ACNE VULGARIS - Watsons Health

ACNE VULGARIS

Acne vulgaris, or simply acne or pimples, is caused by the hair follicles being plugged by oil and dead cells and then being infected.  It usually appears in the face, neck, chest, shoulders, and back.

Almost all teenagers would have acne in their life.  Sometimes it would even last up to your 20s and would then even cause more scarring.  It is uncommon for women to have acne because it may be triggered by increased hormone in their menstrual cycle.

These factors can trigger or aggravate an existing case of acne:

  • Hormones. Androgens, hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production.
  • Certain medications. Drugs containing corticosteroids, androgens or lithium can worsen acne.
  • Diet. Including dairy products and carbohydrate-rich foods — such as bread, bagels and chips — may trigger acne.
  • Stress. Stress can make acne worse.

Acne appears on the skin as:

  • occluded pores (“comedones”), also known as blackheads or whiteheads,
  • tender red bumps also known as pimples or zits,
  • pustules, and occasionally as
  • cysts (deep pimples, boils).

The different types of acne include:

  • Newborn acne. Newborns with acne usually only have whiteheads. And these go away without treatment.
  • Infantile acne. can have blackheads and pimples at the same time. The pimples rarely leave scars. Infantile acne may be caused partly by higher-than-normal hormone levels.
  • Acne vulgaris. The most common type of acne is acne vulgaris. It appears most often in teens and young adults.
  • Acne conglobata (cystic acne). In acne conglobata, deep pimples develop on the face, chest, back, upper arms, and thighs. This type of acne can be hard to treat and often leaves scars. Acne conglobata may last well into adulthood.
  • Acne fulminans. In acne fulminans, a large number of pimples develop very quickly on the teen’s back and chest. Teens with acne fulminans often have a fever and also muscle and bone pain.

Acne signs and symptoms vary depending on the severity of your condition:

  • Whiteheads (closed plugged pores)
  • Blackheads (open plugged pores — the oil turns brown when it is exposed to air)
  • Small red, tender bumps (papules)
  • Pimples (pustules), which are papules with pus at their tips
  • Large, solid, painful lumps beneath the surface of the skin (nodules)
  • Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)

DIAGNOSIS

When you see a doctor about acne, you’ll have a physical exam, and your doctor will ask about your medical history. Women may be asked questions about their menstrual cycles. This information can help your doctor find out if hormones are playing a role in acne flare-ups. Most often, you won’t have any special tests to diagnose acne.

 

RECOMMENDED MEDICATIONS

Medicines can help manage the severity and frequency of acne outbreaks. A number of medicines are available. Your treatment will depend on the type of acne you have (pimples, whiteheads, blackheads, or cystic lesions).

Treatment of acne depends on whether inflammation or bacteria are present. Some acne consists only of red bumps on the skin with no open sores (comedonal acne). Topical creams and lotions work best for this type of acne. But if bacteria or inflammation is present with open sores, oral antibiotics or isotretinoin may work better.

Topical medications

These products work best when applied to clean, dry skin about 15 minutes after washing. You may not see the benefit of this treatment for a few weeks. And you may notice skin irritation at first, such as redness, dryness and peeling.

The most common topical prescription medications for acne are:

  • Retinoids. These come as creams, gels and lotions. Retinoid drugs are derived from vitamin A and include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage).
  • Antibiotics. Examples include clindamycin with benzoyl peroxide (Benzaclin, Duac, Acanya) and erythromycin with benzoyl peroxide (Benzamycin).
  • Dapsone (Aczone).

Oral medications

  • Antibiotics. Choices for treating acne include tetracyclines, such as minocycline and doxycycline
  • Combined oral contraceptives. The Food and Drug Administration approved three products that combine estrogen and progestin (Ortho Tri-Cyclen, Estrostep and Yaz).
  • Anti-androgen agent. The drug spironolactone (Aldactone) may be considered for women and adolescent girls if oral antibiotics aren’t helping.
  • Isotretinoin. This medicine is reserved for people with the most severe acne. Isotretinoin (Amnesteem, Claravis, Sotret) is a powerful drug for people whose acne doesn’t respond to other treatments.

Therapies

These therapies may be suggested in select cases, either alone or in combination with medications.

  • Light therapy. Light therapy targets the bacteria that cause acne inflammation. Some types of light therapy are done in a doctor’s office. Blue-light therapy can be done at home with a hand-held device.
  • Chemical peel. This procedure uses repeated applications of a chemical solution, such as salicylic acid. It is most effective when combined with other acne treatments, except oral retinoids.
  • Extraction of whiteheads and blackheads. Your dermatologist uses special tools to gently remove whiteheads and blackheads (comedos) that haven’t cleared up with topical medications.
  • Steroid injection. Nodular and cystic lesions can be treated by injecting a steroid drug directly into them. This improves their appearance without the need for extraction.

Treating children

If your child has acne, you may want to consult a pediatric dermatologist. Ask about drugs to avoid in children, appropriate doses, drug interactions, side effects, and how treatment may affect a child’s growth and development.

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