Acne is one of the most common chronic disorder of the skin affecting the hair follicle and sebaceous gland, in which there is expansion and blockage of the follicle and inflammation. There are several clinical variants of acne which may be occurred in different age:
- acne of newborns – common skin condition that affects newborns in their first few weeks of life. Newborns acne is harmless and usually goes away on its own without treatment
- acne vulgaris – common form of chronic inflammatory disorder of pilosebaceous unit with formation of comedones, pustules, nodules located on the face, back and upper arms
- acne conglobata – severe form of acne presented by tender inflammatory nodes and papules and large painful pus-filled cysts
- inverted acne, acne inverse (hidradenitis suppurativa) – a chronic inflammatory disease with painful nodules, pustules and abscesses in the hair roots and near sweat gland
- late acne in women – most common in women going through menopause, caused by hormonal disturbance in this age and sometime contributed by oral contraceptives
- Acne cosmetic is a mild type of comedonal acne resulting from the use of cosmetics and others.
Acne affects males and females of all races and ethnicities. It is prevalent in adolescents and young adults, with 85% of 16 to 18 year-olds affected. However, it may sometimes occur in children and adults of all ages.
Why it happens?
The four factors contribute to development of acne:
- Production of excessive sebaceous gland secretion
- Obstruction to outflow of sebum at the mouth of the pilosebaceous canal
- Inflammation arising as a result of the leakage of contents of the pilosebaceous follicle to the surrounding dermis
- Excessive colonization or infection of the pilosebaceous duct with P. acnes
For about 40% of women, acne may continue into their 40s because of hormonal changes and other causes, including:
- Hormonal changes in pregnancy or from the menstrual cycle
- Some medications
- Certain cosmetics and lotions
- High humidity and sweating
- Polycystic ovary syndrome (PCOS)
What are the clinical features of acne?
Acne is often confined to the face but it may involve the neck, chest, and back.
It is characterised by:
- Open and closed uninflamed comedones (blackheads and whiteheads)
- Inflamed papules and pustules
- In severe acne, nodules and pseudocysts
- Post-inflammatory erythematous or pigmented macules and scars
- Adverse social and psychological effects.
How do we treat acne?
Before starting the treatment, it is necessary to find out the true cause of the disease.
We should also take into account the type of acne, underlying diseases, hormonal status, skin type. It is also important to know what treatment the patient received before coming to us and how effective it was.
Acne can be effectively treated, although the response may sometimes be slow. Most patients with mild acne can be treated with topical treatment (gels, solutions and lotions), treatment for moderate acne includes antibiotics and treatment for severe acne may require a course of oral isotretinoin. We use also some cosmetic procedures, mesotherapy with phages and etc.
Key Recommendations for Acne Patients
Starting acne treatment early is extremely important as it helps reduce the chance of complications such as scarring.
There are very effective treatments for this disease.
Treatment can lead to the rapid disappearance of some rashes, however, the full effect of therapy will take some time.
If you have acne prone skin, you should consult a dermatologist.
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