Acne Disease

TYPES OF ACNE

Acne vulgaris

BASICS

DESCRIPTION

Acne, also called acne vulgaris, is an inflammatory disorder of the sebaceous glands of the skin, resulting in pimples, boils, and occasionally scarring.

SIGNS AND SYMPTOMS

Pimples (whiteheads or blackheads)
Bumps or nodes of the skin
Scars
Pimples occur over the forehead, cheeks, and nose and may extend over the central chest and back.

CAUSES

Hormones stimulate the rate of skin growth in the sebaceous gland, blocking the pore. Bacteria stimulates an inflammatory response, resulting in a pimple.

RISK FACTORS

Adolescence
Male gender
Use of steroids or birth control pills
Oily cosmetics, including cleansing creams, moisturizers, and oil-based foundations.
Rubbing or occluding the skin surface, as may occur with sports equipment (helmets and shoulder pads) or holding the telephone or hands against the skin.
Prescription drugs
Hair growth disorders
Hot, humid climate

DIAGNOSIS

WHAT THE DOCTOR LOOKS FOR

The doctor will evaluate the condition of the skin.
Other causes of skin disorders will be considered, such as occupational exposure or drug side effects.

TESTS AND PROCEDURES

Levels of hormone in the blood may be measured in rare cases.

TREATMENT

GENERAL MEASURES

Acne is managed on an outpatient basis.
Pimples may be treated with surgery or injections.
Gentle cleansing with a mild soap once or twice a day will control surface oiliness. More frequent washing will further irritate the skin and increase sebum (oil) production.
Oil-free sun screens: UV light reacts adversely with the medications used to treat acne. Long-term UV exposure causes permanent skin damage. Oil-free sun screens should be used to protect the skin.
Stress management may be helpful if acne flares with stress.
There is no cure for acne; treatment only controls the lesions.

ACTIVITY

Full activity. Physical conditioning is important.

DIET

Good nutrition is important to normal skin health.
No special diet has been shown to diminish acne. Chocolate and fatty foods do not aggravate acne.

FOLLOW UP

PREVENTION/AVOIDANCE

N/A

COMPLICATIONS

Topical medications
- Benzoyl peroxide
- Tretinoin (retinoic acid, Retin-A, Renova)
- Topical erythromycin
- Clindamycin (Dalacin T)
Oral Medications
Tetracycline
Erythromycin
Oral contraceptives
Isotretinoin (Accutane)

WHAT TO EXPECT

Acne gradually improves over time.
Any treatment takes at least 4 weeks to show results.
Topical agents cause redness and drying of the skin.

MISCELLANEOUS

OTHER FACTORS

N/A

PEDIATRIC

A mild form of acne, called acne rosacea, can occur in the neonate.

GERIATRIC

N/A

OTHERS

N/A

PREGNANCY

May result in an acute episode, or remission, of acne
Isotretinoin causes severe birth defects; effective contraception should be ensured 1 month prior to and 1 month following isotretinoin therapy.
Erythromycin can be used during pregnancy, but it is less preferable to topical agents.

Clinical Investigations

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