Acne

General Illness Information


Common Name:

ACNE

Medical Term: Acne vulgaris

Description: Acne vulgaris is a sebaceous gland disorder wherein the skin pores become clogged by dried sebum and flaked skin, causing lesions such as whiteheads and blackheads (comedones) which may become inflamed and/or infected. It is a chronic inflammatory skin condition common in adolescence and characterized by skin eruptions on the face, chest and back. It is more commonly seen in males than in females. Characteristic skin lesions include comedones, papules, papulopustules, and nodules.

Causes: The causes of acne are not yet fully known, but are assumed to be the result of a complex interaction between androgenic hormones and bacteria. Genetic background may be a predisposing factor, as acne is less commonly seen in those of Asian and African-American ancestry. Acne occurs more commonly in teenagers due to the increased hormonal activity during puberty.

The sebaceous glands of the skin produce oils (sebum) in response to androgenic hormones. When these oils accumulate behind a clogged pore, they become infected by the bacteria, which normally reside in the glands and the resultant inflammatory response produces lesions characteristically seen with acne vulgaris (i.e “pimples” or comedones). If the blockage of the pore is incomplete, a blackhead is formed; if the blockage is complete a whitehead appears. With increasingly severe inflammation and infection, the pimples form the abscesses which are characteristic of cystic acne.

Acne is not caused by dirt or foods, although they can worsen it. Cleanliness can lessen it, but sexual activity has no effect on it.

Prevention: None known.

Signs & Symptoms

  • Blackheads (black spots the size of a pinhead);
  • Whiteheads (white spots similar to blackheads);
  • Pustules (small pus-filled lesions);
  • Redness and inflammation around eruptions;
  • Cysts (larger, firm swellings in the skin), and abscesses (swollen, inflamed, tender area of infection containing pus), in some cases;
  • Scars (often pitted, sometimes keloid);
  • Seborrhea (scaly eruption especially of the scalp).

Risk Factors

  • Exposure to extreme temperatures;
  • Stress;
  • Oily skin;
  • Endocrine disorders;
  • Medications, such as cortisone, male hormones, or oral contraceptives;
  • Family history of acne;
  • Some cosmetics.

Diagnosis & Treatment

General Measures:

Although the underlying causes of acne vulgaris have not been completely identified , it is important to note that effective treatment for acne is available. Acne should be treated to prevent scarring.

For oily skin: Gently massage face with unscented soap for 3 to 5 minutes. Don’t massage sorest places. Cleanse skin gently. Do not use abrasives. Rinse soap off for 1 to 2 minutes. Sometimes an antibacterial soap will help. Apply an astringent, such as alcohol, to remove oil after cleansing. Use a fresh washcloth each day. Shampoo hair at least twice a week. Keep hair off face. Use dandruff shampoo to treat or prevent dandruff. Avoid cream rinses. After vigorous exercise, wash the sweat and oil off as soon as possible. Avoid the heavier oil-based cosmetics. Avoid cream or moisturizers unless prescribed by doctor. Don’t squeeze, scratch, pick or rub the skin. Acne heals better without damage to the skin. Removal of comedones (blackheads) may be done by the doctor. Exposure to ultraviolet light may be a recommended treatment. Cosmetic surgery (dermabrasion) may be recommended to remove unsightly scars after acne heals.

Medications:

  • Mild Acne 5% or 10% benzoyl peroxide may be helpful Local application of antibiotic lotions such as clindamycin or erythromycin Local application of retinoic acids (e.g. tretinoin) is effective in unplugging the pores;
  • Moderate Acne Add oral antibiotics such as tetracycline or minocin to the above regimen In females, oral contraceptives containing an estrogen and an anti-androgenic progesterone can be effective methods of treating moderately severe acne;
  • Severe Acne For severe cases of cystic acne which do not respond to the above-mentioned treatments, oral isotretinoin (Accutane) has proved to be a very effective treatment for severe acne.

This medication must not be used in pregnancy due to the proven teratogenic effect on the fetus.

In females who are of child-bearing age, this medication is always prescribed in conjunction with an oral contraceptive.

Istretinoin is only prescribed after all the above-mentioned treatments have failed to produce a response.

Activity:

No restrictions.

Diet:

  • Foods don’t cause acne, but some foods may make it worse;
  • Keep a record of the foods you eat. If acne flares up 2 or 3 days after a food is eaten, leave it out of your diet. If not, you may eat it.

Possible Complications:

  • Psychological distress;
  • Facial scars or pitting of the skin.

Prognosis

There is no true cure for acne Most cases respond well to treatment and the condition tends to disappear after adolescence; however, despite good treatment, acne will flare up from time to time.

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