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Pimples - Acne.Acne simplex, or simple acne, is the affection commonly known as pimples, black heads or flesh worms. It is, perhaps, the most frequent of all the affections of the skin ; indeed, few people attain the age of 30 years without having suffered-in mind if not in body - from the occurrence of this annoying affection. It is especially aggravating, from the fact that it usually flourishes most during the very years when the individual is most sensitive as to his personal appearance and condition, and from the further fact that if these pimples occur anywhere on the body, they are almost sure to appear on the face, where they cannot be concealed. It is a curious and familiar fact that the disease never makes its appearance before puberty; that it is most luxuriant during the ten years following this period, and that it subsides spontaneously in early manhood, usually by the thirtieth year. This occurrence during these particular years of life has led to the popular impression that there is some intimate connection between the presence of this disease and the sexual function. Various ideas prevail as to the reasons for the occurrence of pimples upon the face. Some people ascribe them to a repression of the sexual instinct, and are firmly convinced that marriage would be a sovereign remedy, while others regard the occurrence of acne as evidence of improper excitation of the genital organs. Long observation by medical men has failed to reveal the slightest foundation for either of these beliefs, and both are certainly extremely unjust to a great many young men and young women. Acne is essentially a disease of the sebaceous glands. The mouths of these glands become stopped up, so that the material which is secreted in the little sac cannot escape. It will be remembered that these sebaceous glands secrete a certain oily material, which is in the natural condition poured out upon the skin, and serves to keep the surface smooth and flexible. This oily matter should be constantly poured out upon the skin, since it is constantly being secreted in the interior of the sac or gland. When from any cause it fails to escape, either because there is some mechanical obstruction, or because the secretion itself becomes so thick that it cannot pass out of the little orifice or " pore," there results an accumulation of this oily material in the sac. This sac is therefore gradually distended, and becomes large enough to make a little elevation on the skin. Meanwhile the oily matter located in the pore of the skin has usually absorbed enough dust and dirt to become black, whence the name " black heads. " In some individuals these distended sacs remain for a considerable time without undergoing further change ; in others the matter accumulates constantly, until finally a considerable lump appears, which is known as a wen. This happens with especial frequency when the sebaceous glands of the scalp become stopped up. But in the majority of cases the pressure of the distended sac on the tissues around it causes an inflammation. This manifests itself by redness and by swelling; in this way the familiar " pimple " is developed. Sometimes there occurs nothing more than a red swelling, but in the majority of cases the inflammation proceeds until matter is formed around the distended sebaceous sac, making the pustule which so often disfigures the face of the unfortunate patient. If the contents of the sac be pressed out before the inflammation has proceeded to this extent, there appears a white, spiral shaped body, resembling a worm somewhat in shape. From this appearance there is derived the popular notion that the disease is due to the presence of worms in the skin. These white bodies are however, not worms, but merely the accumulated secretion of the gland ; their form is simply that of the distended sac. There is sometimes found in the contents of these glands a microscopic parasite, which is not, however, a worm. There is no reason for believing that these parasites have anything to do in causing the disease, since they are not found in all the pimples, but simply in comparatively few. Cause.-Acne is essentially a disease of the sebaceous glands; yet there must evidently be some cause affecting the system whereby this diseased action of the glands is induced. For it seems certain that the starting point of the whole difficulty is the change in the nature of the secretion, so that the oily matter no longer flows out of the gland but remains in a hardened condition. It is also established by experience that this affection of the skin can be and is often induced by derangements affecting other parts of the body. There is a well-established relation between the diet and the occurrence of this disease. Thus in many persons a crop of acne pustules is sure to appear after eating buckwheat cakes or mince pie ; in other individuals cheese, nuts, raisins and pastry induce the same effect. In some cases acne can be traced directly to the abuse of alcoholic beverages ; indeed, this is frequently the case in those instances of acne which occur in elderly people. The condition of the bowels also seems to have a direct con nection with the appearance of these pimples upon the face ; many individuals who suffer from acne are troubled with habitual constipation, and procure relief from the skin eruption only after the bowels are regulated. In other cases there is evidently imperfect activity of the liver. Sometimes the appearance of these pimples is a regular sequel to over-indulgence in the pleasures of the table. Another form of acne occurs particularly in poorly nourished individuals, especially in those who are commonly termed " scrofulous. " This form, however, is apt to appear more particularly on the breast and on the limbs; it is not so troublesome as a deformity in the face. It should be mentioned in this connection that a rash quite similar to acne is produced by the use of certain drugs. Thus, if tar be painted upon the skin for several days in succession, a rash quite similar to acne appears ; and this rash is often noticed on the persons of those who have to use tar constantly in their work. The same effect is produced by the long continued use of the iodide of potassium or by the bromide of potassium ; and may also follow the application of petroleum to the skin. It has sometimes been observed in those who have to oil machinery, presumably from the irritating effects of the rancid oil. Treatment.-The treatment of acne is one of the most troublesome undertakings which the physician is ever called upon to perform. This difficulty arises doubtless from the fact that it is often impossible to locate the source of the disease. For, as has been said, the starting point of the affection may be found in derangements of the various digestive organs ; while on the other hand the individual gives absolutely no other signs of disease than are manifest on his face. In general it is necessary to secure regular evacuations of the bowels. This may be accomplished in the way indicated while speaking of constipation : the use of a glass or two of mineral water, or of a wineglassful of the liquid citrate of potassium, will be one of the preparatory steps in the treatment of the disease. The diet, too, must be regulated so as to avoid those particular articles which are found, by the experience of the patient himself as well as others, to provoke the formation of pimples. In general it may be observed that whatever causes marked flushing of the face will be apt to favor the production of acA.e pustules. The use of alcoholic beverages, of hot drinks, pastry, buckwheat cakes, etc., should be carefully avoided in case it is found that pimples appear in unusual number after indulgence in these articles. The local treatment of acne must vary somewhat with the general condition of the patient, as well as with the assumed cause of the disease. The patient's inclinations lead him to remove the unsightly black spots on the face. This may be done, but should be done with care ; if the skin be merely compressed between the fingers, there is apt to result much redness and swelling, which is far more unsightly than the object whose removal is sought. It is generally recommended that a watch key be employed for the purpose, being pressed firmly against the skin around the black spot. A still better article is a small silver tube which is made for the purpose. Even this procedure is apt to be followed by considerable redness and swelling, hence it is advisable to employ this measure only at night. The irritation may be somewhat lessened by bathing the face with hot water or with bay rum. Numerous lotions and ointments are recommended and sold for the cure of acne; yet none of these can be relied upon, unless proper measures are taken to remove the condition of the stomach, bowels, liver, etc., upon which the difficulty depends. Among the best of these are the following : Flowers of sulphur, - Two drachms. Tincture of camphor, - Three drachms. Glycerine, ----- One ounce. Rose water, - . - - Four ounces. This may be applied over the affected spots, and may be rubbed gently on those parts of the skin affected with the disease two or three times daily. Borax, ' - - - - - One drachm. Carbonate of soda, - One drachm. Glycerine, - - - - - Four drachms. Tincture of camphor, - One ounce. Distilled water, - To make six ounces. This may be applied in the same way. Precipitated sulphur, - - - Half an ounce. Carbonate of potash, - Four drachms. Glycerine, - - - - Two ounces. Sulphuric ether, - One ounce. Alcohol, - - One ounce. This mixture should be carefully applied to the pimples and to those parts of the skin that seem liable to exhibit an eruption. In all these cases no more friction should be employed than is necessary to apply the lotion. In all cases success can be hoped for only after persevering use of the remedies, both those for application to the skin and those which are designed to improve the condition of the digestive organs. Cases are found which seem to resist almost all measures of treatment ; such individuals have at least the consolation that the affection will yield to time, even if all medicines prove unavailing. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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