Acne

Description

What is Acne?

Acne, also known as Acne vulgaris is a chronic skin disease which involves inflammation of pilosebaceous units. It is the most common skin disorder during puberty, when the sebaceous gland activates, though it affects people of all ages. Classification of Acne into two categories:

• Non-inflammatory Acne – Comedones
• Inflammatory Acne – Pustules, Papules, Nodules, Cysts

Symptoms of Acne

Acne primarily appears on the skin as:

• Blackheads (open comedones)
• Whiteheads (closed comedones)
• Red bumps (papules)
• Bumps containing pus (pustules)
• Nodules (painful pimples deeply embed in the skin)
• Deep pimples and boils (cysts).

Acne especially appears on the areas of the skin with a relatively high number of sebaceous glands like face, neck, shoulders, back, upper arms.

Causes of Acne

In almost 80 percent of the cases, genetics is thought to be the primary cause of Acne. In both sexes androgen hormones are responsible for the increased production of sebum, thus appear to be a significant player in the underlying mechanism. Excess growth of Cutibacterium acnes, bacterium present on the skin also contributes to Acne. Other factors contributing to Acne includes:

• Excessive exposure to sunlight
• Medications like steroids, lithium, and anticonvulsants
• Clothing like headbands, shoulder pads, and underwire brassieres
• Polycystic ovarian syndrome
• Pregnancy
• Foods (Dairy products and Carbohydrates)
• Stress
• Greasy Cosmetics
• Environmental Factors

Side Effects of Acne

• Scars
• Redness and dryness of skin
• Eye and Skin Irritation
• Allergic Reaction
• Abnormal Peeling of Skin
• Skin Discoloration
• Fluid Accumulation Around The Eye
• Cholesterol levels and liver function are severely affected.

Diagnosis and Treatment of Acne

Depending on the severity of acne vulgaris, the doctor prescribes the medication. Categories of medications which have proved efficient in reducing acne lesions are:

Typical Medication:

Retinoids and retinoid-like drugs: Drugs under this category include Avita, Retin-A, Differin, Tazorac, Avage.

Antibiotics: Retinoid combined with antibiotics, reduces skin redness and killing excess bacteria on the skin. Examples include erythromycin with benzoyl peroxide (Benzamycin), clindamycin with benzoyl peroxide (Acanya, Benzaclin).

Salicylic acid and azelaic acid:  Salicylic acid is useful in the treatment of blackheads and whiteheads. 20% of Azelaic acid is recommended for the treatment of conventional Acne. Combination of azelaic acid and erythromycin like Azelex, Finacea is prescribed during pregnancy.

Dapsone: Aczone, 5% gel, is recommended for inflammatory Acne.

Oral Medication:

Antibiotics: Minocycline or Doxycycline or Macrolide can be used to treat moderate to severe Acne.

Combined oral contraceptives: Examples include a combination of estrogen and progestin products like (Ortho Tri-Cyclen, Yaz, others).

Anti-androgen agents: Examples include drug-like Spironolactone (Aldactone).

Isotretinoin: Isotretinoin like Amnesteem, Claravis, Sotret are used to treat severe Acne.

Therapies

Therapies can be used alone or in combination with medication. Therapies involved in acne treatment are as follows:

• Lasers and photodynamic therapy
• Chemical peel
• Extraction of whiteheads and blackheads
• Steroid injection