Is acne vulgaris due to excessively hot showers?

Acne vulgaris is a skin disorder with obstruction of the pilo sebaceous canal, increased sebum, skin surface lipid changes, and bacterial involvement. It is more common in temperate zones winter and the distribution is mainly on the face, the back of the neck, the back and chest. We believe hot showers, which are more common in cold climates, damage the skin and remove the protective lipids leading to bacterial entry. The areas affected are those which are usually exposed to the highest water temperature. Forty women were randomised into groups: Group A took hot showers (temperature > 40 degrees C) for one month and Group B cold water showers (temperature <40 degrees C) also for one month. The subjects were examined weekly to determine the number of acne lesions present on the face, neck, chest and back. The investigators were blinded as to the water temperature of each subject. Thirty women completed the study successfully 14 in Group A and 17 in Group B. There were no group differences in age, parity, race, confounding variables (steroids, iodides and hairoils.) and mean number of acne lesions prior to inervention. There was a significant difference in the mean group temperature for weeks one, two and four. The mean hot water temperatures were 43.6 (SD 18.3), 40.7 (SD 6.14) while mean group cold water temperatures were 35.8 (SD 1.09), 33.5 (SD 1.05) and 35.5 (SD 1.05 respectively. In week three the mean group temperatures were similar 38.7 (SD 2.61) and 38.6 (SD 12.50). There was however no group difference in the number of acne lesions with time (p=0.225) as determined by Anova. In conclusion, we did not find that hot showers had any impact on the occurrence of acne lesions (AU)

Acne in black women

Although acne is rampant in young black women, many of them do not really understand the nature of the disease and what treatment is available. Common as acne is, there is no easily understood book available to black people, hence the need for this publication. In Acne in Black Women, in plain simple language, I address concerns such as cosmetics, and newer treatments for acne such as peels, facials and laser treatments. I discuss how to use certain medicines to get the most benefit from them. How certain drugs work on acne and how long a patient should be kept on the drug is also addressed. We also take a look at the patient's general health in the management of acne... This book contains information for all black people who have acne or who have relatives who suffer from this disease. You will find advice on how to prevent acne, and how to treat it. This book is not meant to replace a visit to your dermatologist. In most cases he/she alone has the experience to treat your acne, and to combine different medications, so that you can get the best results from them (AU)

Black Skin Disease in South East London

Skin disease in black patients can present a diagnostic challenge both because of variations in clinical appearance and because certain disorders appear unique to black skin. The majority of dermatology text books and atlases concentrate mainly on white skinned patients. Our hospital serves a cosmopolitan local community in whom 40 percent of the population is black. We recorded the diagnosis made in 461 consecutive black (African, Afro-Caribbean and mixed-race) patients who attended a general dermatology new patient clinic in South East London. The aim of the study was to document the spectrum of skin disease seen in black patients and to highlight these disorders. 187 children and 274 adults were studied. In the black children atopic eczema was diagnosed in 38 percent, tinea capitis 26.7 percent, pityriasis alba 3.7 percent, viral warts 3.2 percent, keloids 2.7 percent, others 25.7 percent. Diseases recorded which are not seen in the white children included Facial Afro-Caribbean Childhood Eruption (FACE) and infantile acropustulosis. Of the 274 adults assessed, acne was diagnosed in 14.6 percent, eczema 10.2 percent, psoriasis 5.1 percent, pityriasis versicolor 4.0 percent, alopecia areata 3.3 percent, dermatofibroma 2.9 percent, urticaria 1.8 percent, pityriasis rosea 1.8 percent, cutaneous sarcoid 1.5 percent, discoid lupus 1.1 percent. Diseases more commonly seen in black skin were acne nuchae keloidalis/scalp folliculitis 14.6 percent, keloids 4.4 percent, post inflammatory pigmentation 3.6 percent and traction alopecia 1.1 percent; other disorders were seen in 30 percent. Normal variants recorded were dermatosis papulosa nigra, linear nail pigmentation and palmar pits. As the UK population becomes increasingly cosmopolitan, familiarity with skin disorders in both black and white skin is increasingly relevant to our practice. (AU)