Acne vulgaris

From ArticleWorld

Acne vulgaris is an inflammation and infection of one or more hair follicles that contain sebaceous glands within them. This is the medical name for common acne. Acne generally begins in puberty and is, in part, due to the skin’s response to the hormone, testosterone. It is more common in males than in females and those with oilier skin are more likely to develop this condition.

Pathophysiology

The hair follicles of the scalp, face, chest and back contain more sebaceous or oil glands than other parts of the body. More oil is produced when testosterone is present. When dead skin cells build up, they can clog the pore, leading to an excess of oil beneath the skin. This area can become infected with the bacterium called Proprionibacterium acnes. The infected area then becomes inflamed, leading to what is seen as a bump in the skin that generally contains a white center and surrounding redness.

Those that squeeze the pimple caused by acne vulgaris will often exude some whitish, oily material from the sebaceous gland, including the bacteria. This often results in resolution of the pimple with the possibility of later scarring. Very deep lesions often scar.

Causes

Acne vulgaris is definitely triggered by hormonal changes, such as the variation noted throughout the female menstrual cycle. Increased stress can trigger the onset of lesions. Obese women can be more prone to acne due to an excess of testosterone. Those that do not cleanse the skin on a regular basis develop more acne lesions. Certain medications will trigger acne as do anabolic steroids. Those that are insulin resistant (often pre-diabetic) will have a greater likelihood of acne.

Treatments

There are multiple treatments for acne. The basics of acne treatment include the use of regular skin cleansing and mechanical exfoliation, such as with an abrasive scrub or cloth. Medical exfoliants include salicylic acid and glycolic acid. Both agents prevent the excess build-up of skin that contributes to this problem.

Topical antibiotics against acne are also possible. Benzoyl peroxide often kills the bacteria that cause mild to moderate acne in many cases. It is used in a soap as well as gels and creams. Topical erythromycin, clindamycin and tetracycline are other antibiotics that are used to treat this condition. Oral antibiotics can also be used on a regular basis to prevent acne breakouts.

Retin-A cream is a topical cream that is related to vitamin A. This product can alter the excess skin production that causes the pores to become clogged but can also be very irritating. Oral retinoids, such as Accutane or Sotret, mimic vitamin A and work extremely well in severe cases of acne.

Some dermatologists add phototherapy to the treatment of acne. This therapy gives the skin a short dose of blue light therapy and is known to reduce the number of acne lesions by 64% if used just twice weekly for about 15 minutes. It is believed that the light therapy is safe and causes the bacteria to generate free radicals that ultimately cause auto-destruction of the bacteria.