Acne or Acne vulgaris is one of the most embarrassing clinical condition of the skin that affects mostly at a young age when people are most sensitive about their personal look.
Acne is an inflammatory condition of the sebaceous gland and hair follicles present in the skin. The sebaceous gland produces oil or grease-like substance known as ‘sebum’ which naturally moisturizes our skin. When pores of the gland that opens on the skin surface are clogged by dirt, dead skin cells, oil, or bacteria it produces acne. It mostly affects the skin part of the face, neck, chest, and shoulders.
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Age:
Mostly 80% of the younger people between the age group of 12 to 24 years are affected by less or more degree of acne. Hormonal changes during puberty are mostly responsible for the appearance of acne.
At the age of 20-30 years, most of the patients recover from acne, while in men still common beyond the age of 30 years. In women, it rarely remains after the age of 30 and may appear before menstruation.
Causes:
- Hormonal changes:
The main cause is hormonal changes during puberty which stimulate the sebaceous gland to produce more oil or sebum. Due to excessive oil, sometimes it may plug the pores opening on the skin surface causing acne.
- Medicinal:
Medicines like corticosteroids, birth control pills, lithium, etc. can cause or sometimes worsen the acne.
- Occupation:
Person having an occupation in which they deal with oil and oil products can have frequent contact with the skin. This contact of oil on the skin sometimes blocks pores, resulting in acne.
- Cosmetic:
Many cosmetic products are oil-based. Frequent use of it can trigger it. This type of cosmetic products are also known as ‘comedogenic’. To reduce risk, one should use products having water-based or non-oil based cosmetic products.
- Heredity:
A person having a family history of severe acne of both parents is at a higher risk side for developing it and it’s also difficult to treat such patients.
- Stress:
Stress directly doesn’t cause acne but anyone gets stressed by it and in this condition, if he or she picks acne, the condition may get worsen.
- Hygiene:
Dirty skin is not directly connected in causing acne but dirt and bacteria on the skin in unhygienic conditions can clog skin pores. On the other side, frequent hard hand cleansing of skin with some chemical or irritant substance can irritate skin and thus worsening acne.
- Friction or pressure on skin:
Frequent pressure on the skin by mobile phones, chin straps, helmet, etc. can irritate skin and thus worsen the acne.
- Food:
A high carbohydrate and sugar-containing diet such as bread, chocolates, etc. may cause or aggravate it.
Symptoms of acne:
- Comedone:
Collection of sebum or oil due to clogged hair follicle pores of the skin, resulting in bump under the superficial thin layer of the skin is known as comedones.
Sebum collection just under the superficial layer of the skin looks like a white color bump. So this type of commodore is known as a whitehead.
And when it comes into contact with air it becomes black due to oxidation. So it is called as blackhead.
- Pimple or papule:
Enlarged follicles eventually may rupture which attracts bacteria or allows irritating substances into the deeper layer of the skin, resulting in inflammation. This inflammation appears as papule or pimple which are small and red as a raised bump.
- Pustule:
Pimple with pus formation is called pustules.
- Nodules or Nodular acne:
When infection and inflammation are increased at a deeper layer of skin it produces solid and painful lump called nodules on nodular acne.
- Cyst or cystic acne:
It is a large lump beneath the skin containing pus. Cysts are usually painful and it is formed in more deeper in the skin.
- Scar:
Scarring develops as a complication of the acne.
Differential Diagnosis:
There are many clinical conditions resembling acne vulgaris which should be differentiated like Rosacea, pseudofolliculitis, folliculitis, Gram-negative folliculitis, etc.
Treatment of acne:
Acne treatment should be initialized under the care of dermatologists or professional experts in skin diseases. Acne treatment depends on its type and how severe it is. The following line of treatment and care should be used for treating acne.
- Proper skincare:
Proper care of the skin should be taken because playing with or popping pimples irritate the skin more and make it difficult to treat.
- Cleansing product:
Cleaning the skin with a mild cleansing bar or liquid used to clean and reduce irritability of skin.
Salicylic acid containing exfoliating cleanser products can also be used. This type of cleanser helps to open pores by peeling effect on the outer layer of the skin.
- Antibacterial:
Oral: Oral antibiotics like doxycycline, Azithromycin, amoxicillin, etc. are useful but must be taken under the care of an expert doctor.
Topical: Topical antibiotics are available as cream, gel, or lotion containing erythromycin, clindamycin, azelaic acid, etc. are used to treat acne. Other topical products containing benzoyl peroxide, sulfur is also very effective as antibacterial.
- Retinoids:
Oral retinoids like tretinoin or isotretinoin is very effective when acne is very severe or in cystic form. But it should be used with caution as it has some side effects.
Topical retinoid contains tretinoin or adapalene is also much effective. It is much irritative agent and one can have irritability of skin on exposure to Sun. So it is better to use these topical products at evening or night.
- Light therapy:
Recently acne treatment using special light with some device along with photosensitizing dye is also used effectively but long-lasting effectiveness with this treatment is not clear.
- Chemical peeling:
This is also used by many doctors as a supportive benefit along with another treatment line.
- Laser resurfacing and other surgical procedures are also used in the treatment of deep and depressed acne scars.
Also read: Home remedies for acne