ACNE, ik'nE. Among the diseases of the skin there is none which is more annoying than this, particularly because of its frequent loca tion upon and disfigurement of the face and because of its common occurrence in young people of both sexes with whom disfigurements of this character are keenly distressing. It also appears upon the scalp, back, chest and shoulders, and in people of all ages. It may be a serious matter in the aged for it sometimes terminates in cancer.
Specifically it is a disease of the sebaceous glands of the skin, due sometimes to retention of their oily, greasy secretion, to the action of certain drugs like the bromides, or to the in fluence of various kinds of germs which find a lodgment upon the skin. It appears in various forms, as black specks or comedones, as reddened spots, as hardened shot-like points, as elevated conical lumps from a pinhead to a pea in size, as suppurating sores resembling boils, etc. In many instances it terminates in disfiguring scars which (gradually become in conspicuous, in stains, or in increase or atrophy of the skin. When the scalp is involved there is dandruff and loss of hair, on the nose and cheeks it gives rise to crusts and scales, and on the face of the aged it may take the form of horn-like masses. Wens and similar tumors of the face and scalp are other forms of this disease.
It may result from indigestion, constipation, bad nutrition, bad habits connected with the sexual apparatus and disturbance of the peri pheral' nerves. The sebaceous glands which may be involved in this disease are destroyed, and if they perish in very large numbers the nutrition of the skin to which they have been distributed is of course impaired.
The symptoms are sometimes active and acute and the eruption painful, and at other times the eruption will disappear only to return when provoked by the use of sweets, pastries, fats or other substances which are not easily digested, after an attack of constipation, or after the use of irritating drugs. It is very apt to recur periodically in young women in connection with the function which is peculiar to their sex, especially when there are anatomi cal defects which prevent its normal perform ance. Therefore all persons who have a tend ency to this disease, for some are immune and some are sensitive just as they are to other diseases, must avoid all things which have an irritative action upon the skin, whether drugs or food, or bad habits; as a rule they must also avoid tea, coffee, alcohol, pork, veal, game, shell-fish, cheese and fats of all kinds, also sweets, nuts, fried and greasy food and hot and imperfectly baked biscuits. The diet must be
very simple and nutritious, and include milk, eggs, cereals, fresh vegetables, stale bread or toast, prunes, figs and a minimum of meat and fish. Those foods which have a constipating tendency must be rigidly avoided, and if consti pation exists it must be combatted by the sys tematic and regular use of efficient laxatives, including castor oil, fluid extract of cascara, the salines — Epsom and Rochelle salts, and phosphate of soda, or the saline mineral waters. The old-fashioned sulphur and motasses which was a standard, though disagreeable, household remedy a generation ago need not be despised in the treatment of acne. Exercise is very im portant and it will tend to equalize the blood circulation and direct to the face its proper share of this vital fluid. The sebaceous glands are far more likely to do their work properly when the face and scalp have an adequate supply of freely circulating blood. Bathing is very important, both for preventing and curing this disease, hot baths being preferable. Ap plications of very hot water to the face and scalp will frequently be found both agreeable and serviceable. Solutions of alcohol, boric acid, mercury and formaldehyde are often used in the treatment of acne and the X-ray has been found beneficial when used skillfully and cautiously. The most recent mode of treat ment, which however is not uniformly success ful, consists in the use of autogenops vaccines composed of dead cultures of acne bacilli and staphylococci in a saline solution. A stock vaccine from four to ten million with staphy lococci at intervals of one or two weeks is sometimes used successfully. When the erup tion takes the pustular form, a polyvalent vac cine of cultures of staphylococcus albuf, citreus and aureus may be used. In all cases it is im portant that the general health be kept in the best possible condition and that the habits of life be simple and normal. The disease is not a dangerous one and is seldom painful except when the glands become inflamed, but when once acquired it is seldom gotten rid of easily.