The Dermatology Practice.

#acne #teenageacne #pimples #acnetreatment

Acne is a chronic inflammatory skin condition affecting millions worldwide, causing significant physical and emotional distress. While thought of as a condition afflicting the young, acne can also occur in other age groups. It occurs when the pores on the skin become clogged with dead skin cells, oil, and bacteria, leading to various types of lesions. This article will delve into the types of acne, investigations, and treatment options available.

Different appearances of acne

  1. Non-Inflammatory Acne – Characterized by open and closed comedones (blackheads and whiteheads respectively)
  2. Inflammatory Acne – Includes papules, pustules, nodules, and cysts.
  3. Cystic Acne- Large, painful cysts and nodules- often a more severe state of inflammatory acne

Credit: Vasam et al. Acne vulgaris: A review of the pathophysiology, treatment and recent nanotechnology based advances. Biochemical and biophysics report. (2023).

Common acneiform conditions

  1. Acne Vulgaris: Most common type, typically affecting adolescents and young adults.
  2. Acne Conglobata: Severe, chronic form with connected nodules and abscesses.
  3. Acne Rosacea: Combination of acne and rosacea symptoms

Be mindful that acne may also occur in adulthood, for which other causes must be elucidated. For example:

  1. Occupational acne (Chloracne): Exposure to hydrocarbons at work
  2. Medication-induced acne: Steroids, testosterone, certain birth control/ hormonal preparations
  3. Familial syndromes
  4. Systemic acne affecting other areas e.g. hidradenitis suppurativa

Causes and Risk Factors

  1. Hormonal fluctuations
  2. Genetics
  3. Stress
  4. Poor skincare habits
  5. Medications (corticosteroids, testosterone)
  6. Diet (dairy, refined carbohydrates)

Investigations

  1. Physical Examination: Visual inspection of skin lesions.
  2. Medical History: Assessing hormonal imbalances, medication use.
  3. Laboratory Tests: Blood tests for hormonal imbalances, bacterial infections.)
  4. Skin Scrapings: Microscopic examination for fungal or bacterial infections.
  5. Imaging Studies: Rarely used, but may help identify underlying conditions.

Treatment options

Topical Treatments

  1. Benzoyl Peroxide: Kills bacteria, reduces inflammation
  2. Salicylic Acid: Exfoliates, unclogs pores
  3. Retinoids: Derivatives of vitamin A, prevent clogged pores

Do bear in mind that most acne topicals can cause skin redness, irritation and dryness. A suitable skin barrier repair cream is recommended as part of the acne skincare regimen.

Oral Treatments

  1. Antibiotics: Doxycycline, minocycline and erythromycin for anti inflammatory properties and bacterial infections
  2. Hormonal Treatments: Birth control pills, spironolactone
  3. Isotretinoin: Oral retinoid for severe acne

Other Treatments

  1. Light Therapy: Targets bacterial growth
  2. Extraction: Removing blackheads and whiteheads
  3. Chemical Peels: Exfoliates, improves skin texture
  4. Microdermabrasion: Non-invasive exfoliation

Lifestyle changes

  1. Dietary Modifications: Avoid trigger foods
  2. Hydration: Adequate water intake
  3. Stress Management and mindfulness activities: Relaxation techniques
  4. Skincare Routine: Gentle cleansing, moisturizing

Conclusion

Acne is a complex condition requiring comprehensive understanding and treatment. By recognizing the types of acne, conducting thorough investigations, and exploring various treatment options, individuals can effectively manage their symptoms and improve their quality of life. Consultation with a dermatologist is essential for personalized guidance and care.

References

  1. Journal of Clinical and Aesthetic Dermatology. (2019). Acne Treatment Options.
  2. Vasam et al. Acne vulgaris: A review of the pathophysiology, treatment and recent nanotechnology based advances. Biochemical and biophysics report. (2023)
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