Acne [Acne Vulgaris] is a skin disease caused blockage in the pilosebaceous units. Pilosebaceous unit is a structures consisting of a hair follicle and a sebaceous gland with its duct. Acne lesions are commonly known as pimples, spots, or zits.
Acne is predominant during adolescence, frequently persisting even in adulthood. Meaning, acne decreases in intensity as age advances to clear by the person reaches adulthood, however this is not rule per se since some do continue to suffer even during adulthood.
The term acne comes from a corruption of the Greek ¬κμ® (acme in the sense of a skin eruption) in the writings of Aëtius Amidenus.
The most common sites are face and neck. The other sites are chest, back and shoulders.
There are 2 main forms of acne:
1. open comedo (blackhead)
2. closed comedone. (whitehead).
Causes of acne
The main pathology is blockage of the pilosebaceous.Hyperkeratinization and formation of a plug of keratin and sebum (a microcomedo) are the earliest changes. The microcomedo may enlarge to form an open comedo or closed comedo. In these conditions Propionibacterium acnes a naturally occurring largely commensual bacteria causes infection which eventually leads to scarring.
Primary causes
· Family/Genetic history.
· Hormonal activity, such as menstrual cycles and puberty. During puberty, an increase in androgens cause the sebaceous glands enlarge and secrete more sebum.
· Stress
· Use of anabolic steroids.
· Exposure to certain chemical compounds.
· Hygiene: poor hygiene
· Diet
1. Milk
2. Seafood: often contains relatively high levels of iodine which is known to make existing acne worse
3. High carbohydrates/High Gycemic index
4. Vitamins A and E: lower levels associatied with increased chances of acne
Available treatments:
Most available drugs act in one of the following way
· hormonal manipulation
· normalising shedding into the pore to prevent blockage
· killing P. acnes
· antinflammatory effects
A combination of drugs is preffered. Topical bactericidals widely available Over the counter [OTC] drugs containing benzoyl peroxide are popular. The gel or cream containing benzoyl peroxide is rubbed, twice daily, into the pores over the affected region. Benzoyl peroxide also kills P.acnes. It is a strong oxidizer and doesn't have any bacterial resistance. It causes dryness, local irritation and redness.
Other antibacterials are
Triclosan
chlorhexidine gluconate
Topical antibiotics
Erythromycin,
Clindamycin,
Tetracycline
kill the bacteria that are present in the blocked follicles.
Oral antibiotics:
Erythromycin
Oxytetracycline
Doxycycline,
Minocycline,
Hormonal treatments
Topical retinoids
tretinoin (brand name Retin-A),
adapalene (brand name Differin)
tazarotene (brand name Tazorac
Oral retinoids
Phototherapy
Photodynamic therapy
Laser treatment:
· to burn away the follicle sac from which the hair grows
· to burn away the sebaceous gland which produces the oil
· to induce formation of oxygen in the bacteria, killing them
Other treatment options
· Aloe vera:,
· Haldi (Turmeric),
· Papaya.
· Heat: local heating may be used to kill the bacteria in a developing pimple and so speed healing.
· Ibuprofen or Naproxen are used for some moderate acne.
· Nicotinamide, (Vitamin B3) used topically in the form of a gel.
· Rofecoxib
· Zinc: Orally administered zinc gluconate.
· Honey: One of the strongest naturally occurring antibiotics. When placed on the skin like a mask for 20 minutes and washed off with hot water, the results over the next day should be pleasing.
There are however natural treatments that seem to be proving successful, these basically work by adjusting the bodies balance naturally using certain diets and foods, for many this seems a positive approach to the treatment of acne.
There is more information on Natural Acne Treatments on my blog
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