Acne

“ Describe the symptoms of acne rosacea.
The disease may be slight or well-marked. Redness, capillary dilatation, and acne lesions seated on the nose and cheeks, and sometimes on chin and forehead also, constitute in most cases the entire symptomatology.
A mild variety consists in simple redness or hyperæmia, involving the nose chiefly and often exclusively, and is to be looked upon as a passive congestion; this is not uncommon in young adults and is often associated with an oily seborrhœa of the same parts. ”

“ Acne rosacea is a chronic, hyperæmic or inflammatory disease, limited to the face, especially to the nose and cheeks, characterized by redness, dilatation and enlargement of the bloodvessels, more or less acne and hypertrophy. ”

“ The small, hard, distinct pimples—“acne, or acne simplex” of medical writers—that occur on the forehead, and occasionally on the temples and chin, generally yield to stimulating lotions, consisting of equal parts of strong vinegar, or spirit, and water, or to weak lotions of sulphate of zinc, assisted by occasional doses of cooling laxatives, as the salines, or a mixture of sulphur or cream of tartar. ”

“ Those of a light complexion are more liable to its development, while menstrual difficulties, chlorosis, scrofulosis, and general debility may all predispose to the disease. Medicinal substances, such as the iodides and bromides, and tar externally, are also prone to produce acne-form lesions. The retention of the secretion within the sebaceous gland is the first step in the formation of an acne lesion, and its presence—or it may be its decomposition—gives rise to inflammation, which usually involves the gland-structure and the surrounding tissue. ”

“ You will find all about indigestion in the medical articles and correspondence in last year's Girl's Own Paper. Read the answer to "Fair Isobel," which appeared some months ago, and contained a long account of acne. We would however suggest ichthiol rather than sulphur ointment in your case. Otherwise, follow all the advice given in the above-mentioned answer. You are at the age for acne, and although it is sure to disappear in time, you will have to persevere in your treatment.
Mary Noble.—Undoubtedly you do suffer from chronic nasal catarrh. ”

“ Nasal acne occurs mainly in dyspeptics and tea drinkers, and the more advanced condition, lipoma nasi, chiefly in elderly men addicted to alcoholism. The treatment of acne is the removal of the dyspepsia with the local application of sulphur ointment or of a lotion of perchloride of mercury. ”

“ The condition of your face is almost for certain due to acne rosacea. The only other disease which we think it likely that you could be suffering from would be lupus erythematosus—a form of lupus which is not due to tuberculosis or scrofula, but which is a highly-developed form of chilblains. Your description agrees so well with that of acne rosacea that there can be little doubt but that it is that complaint. This disease would be in no way dependent upon nor influenced by any disease that your parents may have had. ”

“ Treatment of Acne. In the treatment of this, as in that of other diseases, we should seek to ascertain the cause, and, when possible, remove it. Outdoor exercise, a spare, unstimulating diet, and perfect cleanliness are of the first importance. The affected parts should be bathed with warm water and Castile, or, what is better, carbolic soap. Washing the face in cold water generally aggravates the disease. As a local application to the pustules, we have used with good results the following lotion: Oxide of zinc, twenty grains; morphine, five grains; glycerine, two ounces: mix. ”

“ The skin, partly for this reason, and partly because it shares in the general disturbance of nutrition, becomes dry, harsh, and scaly; after a time the face, and especially the nose and neighboring parts, assumes in many instances a violaceous hue, the minute superficial cutaneous veins are enlarged, and acne is common. The resulting appearance is almost characteristic of the habits of the individual. Alcoholic subjects frequently suffer from pruritis, urticaria, and eczema. ”

“ In young subjects the affection is seen in this stage, and rarely passes beyond it. In other cases, however, sooner or later, dilatation and enlargement of the vessels (telangiectasis) take place, and acne papules and pustules are scattered over the parts, constituting the second stage of the disease. This stage is frequently met with, and illustrates the acne rosacea usually seen. Exceptionally, however, the disease progresses, the vessels increase in calibre, the glands are enlarged, and there is more less hypertrophy of the connective tissue and the third stage is developed. ”

“ There may or may not be itching. In what appears to be a variety of this disease, known usually as acne urticata, there is considerable itching just at the time the lesion is appearing. The malady is not frequent, but occurs in both sexes, usually in those between the ages of twenty and fifty. It seems probable that the eruption is parasitic in origin. ”

“ Tannic Acid: in acidity associated with chronic catarrh and flatulence. Glycerin 1 minim, tannic acid 4 grn., as pill.
Acne.
Adeps Lanæ: topically.
Alkaline lotions: when skin is greasy and follicles are black and prominent.
Aristol.
Arsenic: in chronic acne; generally, though not always, prevents the acne from bromide or iodide of potassium.
Belladonna: as local application to check a too abundant secretion.
Berberis: for acne of girls at puberty.
Bismuth: as ointment or powder. In acne rosacea, if acute. ”

“ As a rule, an acne papule or pustule runs an acute course, disappearing in the course of one or two weeks, and a new lesion appearing at another point to supply its place. The disease is essentially chronic, in the sense that the parts are never or seldom free, new lesions forming and old ones disappearing from time to time, in some cases indefinitely. As a rule, there are no subjective symptoms, but in some markedly inflammatory cases the lesions are painful; in other exceptional instances there is slight itching. ”

“ Should slight scaliness or a mild degree of irritation of the skin be brought about, active external treatment is to be discontinued for a few days and soothing applications made. Resorcin, in lotion, 3 to 25 per cent strength, is through the exfoliation it provokes, frequently of value; the resorcin paste referred to in acne can also be used for this purpose. ”

“ The pimples on the face of young people is a harmless skin disease known under the name of Acne, and is due to the surplus of fat secreted 158by the young skin, but it has nothing to do with the sexual function. It is just as much and to an equal degree spread among people indulging in sexual intercourse as among those who are continent. ”

“ We have so frequently discussed this trouble that we cannot again enter into a full description of its cause and cure. Wash your face with warm water and sulphur soap, and every evening apply sulphur ointment to the place where the pimples are most numerous. Wash away the ointment in the morning and squeeze out a few of the most prominent spots. You are at the age for acne, but with a little care you are not likely to be troubled for long with it. For your hands, wash in warm water and use sulphur soap. Always wear thick gloves when you go out. ”

“ The skin, in which disturbances so readily occur at the time of the menarche, requires careful attention, all the more because it is precisely at this age that young girls have the greatest need of their personal charms. The skin of the face, which is often disfigured by comedones and acne, must be carefully guarded against the accumulation of sebum in the sebaceous glands by sedulous washing with warm water and a good soap. ”

“ Pimples on the face are usually due to obstruction of the sebaceous glands; sometimes the obstruction leads to inflammation around the sebaceous gland (acne) which often permanently injures the skin.
2. Accumulation of effete matter on the skin occurs, unless frequent ablutions are performed. The epidermis is constantly shedding its older and more superficial parts, in the form of minute scales or “scurf.” In the absence of frequent washing, the scales of epithelium tend to accumulate, the sebaceous secretion matting the scales together, and rendering them more adhesive. ”

“ TREATMENT.—Cases of acne vary considerably as to their course and curability. There is in almost every case a natural inclination toward disappearance of the eruption at the age of twenty or thirty. Although the lesions are at any age of the patient generally easily removable by treatment, relapses are the rule; but the older the patient the less probability is there of a recurrence. Even in young subjects, however, the cure may be permanent, depending upon the ability to discover and remove the cause. The disease requires both constitutional and local treatment. ”

“ Usually the earliest appearance of the sore is similar to that of a mosquito bite. The papule continues to enlarge, becoming purplish in color with a glazed surface. It somewhat resembles an inflamed acne lesion. Growing larger, the surface of the blind boil-like lesions now becomes covered with brownish scales and, either from scratching of the rather pruriginous spot or from the development of vesicles, it becomes covered with a yellowish crust, beneath which is an ulcer with raised edges and discharging a thin offensive pus. ”

“ Irregularly scattered over the face, and in some cases also over the neck, shoulders and upper part of the trunk, are to be seen several, fifty or more, pin-head- to pea-sized papules, tubercles or pustules; commonly the eruption is of a mixed type (acne vulgaris) , the several kinds of lesions in all stages of evolution and subsidence presenting in the single case. Interspersed may generally be seen blackheads, or comedones. The lesions may be sluggish in character, or they may be markedly inflammatory, with hard and indurated bases. ”

“ If choking is threatened, give an emetic of mustard, one teaspoonful, and warm water, half a pint.
PIMPLES; BLACKHEADS (Acne) .—This eruption is situated chiefly on the face, but often on the back, shoulders, and chest as well. It is a disorder which is seen mostly in young men and women at about the age of puberty. It consists of conical elevations of the skin, from a pin head to a pea in size, often reddened and tender on pressure, and having a tendency to form matter or pus, as shown by a yellow spot in the center of the pimple. ”

“ The intimate connection between the skin and the sexual sphere is also shown in pathological conditions of the skin, especially in acne as well as simple pimples on the face. The sexual development of puberty involves a development of hair in various regions of the body which previously were hairless. ”

“ Obstinate and indurated lesions may be incised, the contents pressed out, and the interior touched with carbolic acid by means of a pointed stick. The x-ray has proved a most valuable addition to our resources in the treatment of acne, and is especially serviceable in extensive and obstinate cases. An exposure should be made about twice weekly, at a distance of five to ten inches and for from three to ten minutes, and a tube of medium vacuum used. It must be used with great caution and never beyond the production of the mildest erythema. The hair, eyes, and lips should be protected. ”

“ SANDHOLM'S SKIN LOTION is a clear liquid used externally. Eradicates all
skin and scalp trouble by absorbing the germ--returns the skin to normal
condition. IT HAS NO EQUAL for
Salt rheum, Eczema, Rash, Tetter (Herps) , Scald head, Milk scald, Plant
poisoning, Hives, Mosquito bites, Small burns or scratches, Barbers'
Itch, Parasitic diseases, Scaly or scabby eruptions of the skin, Itching
piles, Acne, Psoriasis, Pimples, Blackheads, Cracked hands and lips,
etc. A perfect antiseptic after shaving.
WHAT IS MORE DESIRABLE THAN A CLEAR, HEALTHY SKIN? ”

“ In such instances the application of a strong alcoholic resorcin lotion, ten to twenty-five per cent. strength, repeated several times daily till marked irritation and exfoliation occur (a matter usually of one to three days) , will sometimes be followed by marked improvement. Acne of the back is treated with the same applications, but usually stronger ”

“ That is very cleansing, but as it is also drying, a face cream must be smeared on immediately after the face is rinsed and wiped. For some days it may seem that the pores are large and coarse and open, but they are simply undergoing a cleansing process that in the end will bring a lovely white, perfect skin. Whenever I hear women say that they never wash their faces, but use a cream instead, I always wonder if they really feel clean. I am sure I would not. Fancy the state of our hands were we never to wash them! And the face, having more oil glands, is in still greater need of soap and water. ”

“ Miss Ennis shrank. “Pimple is an inexcusable word,” she protested.
“Word? We’re dealing in realities now. And pimples were an inexcusable reality in your case, because they were the blossoms of gluttony, torpor, and self-indulgence.”
He leaned forward and looked closely at her chin. The surface, once blotched and roughened, was now of a smooth and soft translucency. “You once objected to the word ‘sweat,’” he continued. “Well, it has eliminated the more objectionable word ‘pimple’ from your reckoning. And it has done the job better than your blemish-remover—-which leaves scars.” ”