source of rash on the area of the skin where it is placed. In order to prevent this clean the mobile phone while cleaning your skin in the evening.  Simply apply a cotton pad lightly soaked in a toner or use an antibacterial tissue. 


• Use emergency disinfectant sticks during the day. They contain a high concentration of antibacterial substances.  Dot the problem spots with them several times a day. This makes it possible to treat an inflammation early on and also prevent the spread of the inflammation over the rest of the skin.

- Prof. Katharine Horak, Doctor of Natural Science

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