Acne is a common skin disease which affects 60 - 70% of Americans. 20% have severe acne which leads to permanent physical scarring. The severity depends on various factors such as race, sex and age.
Acne is common in white Americans. During adolescent age acne is more common in males than in females. But in adults acne is more common in females than in males. Acne sometimes can be present during the first few weeks of the life which is called neonatal acne. In the adolescence it usually begins with the puberty. Acne presents as black heads, white heads, pustules or nodules. Usually face may be the only involvement but sometimes chest, back, and upper arms are also getting involved.
The main underlying cause for acne is determined by the genetic factors. But there are many more recognized aggravating factors.
- Cosmetic agents
- Some medicines such as steroids, lithium, some snit epileptics, and iodides
- Some endocrine disorders such as congenital adrenal hyperplasia and polycystic ovarian syndrome
- Mechanical occlusion to the skin with head bands, shoulder pads or back packs
- Excessive sun light
Treatment of acne disease depends on the severity of the disease. For those who are having less severe acne treated only with local application (topical) of anti inflammatory agents and antibiotics. But in severe cases systemic antibiotics are needed. Sometimes combination of several drugs also used in treatment of severe acne.
Topical Retinoids (topically applying anti inflammatory agent) such as Adapalene, Tazarotene and Tretinoin are a commonly using drug in treatment of mild to moderate acne vulgaris. These should be applied once daily to a clean and dry skin. Sun protection should also be encouraged apart from the medical treatment.
Antibiotic local applications such as Erythromycin and Clindamycin alone or in combination with Benzoil peroxide. They also may be applied once or twice daily.
Benzoyl peroxides are available in local markets as soaps, washes, lotions, creams and gels and are being purchased without doctor’s prescriptions. But in case of any skin irritation, all the local applications should be discontinued and much seek a medical advice from a qualified doctor.
Systemic antibiotics, specially the drugs that taken by mouth (oral) are being used commonly and found to have more successful in treatment of moderate to severe acne vulgaris.
Most commonly using antibiotics are Tetracyclines and nowadays Doxycycline and Minocycline found to have more effective in treating acne over Tetracycline.
Trymethoprim, Sulfonamethoxazole and Azithromycin are also been used and reportedly helpful. Birth control pills and Spironolactone also shown some efficacy in the treatment of acne. Some of these drugs are affecting the fetus of a pregnant woman. So prior to therapy, in women in child bearing age groups, a pregnancy should always be excluded and advised to avoid pregnancy while on treatments with such drugs.
Having acne can be a very depressing situation, specially for those who are in adolescence and it adversely affects the personality development of an adolescent. Sometimes it may create hostility, anger and anti social behaviors associated with some suicidal ideas.
Apart from the medical treatments, some surgical measures also been used to treat severe acne.
- Manual extraction of comdones (black heads and white heads)
- Phototherapy with red light or blue light
- Laser treatment
Diet has not been identified to play a major role in controlling acne.
Tips and comments:
Acne Vulgaris is a treatable skin condition and it is better to consult a doctor prior to buy medications to exclude other possible skin diseases.
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