Acne Vulgaris

Subject of the leading article in last week's American Medical Association Journal was acne vulgaris--the blackheads and pimples of adolescence. Dr. Jeffrey Charles Michael, Houston acne specialist who wrote the article, included the address he made as chairman of the skin specialists attending the American Medical Association convention in Atlantic City last June. Here was a disease that has marred to some extent the face, back and chest of every other human being who ever grew up to manhood. It has gouged ugly pits in multitudes of skins. Doctors have dealt with it for 3,200 years of recorded medical history. Yet Dr. Michael, in his two cardinal discussions of acne vulgaris, was obliged to state: "The pathogenesis of the disorder is still lacking. . . . The therapeutic problem is not yet satisfactorily solved." Doctors, in plain words, do not know the cause of acne, nor its cure.

They do know that pores of the face, chest and back, through which sebum oozes to oil the skin and hair, sometimes close up. Sebum, thus suppressed, pushes outward, forms a blackhead or a pimple.

Doctors do know that the condition appears with puberty, usually vanishes at maturity, but may persist, particularly in women. Therefore doctors think that acne is tied up in some way with sex.

Acne also seems to be associated with sagging viscera, sluggish bowels, and intestinal toxemia. There is an acne bacillus. But it probably merely thrives on the disease, does not cause it.

Best treatment for acne which Dr. Michael knows of, after dealing with the disease for 25 years, is to spray the pimpled skin with x-rays. Treatment must go on for several years. Relapses frequently occur.

However, Dr. Michael no longer uses x-rays on boys and girls under 18. He has them watch their diet and bowels, wash their faces well, on the expectation that most of them will outgrow their acne naturally. On acne patients between 18 and 22 years of age, he uses x-rays. In older patients he first makes a search for pelvic and gastrointestinal diseases. If he finds and cures such conditions, the acne usually disappears. If not, he resorts to x-rays; and with women, if nothing else works, to female sex hormones.

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