A Family Doctor's Tale - ACNE

DOC I HAVE PIMPLES

Acne ( A Simple Guide to Acne) is a skin condition which is characterized by papules, pustules and inflamed sebaceous oil glands. 
It typically occurs on the face, neck, upper back, chest, or shoulders where the concentration of these glands are normally located.


It is a disease caused by the hyperactivity of the skin's sebaceous glands which are located at the base of the  hair follicles. Sebaceous glands produce an oily moisturizing secretion (sebum)which helps to wax the hair growing from the hair follicle.


The sebum then empties into the skin's hair follicles which cover most of the body. Normally tiny skin cells shed so that new skin can replace the ones on the surfaces. When the shedding of such cells is abnormal, the opening of the hair follicle can be blocked. The result is a accumulation of sebum in the follicle which can easily become infected.


Bacteria Infection of the accumulated sebum produce pus and toxins which then resulted in a infected swollen gland or infected pimple. 
The infected pimples if severe may result in scars or keloids( A Simple Guide to Keloid).


The severity of symptoms depends on the individual. 
Acne usually occurs during puberty when the production of male hormone in teenagers both male and female are higher.
1.Small bumps which appear under the skin and have no opening are known as whiteheads.
2.Dark spots with plugged pores in the center are blackheads.
3.Persistent, recurrent red spots or swellings on the skin, filled with pus, are pustules.
4.Lumps under the skin which are inflamed and solid are nodules, or if fluid filled are cysts.


Often the acne become worse during stress or using oily cosmetics or hair creams. 
In girls the acne may be aggravated during menses or during pregnancy


Reassurance of worries about their looks in teenagers is very important because it reduces stress and the production of more male hormones.

Fresh air, enough rest and a healthy lifestyle will help psychologically.
A small amount of sun exposure may also help acne problems.
Do not touch the acne spots with dirty hands,
Do not try to squeeze the pimples.


Patients with minimal symptoms:
1. simple healthy skin care can resolve the problem.
Oily skin can washed with simple soap and water.
Topical medications that help to dry up the oil and promote skin peeling can be applied on the skin. Such products may contain benzoyl peroxide, sulfur, resorcinol, salicylic acid or tretinoin, or retinoic acid (Retin-A).


2.antibiotics (such as tetracycline or erythromycin) is 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.


3.New treatment with synthetic vitamin A analogues (isotretinoin, Accutane) have been shown to be beneficial in the treatment of severe acne.
This medication is not to be taken by pregnant women and sexually active adolescent females.


4. Sometime in severe cases, estrogen therapy (Diane 35) on a short term may benefit girls with very severe acne and whose menses are not regular.


Most important every person who has gone through puberty has some form of acne and usually do not have any complications or bad scarring with the condition.


Prognosis is very good for 99% of cases.