Acne vulgaris commonly known as acne is a common skin condition that affects the oil glands in the skin. It is characterized by the appearance of pimples, blackheads, and whiteheads on the face, neck, chest, and back. Acne is most common during adolescence but can affect people of all ages.
Pathogenesis:
The pathogenesis of acne vulgaris involves hormonal activation of sebaceous glands, the development of the comedo (plugged pilosebaceous follicle), and involvement of Propionibacterium acnes in the follicle, causing inflammation.
Causes Of Acne
- Acne vulgaris is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. There are several factors that can contribute to the development of acne vulgaris, including:
- Excess oil production: Excess oil production in the skin can clog the hair follicles and contribute to the development of acne.
- Bacteria: The presence of bacteria on the skin can also contribute to the development of acne vulgaris. The bacteria that are commonly associated with acne are called Propionibacterium acnes.
- Hormonal changes: Hormonal changes, such as those that occur during puberty, menstruation, or pregnancy, can contribute to the development of acne. Hormonal imbalances can cause an increase in oil production, which can lead to clogged hair follicles and the development of acne.
- Genetics: Acne can run in families, suggesting a genetic predisposition to the condition.
- Medications: Certain medications, such as corticosteroids and hormonal medications, can contribute to the development of acne.
- Diet: Some studies suggest that a high-glycemic diet or a diet high in dairy products may contribute to the development of acne.
- Environmental factors: Exposure to certain environmental factors, such as pollution and humidity, may also contribute to the development of acne.
Presentation :
Acne vulgaris typically presents as a variety of lesions on the skin, including:
Stage 1:Comedones: Non-inflammatory, black or whiteheads that form when hair follicles become clogged with oil and dead skin cells.
Stage 2;Inflammatory: The comedones rupture, creating in ammatory papules, pustules, nodules, and cysts.
- Papules: Small, raised bumps that are usually red in color.
- Pustules: Similar to papules but with a white or yellow center that is filled with pus.
- Nodules: Large, painful, solid lesions that develop deep in the skin.
- Cysts: Similar to nodules but filled with pus and can cause scarring.
- Stage 3: Scar: May develop as in inflammation heals. Picking at lesions exacerbates scarring.
Diagnosis of acne vulgaris:
Acne is usually diagnosed through a physical examination by a healthcare professional, such as a dermatologist. During the examination, the healthcare professional will evaluate the skin to identify the presence of different types of acne lesions, such as blackheads, whiteheads, papules, pustules, nodules, and cysts. They may also ask about the patient’s medical history, including any medications they are currently taking, as some medications can cause acne as a side effect.
Treatment:
Acne vulgaris can be treated with a variety of different approaches, depending on the severity of the condition and the individual’s skin type and medical history. Some common treatment options include:
Topical Treatments (Mild–Moderate Acne): These include creams, gels, and lotions that are applied directly to the skin. Topical treatments may contain ingredients such as benzoyl peroxide, salicylic acid, or retinoids, which can help reduce inflammation, unclog pores, and prevent the formation of new acne lesions.
Oral medications(Moderate–severe acne): Antibiotics, hormonal treatments, and isotretinoin are some oral medications that may be prescribed for moderate to severe acne. Oral Antibiotics such as doxycycline or minocycline can help reduce inflammation and kill bacteria on the skin, while hormonal treatments can help regulate hormonal imbalances that can contribute to acne.
- Isotretinoin is a potent medication that can effectively treat severe acne, but it also has potentially serious side effects and must be closely monitored by a healthcare professional. All other medications are stopped.
Isotretinoin is a teratogen and elevated LFTs. Patients require periodic blood tests to check LFTs, cholesterol, and triglycerides.
Procedural treatments: Some procedural treatments, such as chemical peels, light therapy, and acne extraction, can help improve the appearance of acne and reduce the risk of scarring.Lifestyle changes: Making changes to one’s diet and lifestyle may also help reduce the severity of acne. For example, reducing consumption of dairy products, sugary foods, and processed foods, as well as managing stress levels, can potentially help improve acne symptoms