DR K TAMILSELVAN

Acne

Acne, commonly known as pimples, and also known as Acne vulgaris, Cystic acne, Zits. It is more common and more severe in males than females in their teens. Contrary to belief pimples do not clear spontaneously when maturity is reaches. 6% patients may have the disease continuing up to 25 to 40 years of age. There is genetical predisposition and similar involvement may occur in identical twins. Androgens play a positive role. Oily and glossy skin is more predisposed.

Acne Vulgaris Image

There is blockage of sebaceous ducts at the surface of sebaceous the skin with keratinization and melanin deposits from hair follicle giving rise to the characteristic black head spots (comedon) or early acne. The lesions are likely to occur in areas like face, shoulder and upper chest where sebaceous glands are in plenty. Retained sebum inside the gland and growth of Propionibacterium acne, an anaerobic diphtheroids normally present within pilo-sebaceous duct sets in complement mediated inflammation so that the blackhead turns to a vesicle and pustule. The pustules are sterile on routine culture. When the pustule bursts the chemo irritant (Chemotherapy)fatty acid content of sebum causes inflammation on surrounding skin. Following rupture and healing, deep pitted scars may from which progress to keloid.

Excess of androgen secretion due to tumor of adrenal, ovary or tests be excluded. Polycystic ovary need exclusion by pelvic ultrasound. 21 hydroxylase deficiency causing adrenal hyperplasia has excess of androgen secretion too.

Besides mild in itching, soreness of pain, there is more of self consciousness, embarrassment and psychic trauma. The morbid fear of scarring and pitting always haunts the patient, especially the girls.

Cystic acne

Initial lesion

Comedones-Conical raised lesion with broad base and plugged apex. Plug may be black (black head) or white (white head) 25% white heads resolve, 75% develop into inflamed lesion.

Zits Image

Symptoms

Black heads, Pustule, Nodule, White heads, Papule and Cystic Acne

Acne commonly appears on the face and shoulders. It may also occur on the trunk, arms, legs, and buttocks

Blackheads

Crusting of skin bumps

Cysts

Papules (small red bumps)

Pustules

Redness around the skin eruptions

Scarring of the skin

Whiteheads

Inflammatory lesion : severity grades

Gr. 1 (Mild)           :     Open and closed comedones

Gr. 2 (Moderate)   :     Comedones, papules, few pustules

Gr. 3 (Severe )      :      Predominant pustules, nodules, abscesses

Gr. 4                     :     Mainly cysts and abscesses. Wide spread scarring as Inflammatory lesions resolve.

Patients should be discouraged to apply oils and greases on the affected area.

Treatment

 SELF-CARE

       Clean your skin gently with a mild, nondrying soap. Remove all dirt or makeup. Wash once or twice a day, including after exercising. However, avoid scrubbing or repeated skin washing.

          Shampoo your hair daily, especially if it is oily. Comb or pull your hair back to keep the hair out of your face.

          Try not to squeeze, scratch, pick, or rub the pimples. Although it might be tempting to do this, it can lead to skin infections and scarring.

         Avoid wearing tight headbands, baseball caps, and other hats

         Avoid touching your face with your hands or fingers.

        Avoid greasy cosmetics or creams. Take off make-up at night. Look for water-based or “noncomedogenic” formulas. Noncomedogenic products have been tested and proven not to clog pores and cause acne.

        If these steps do not clear up the blemishes, try over-the-counter acne medications. You apply these products directly to your skin.

       They may contain benzoyl peroxide, sulfur, resorcinol, or salicylic acid.

       They work by killing bacteria, drying up skin oils, or causing the top layer of your skin to peel.

       They may cause redness or peeling of the skin.

     A small amount of sun exposure may improve acne a little, but mostly it just hides the acne. However, too much exposure to sunlight or ultraviolet rays is not recommended because it increases the risk for skin cancer.

Topical theraphy  :  Retinoids

Antibiotics           :  Erythromycin, tetracycline, Benzyl peroxide

Homoeopathy and other traditional mode of treatment can also give good results.

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DR K TAMILSELVAN