Human skin, is, if I may say so without appearing impertinent, brilliantly designed, It can withstand tremendous amounts of pressure, it stretches to accommodate the shape of the bones and organs within it and, perhaps most amazing of all, it can regenerate when it’s damaged. Cells which wear out are replaced automatically and skin can protect itself against the sun by increasing the deposit of melanin cells near to the surface. It keeps itself moist by secreting a substance called sebum from sebaceous cells and even contains hair cells which, although rather unnecessary today, were originally designed to help keep the human organism warm when the winter turned nasty.
It is perhaps inevitable, therefore, that occasionally things will go slightly wrong. One particularly common problem, affecting nearly all of us as we pass through our adolescent years, is acne.
Acne is a disorder of the sebaceous glands within the skin, the glands which produce sebum. Without sebum our skin would be dry and it would crack on bending. With sebum the skin is supple and elastic. Problems arise when the channel through which sebum reaches the surface becomes blocked. The dead and useless cells forming the blockage can turn black producing what is commonly known as a ‘blackhead’. If the blocked gland at the base of the blockage becomes infected a reddened, inflamed spot may develop and eventually pus may start leaking out on to the surface of the skin.
There really is not much difference between an infected acne spot and a pimple; and a boil is simply a rather large infected spot. Where two or three infected spots are gathered together in one small area with deep tissue involvement the result is described as a carbuncle.
Antiseptic creams and liquids Many of the products sold for the treatment of acne contain antiseptics (substances which destroy microorganisms). Germolene Antiseptic Ointment is recommended for the treatment of spots as well as the treatment of cuts, scratches, grazes, blisters and rough skin! The manufacturers of TCP Liquid Antiseptic claim that their product is ‘today’s most used spot treatment’. Torbetol Liquid consists of three antiseptics: cetrimide, hexachlorophene and benzalkonium bromide.
Spotoway is available as a tincture or cream and contains ‘powerful, hospital-proved antiseptics’ together with ‘natural, herbal preparations to soothe and cool inflamed and infected skin’. Betadine Skin Cleanser and Betadine Skin Cleanser Foam both contain a type of iodine. A main active ingredient of Swiss Bio-Facial is chlorhexidine which is an antiseptic. Cuxson Gerrard Boil Treatment consists of plasters bearing hexa-chlorophene or aminacrine ointments; both of these are antiseptics, and Sevilan Acne Cream contains among other things decamethylen-bis-4-amino-chinaldinium chloride which is also an antiseptic.
The only problem with all these treatments is that many spots are not infected or infectious and therefore an antiseptic which is designed to treat or prevent infection is not really suitable. Once acne spots have become widely infected then antibiotic therapy is probably necessary .
Special soaps are available for preventing the development of spots and pimples or for treating already infected skin.
Examples of these are Clearasil Soap which contains sulphur and CidalSoap which contains irgasan, an antiseptic.
Prolonged use (more than five days) of any medicated soap cannot be recommended, since continued use can cause allergy rashes.
These are substances which help to clear away dead skin cells, literally peeling away blackheads to unblock the pores. Resorcinol is a basic ingredient of a number of preparations such as Acnil, Avrogel, Clearasil Cream Medication (Skin Tinted and White), DDD Lotion, Eskamel, Medac Acne Cream,pHiso-Ac, Vanispot and Wigglesworth Acne Cream.
Salicylic acid is another keratolytic that is present in Avrogel, Clearasil Cleansing Lotion, Dermaclear and DDD Lotion.
A third keratolytic substance, benzoyl peroxide, is obtainable as Benoxyl 5 and Benoxyl 10, both either plain or with sulphur, Dry Clear Acne Lotion, Panoxyl 5 Acne Gel and Panoxyl 10 Acne Gel, Oninoderm and Vanair.
You can buy non-branded versions of some of these basic ingredients.
Resorcinol is available as Compound Resorcinol Ointment BPC or Resorcinol and Sulphur Paste BPC. Salicylic acid is available as Salicylic Acid and Sulphur Cream BPC. Zinc Sulphide Lotion BNF is also available.
Some of the substances used in proprietary acne preparations work by removing the blockage or blackheads which are sealing up the skin’s sebaceous glands. It is possible to do much the same thing merely by rubbing the skin with something rough – removing the blackheads and dead cells by physical rather than chemical means.
To assist in this process you can buy a non-medicated cleansing sponge called a Buf-pufoi a paste called Brasivol which contains graded particles of aluminium oxide. You can buy Brasivol in three grades: fine, medium and coarse.
However, you don’t have to buy anything special. You can get exactly the same effect by using a rough flannel, a loofah or a fairly soft nailbrush. Individual blackheads can be removed by being squeezed out. This does at least stop the blackheads becoming infected. It is best to remove blackheads after washing the face with hot water and although you can use your fingernails you can buy special devices for squeezing out blackheads or ‘comedones’ as they are known in the trade. Ask for a comedo expressor. One word of warning, however: do not try squeezing infected blackheads – you’ll probably make things worse.
Ultraviolet lamps can help ease the problem by encouraging skin peeling. As the skin peels so the blocked ducts are cleared. Ordinary sunlight produces exactly the same effect, of course, and so it is wise for the acne sufferer to get as much sun as possible. Artificial lamps should be used with great care and instructions followed to the letter. There isn’t much point in replacing acne with burns.
A ‘magic’ solution
Heath and Heather manufacture Blood Purifying Tablets and a Blood Purifying Mixture said to ‘assist in clearing the blood of impurities in the case of boils, pimples, etc.’.
The mixture contains, among other things, arctium lappa (once used as a diuretic and also known in common circles as the dried root of the Great Burdock but that doesn’t sound half so grand and scientific does it ?) and senna (a very effective laxative).
Rather surprisingly the tablets do not contain the same ingredients as the mixture. In a tablet you get such delights as buckbean (also known rather aptly as bogbean) which is a purgative and can cause vomiting, although in larger doses than contained in the tablets.
I suppose the theory is that since constipation is a cause of spots (and I used to have an aunt who swore that all spots were caused by recalcitrant bowels) a cure for the constipation will also prove to be a cure for the spots.
Although there have been many theories about the cause of acne there is not much you can do to prevent yourself developing spots. It has in the past been said that chocolate, peanuts and fatty or milky foods in general can cause spots. I don’t really think that there is any scientific evidence supporting any of these theories, although they may be coincidental.
There are hormonal and hereditary reasons for the skin changes which result in the development of acne and it is the hormonal reasons (related to the level of sex hormones) which result in the high incidence of acne in adolescents. It is this hormonal influence which is responsible for the common phrase ‘you’ll grow out of it’. For most young sufferers that really is the last thing they want to hear. They’re worried about what they look like now, not what they’re going to look like in ten or twenty years’ time.
It is probably worthwhile pointing out to teenage girls who suffer from spots that face creams which are sometimes used to cover up blackheads and acne lesions may in fact make things worse by blocking up the ducts leading out of the sebaceous glands. Even antiseptic creams can do this, thereby making the condition they are intended to treat far worse.
There really isn’t anything much you can do about boils. It certainly is not a good idea to smear them with antiseptic creams. Nor is it sensible to try squeezing them. Both these courses are likely to result in a bigger, longer-lasting boil. It’s far more sensible to put a warm compress on top of the boil (or just hold a hot-water bottle near to it). With warmth the boil will burst quicker and the pain and mess will be over quicker. If a boil doesn’t come to a head after five days then see a doctor. Similarly seek advice if the boil is in a particularly unbearable spot (in your nose or ear or on your bottom) and you want it lanced before then. If you get a crop of boils then it is worth seeking a doctor’s advice. You or some member of the family may be carrying the infective organism which is responsible for the boils. I once treated a family in which the father kept getting boils and the son needed treatment with an antibiotic. The bug that was causing the father’s boils was hiding out in the son’s nose without causing him any ill effects at all.
When to see a doctor
Your doctor cannot do much that you can’t do yourself for simple blackheads that haven’t got infected. But if you have an unsightly crop of red, infected spots on your face or back a course of antibiotic therapy may prove helpful or even essential if you are to avoid future scarring. Most doctors prescribe antibiotics for several months when they’re needed and it is important for patients to be aware of the fact that little improvement can be expected for the first month or two.
It probably isn’t worthwhile trying to do anything about the odd spot or two. They’ll go away by themselves if left alone – even if they become infected.
If you suffer from a lot of blackheads try to get out into the sun as often as possible and either use an abrasive or wash regularly with a coarse flannel or brush. A keratolytic may help to clear out blocked pores.
If spots become red, inflamed and swollen and do not clear up in five days see your own doctor.