Acne Vulgaris : Definition, Etiology, Epidemiology, Symptoms, Management, & Prevention
Definition
- Acne Vulgaris is an inflammatory disease of the pilosebaceous follicle characterized by comedones, papules, pustules, cysts and scars.
Epidemiology
- Nearly all teenagers (>80% ) aged 13- 18 years.
Causes
- Hormonal (androgen)
- Increased sebum production
- Poral occlusion
- Abnormal follicular keratinization
- Bacterial colonization (Propionibacterium acnes)
- Inflammation
Clinical Presentation
- Non-inflammatory lesions (mild acne) – open and closed comedones (blackheads and whiteheads)
- Inflammatory lesions (moderate and severe acne) – papules, pustules, nodules, and cysts
- Commonly affects the face, chest and upper back
Course
- Acne vulgaris clears by the age of 23–25 years in 90% of patients, but some 5% of women and 1% of men still need treatment in their thirties or even forties.
Investigations
- None are usually necessary.
Management
A. General measures
- No specific food which cause acne.
- Treatment needs to be continued for at least 6 weeks to produce effect.
B. Local treatment (for mild acne)
1. Cleansing: Regular gentle cleansing with soap and water should be encouraged, to remove surface sebum.
2. Topical therapies
C. Systemic treatment (for moderate to severe acne)
1. Oral antibiotics
2. Hormonal
- Anti-androgens (in females)
3. Oral retinoids (for severe acne)
D. Physical
- LASER treatment
Acne scar treatment
- Dermabrasion
- Lasers
- Dermal fillers
Complications
- Post-inflammatory hyperpigmentation
- Scarring
- Deformity
- Psychological and social effects
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