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Table Of Contents:
Alternative names
Definition
Causes, incidence, and risk factors
Prevention
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Alternative names:
acne vulgaris; cystic acne; pimples
Definition:
An inflammatory skin condition characterized by superficial skin
eruptions that are caused by plugging of the skin pores.
Causes, incidence, and risk factors:
Acne is most common in adolescent boys, but it can occur in both
sexes and at all ages. There seems to be a familial tendency to
develop acne. The condition usually begins at puberty and may
continue for many years. Three out of four teenagers have acne to
some extent, probably caused by hormonal changes that stimulate the
sebaceous (oil producing) skin glands. Other hormonal changes, such
as can occur with menstrual periods, pregnancy, use of birth control
pills, or stress, also aggravate acne.
Acne is caused when sebaceous glands within the hair follicles
(pores) of the skin become plugged, because secretion occurs faster
than the oil and skin cells can exit the follicle. The plug causes
the follicle to bulge (causing whiteheads), and the top of the plug
may darken (causing blackheads). If the plug causes the wall of the
follicle to rupture, the oil, dead skin cells, and bacteria found
normally on the surface of the skin can enter the skin and form
small infected areas called pustules (also known as pimples or
"zits").
If these infected areas are deep in the skin, they may enlarge to
form cysts. A sebaceous cyst forms when the sebaceous gland
continues to produce oil. Instead of rupturing the follicle wall,
the follicle continues to enlarge and form a soft, pliable lump
(known as a cyst) under the skin. The cyst is usually not painful or
discolored unless it becomes infected. Acne commonly appears on the
face and shoulders, but may extend to the trunk, arms and legs.
Acne is not caused by dirt or by masturbation or other activities,
but dirt and oil on the face can aggravate the condition. Other
factors that increase the chances of acne are hormonal changes,
exposure to weather extremes, stress, oily skin, endocrine
disorders, certain tumors, and the use of certain drugs (such as
cortisone, testosterone, estrogen, and others). Acne is not
contagious. A tendency to have acne may persist through ages 30's to
early 40's.
Prevention:
The tendency to develop acne is inherited. Although acne cannot be
prevented, careful cleanliness can help to lessen the effects.
Symptoms:
- skin rash or lesion on the face, truck (chest) neck, back,
or other area
- comedones (whiteheads or blackheads)
- pustules
- cysts
- papules
- nodules
- redness (erythema) of the skin lesions or skin around a
lesion
- inflammation around the skin eruptions
- crusting of skin eruptions
- scarring of the skin
Signs and tests:
Diagnosis is primarily based on the appearance of the skin. No
testing is usually required.
Treatment:
Treatment is designed to prevent formation of new lesions and aid
the healing of old lesions.
Topical medications that dry up the oil and/or promote skin peeling
may contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or
tretinoin, or retinoic acid (Retin-A).
Antibiotics (such as tetracycline or erythromycin) may be prescribed
if the skin lesions appear infected. Topical antibiotics (applied to
a localized area of the skin) such as clindamycin or erythromycin
are also used to control infection. Note: oral tetracycline is
usually not prescribed for children until after they have all their
permanent teeth, because it can permanently discolor teeth that are
still forming.
Synthetic vitamin A analogues (isotretinoin, Accutane) have been
shown to be of benefit in the treatment of severe acne. However,
pregnant women and sexually active adolescent females should not
take this medication!
Other medications may include topical or injected forms of
cortisone.
Surgical intervention may include professional (chemical) skin
peeling, removal of eruptions or scars (dermabrasion), or removal
and/or drainage of cysts.
A small amount of sun exposure may improve acne. However, excessive
exposure to sunlight or ultraviolet rays is not recommended because
prolonged exposure increases the risk of skin cancer.
Home treatment may lessen the effects of acne:
- Clean the skin gently but thoroughly with soap and water,
removing all dirt or make-up. Wash as often as needed to control
oil, at least daily and after exercising. Use a clean washcloth
every day to prevent bacterial reinfection.
- Use steam or warm, moist compresses to open clogged pores.
- Shampoo hair daily when possible. Use a dandruff shampoo if
necessary.
- Comb or pull hair back to keep hair out of the face.
- Use topical astringents to remove excess oil.
- Don't squeeze, scratch, pick, or rub lesions. These
activities can increase skin damage. Wash your hands before and
after caring for skin lesions to reduce the chance of infection.
- Don't rest your face on your hands. This irritates the skin
of the face.
- Identify and avoid anything that aggravates acne. This may
include foods, lotions, make-up, and so on. Avoid greasy
cosmetics or creams, which can aggravate acne.
- Acne often improves in the summer, so some foods that
aggravate acne may be tolerated in the summer but not in the
winter.
Expectations (prognosis):
Acne is usually chronic from puberty to adulthood, but eventually
lessens. Acne generally responds well to treatment after a few
weeks, but may flare up from time to time. Acne is not medically
dangerous except for untreated, severe infection. Scarring may occur
if severe acne is not treated.
Complications:
- cyst
- skin abscess
- permanent facial scars
- keloids
- skin pigment changes
- psychological damage to self-esteem, confidence,
personality, social life
- side effects of Accutane (including liver damage and damage
to the fetus)
- side effects of other medications
Calling your health care provider:
Apply home treatment and call your health care provider if there are
signs of complications or if acne is severe and progressively
worsening.
Call for an appointment with your health care provider if new
symptoms develop, including large or painful cysts.
Healthcentral 2004
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2005 Georges G. Hayek. All rights reserved |
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