Acne Vulgaris (Pimples and Zits)

Definition

Acne vulgaris is a skin condition, which leads to pimples,pustules, white heads, blackheads, cysts or inflamed patches on the skin of the face, neck, chest or back. Acne usually occurs when the skin pores, which are openings for hair follicles and its oil glands, are blocked and infected. It is associated with hormonal changes that make the oil-producing glands more active. Therefore the condition is seen at points in life where there are hormonal changes, such as puberty, pregnancy and menopause. It is most often associated with the teen years.

Symptoms

Acne is most common on the face, neck, shoulder, chest, back, where most oil glands are present. It can be either inflammatory or non-inflammatory.

Inflammatory acne is characterized by papules, pustules, nodules or cysts. These all are inflammation on the skin or beneath the skin near the hair follicle. They are pus-filled and are accompanied by redness and pain.

Non-inflammatory is characterized by presence of a comedone, which is the blockage of the skin pore due to dirt, oil and dead cells. Depending upon the color of the top of the plug it is called white head or black head.

Causes

Acne is caused by blockage of the pores of the skin. This can be due to excess oil secretion by the oil gland, irregular shedding of skin cells resulting in irritation of the hair follicle. Dead skin cells and dirt can accumulate in these blocked pores. This blockage in non-inflammatory acne is called a plug or comedone. This provides an environment for bacteria to grow, leading to inflammation.

Increase in androgens (male sex hormons) during puberty can lead to acne. These hormonal changes, which lead to a more oily skin, hence it is more common in teens. It can also be associated with hormonal changes associated with menstrual cycle where acne occurs prior to menstruation. Certain medications such as those containing corticosteroids or androgens can lead to acne. Certain cosmetics or direct contact of oily or greasy substances with the skin, may worsen the acne.

Treatment

Treatment of acne can be at several levels, such as treatment of the excessive oil production, of the infection and inflammation. The treatment can be topical (creams, gels, washes, to be applied externally to the skin) or oral (pills) or a combination of the two. Topical agents include antimicrobial applications and drying substances.

For moderate to severe acne, a dose of oral antibiotics is prescribed to reduce bacteria and inflammation. Isotretinoin may be given in certain cases where other modes of treatment are not effective. Administration of this drug requires constant monitoring due to severe side effects. Oral contraceptives are sometimes prescribed for females with acne who have associated menstrual disturbances.

A variety of cosmetic treatments, laser and light treatments which can reduce oil production by the glands are available, which might also help to some degree. To reduce scars caused by acne a host of treatments such as chemical peels, dermabrasion are used to remove the top layer of the scarred skin.

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