How Do Clinical Features Vary In Differing Types Of Skin
All characteristic lesions of acne vulgaris can occur in skin of colour, but it usually presents with less discernible redness and more postinflammatoryhyperpigmentation which persists long after the acne lesion has gone. Post-inflammatory hyperpigmentation is often the major reason for seeking medical attention, causing significant psychological effects.
Pomade acne occurs more commonly in people with skin of colour due to cultural practices with hair styling products in African American and Hispanic populations. The use of greasy hair products leads to follicular plugging and comedones along the hairline.
Keloid scarring is more common in skin of colour following acne lesions, particularly along the jawline, chest, and upper back.
Acne in skin of colour
What Are The Clinical Features Of Acne Vulgaris
Acne most often affects the face, but it may spread to involve the neck, chest and back, and sometimes even more extensively over the body.
Individual lesions are centred on the pilosebaceous unit, ie the hairfollicle and its associated oil gland. Several types of acne spots occur, often at the same time. They may be inflammatorypapules, pustules and nodules or non-inflamed comedones and pseudocysts.
Treatments For Acne Vulgaris
The human skin can be subjected to many diseases which can be due to infections such as the fungal ones, due to allergy which causes hives, urticaria and so on. A common condition of human skin disease which is known as acne vulgaris has been the topic of interest for many dermatologists since years. Acne vulgaris is a condition of skin which causes pimples, blackheads, whiteheads and also scarring. It is a disorder of skin follicles.
Acne Vulgaris can be caused due to a number of reasons. Firstly, it can be due to hormonal changes. This is the reason why teenagers are more likely to develop pimples. Moreover, oily skin, unclean skin, blocked pores and hereditary factors can also develop acne. Acne scars develop due to inflammation inside the skin. Certain drugs, cosmetic products and sweating can also contribute to the development of acne.
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What Is The Pathophysiology Of Acne
Here are the four processes that take place in the pilosebaceous unit of the skin and lead to the occurrence of acne:
Adopt A Good Personal Hygiene Routine
Wash your face at least two to three times each day. If possible, wash it with soap and warm water as well. This would reduce the risk of developing Acne Vulgaris.
After washing your face, pat it dry with a clean cloth
Do not rub it. Then apply a moisturizer that is rich in Vitamins E and C. Also, drink plenty of water during the day to keep your skin hydrated.
Chemical products to cure Acne Vulgaris
While it may seem like a good idea, chemical products tend to dry out your skin and rob it of its natural oils, thus worsening the situation. So, when you are looking for a cure, look first for natural ingredients such as Aloe Vera, Vitamin E and Vitamin A that can not only Acne treatment at home but also keep your skin healthy.
Look at your diet
If you are still taking in an excessive amount of fatty foods, which is a main factor in causing Acne Vulgaris, then change your diet. Instead of eating fatty foods, substitute yogurt, eggs, fruit and vegetables for your daily meals. Youll find that your acne is naturally better once you get rid of the oily foods and instead eat healthier foods. And the best part is, you will feel better as well!
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How To Make A Scrub At Home
Exfoliation is the process of removing the top layer of dead skin cells. It may reduce the appearance of scars and discoloration, but more research needs to be done on its ability to treat acne.
The relationship between diet and acne has been debated for years.
Research suggests that dietary factors, such as insulin and glycemic index, may be associated with acne .
A foods glycemic index is a measure of how quickly it raises your blood sugar.
Eating high GI foods causes a spike in insulin, which likely increases sebum production. As a result, high GI foods may directly affect the development and severity of acne.
Foods with a high glycemic index include processed foods, such as:
- white bread
- whole or minimally processed grains
In one study, 66 people followed either a normal or low glycemic diet. After 2 weeks, the individuals consuming a low glycemic diet had lower levels of insulin-like growth factor-1 , a hormone involved in acne development .
Another study in 64 people found that those with moderate or severe acne ate diets with more carbohydrates and a higher glycemic load than those without acne .
These small studies suggest that a low glycemic diet may help those with acne-prone skin. Additional larger, longer studies are needed.
The relationship between dairy and acne is highly controversial.
Referral To Specialist Care
Urgently refer people with acne fulminans on the same day to the on-call hospital dermatology team, to be assessed within 24 hours.
Refer people to a consultant dermatologist-led team if any of the following apply:
- Diagnostic uncertainty.
Consider referring people to a consultant dermatologist-led team if they have:
- Mild to moderate acne that has not responded to two completed courses of treatment.
- Moderate to severe acne which has not responded to previous treatment that contains an oral antibiotic.
- Acne with scarring.
- Acne with persistent pigmentary changes.
Consider referring people to a consultant dermatologist-led team if their acne of any severity, or acne-related scarring, is causing or contributing to persistent psychological distress or a mental health disorder.
Consider referral to mental health services if a person with acne experiences significant psychological distress or a mental health disorder, including those with a current or past history of:
- Suicidal ideation or self-harm.
- Severe depressive or anxiety disorder.
- Body dysmorphic disorder.
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Diagnosis And Diagnostic Evaluation
The diagnosis is mainly clinical based on the characteristic lesions in a characteristic distribution . Laboratory investigations are usually not necessary unless clinically indicated. Serum concentrations of testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate and, in women of childbearing age, luteinizing hormone and follicle-stimulating hormone may be measured and pelvic ultrasound should be performed to look for polycystic ovarian syndrome if there is a suspicion of hyperandrogenism .,
What Is The Prognosis For Acne
Acne typically improves when people grow out of puberty, but it can persist into adulthood. Around 3 percent of adults suffer from acne over the age of 35. For most people with acne, there are no long-term consequences. However, it is important to keep in mind that this condition can also have a psychological impact and even rarely, it can lead to mortality â due to suicide. Severe acne and lack of treatment can lead to permanent scarring in the affected skin areas. This can cause feelings of low self-esteem and anxiety that can impact one’s social life and even employment. ,,
Patients who are about to undergo treatment should follow the treatment plan discussed with their doctor for at least two to three months before deciding on the effectiveness and further course of action.Acne usually takes a long time to develop and typically repeats itself over many years, so maintenance therapy is an important part of the treatment.
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Common Causes Of Acne Vulgaris:
Here are the top reasons for acne you need to know-
Internal Causes It includes the primary factors that play a significant role in causing acne
- Heredity: If either of your parents had acne, then there is a high probability of you having pimples too.
- Hormonal Changes: Hormonal disorders related to conditions like PCOS can stimulate sebaceous glands to produce more sebum, leading to acne outbreaks. Hormonal changes during puberty, menstruation, pregnancy and menopause too may trigger breakouts.
External Causes Here are some secondary factors that may play a critical role in irritating your acne-prone skin and aggravating your skin condition. These include
- Stress: A high-stress lifestyle can trigger the activity of sebaceous glands and can result in excess sebum production and acne.
- Medications: Specific medicines containing androgen, corticosteroids, DHEA, and lithium cause acne as a side-effect.
- Diet: Regular consumption of sugary foods that have a high glycemic index can also trigger acne.
- Improper Skincare: Using skincare and makeup products that contain harsh chemicals or are not suitable for your skin type may clog your pores and cause breakouts.
What Is The Outlook For People With Acne
Nearly everyone has experienced acne at some point in their lives, and for most, the outlook is excellent. In general, acne peaks during the teen years and usually clears up on its own in early adulthood. But some people continue to experience acne into adulthood.
In moderate and severe cases, scarring can occur. Fortunately, many treatment options are available that can effectively alleviate symptoms and minimize or remove acne scars.
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Treatment Option For Acne Vulgaris
Acne Vulgaris Treatment
Whatever may stand out to be the cause of this disease, no one would ever bear a face accompanied with pimples and people try to get rid of this problem as soon as possible. Many of us wont bear even a single pimple. Hence, there are many possible acne vulgaris treatments now available which vary from the natural ones to the most advanced laser treatments.
Treatment By Vitamins
Certain vitamins provide a great help in preventing the occurrence of pimples and in reducing the acne scars. Vitamin A helps to reduce the oil of skin which prevents acne. Oily skin is more prone to the development of acne vulgaris. Vitamin C, an antioxidant, helps in clearing away toxins from the body and promotes the health of skin cells.
This vitamin stimulates collagen synthesis and in this way reverses the signs of aging. Another antioxidant, vitamin E fights away the free radicals and improves the gland functioning of skin. One may find these vitamins in many of the topical creams.
Treatment By Medications
Acne in a person can range from mild to moderate to severe. The acne vulgaris disease is often found to be associated with a P.acnes bacterium. Hence, for mild acne problem, the first line of treatment could be the use of benzoyl peroxide which is effective against this bacterium.
What Questions Should I Ask My Healthcare Provider About Acne
- What type of acne do I have?
- How severe is my acne?
- Do I need to see a dermatologist?
- Do I need a referral?
- What over-the-counter medications do you recommend?
- What prescription medications do you recommend?
A note from Cleveland Clinic:
Acne is the most common of all skin conditions and can have a profound psychosocial impact.
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Diagnosis Of Acne Vulgaris
Every individual now and then faces acne in their life, and thus it becomes easy for them to recognize it at an early stage. If you are unable to identify yourself with the skin condition it is better to see a doctor. As many symptoms are similar for other skin conditions too, it sometimes becomes tough to identify whether it is acne vulgaris or another skin disease like rosacea. Hence it becomes necessary to diagnose your symptoms or disease so you can have a better option of the treatment for the same. Laser treatment has taken the world to heights. You will not need to get afraid of the operation cuts and surgery.
Are You At Risk
In India alone, more than 10 million people complain of acne every year. People who have a family history of acne vulgaris or hormonal issues like PCOS are more prone to breakouts than others. Also, those of you undergoing hormonal changes due to puberty, pregnancy or menopause have an increased risk of having acne. If you have a stressful lifestyle or poor dietary habits, your probability of having pimples is high. It is advisable to seek medical assistance as soon as you experience an acne outbreak to prevent recurrence and unwanted scarring or pigmentation in the future.
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What Are The Risk Factors For Acne
Scientists are still working out why acne affects some people, but not others. In addition to fluctuations in the levels of androgens, other factors have been associated with acne:
- Genetic factors. There is evidence that people with a family history of acneespecially moderate to severe acnemay be more likely to develop it themselves.
- Diet. Some studies suggest that a high glycemic load diet may contribute to the development or worsening of acne. High glycemic load foods are those that cause blood sugar levels to rise quickly such as white bread, cornflakes, and white potatoes. Other studies have linked the consumption of cows milk, particularly skim milk, with acne. More rigorous research studies are needed to fully validate the role of diet in acne vulgaris.
- Endocrine disorders. Certain endocrine disorders, such as polycystic ovary syndrome and congenital adrenal hyperplasia, can raise androgen levels.
- Medications and drugs. Various medications and drugs can trigger acne, including corticosteroids and anabolic steroids.
- Stress. There is some evidence that emotional stress can exacerbate acne.
- Skin care products. Certain skin care products such as cosmetics, sunscreens, and moisturizers can clog hair follicles, and may play a role in the formation of acne. Many skincare products now report whether they are non-comedogenic, meaning they do not exacerbate the formation of comedonal acne.
How To Treat Different Types Of Acne
To see clearer skin, it helps to know what types of blemishes you’re dealing with. Each type requires different treatment.
Whats that blemish?
Is that a blackhead, papule, or something else? See what the different acne blemishes looks like and how to treat them.
Blackheads and whiteheads
These appear when pores become clogged with excess oil, bacteria, and dead skin cells. If the pore closes up, youll see a tiny bump that looks white or flesh colored. These are whiteheads.
Blackheads and pimples
If the pore fills with debris but stays open, youll see a blackhead. The black dots arent dirt, so resist scrubbing. It will only worsen your acne.
Treating whiteheads and blackheads
To unclog pores, dermatologists recommend using a retinoid. You can buy one retinoid, adapalene, without a prescription. Youll also want to use a benzoyl peroxide wash. It can help get rid of the excess P. acnes bacteria on your skin.
Stubborn whiteheads and blackheads
Give treatment six to eight weeks to work. If you still see blemishes, you may want to see a dermatologist. A procedure like comedo extraction may help. Prescription-strength acne treatment is another option.
When excess oil, bacteria, and dead skin cells push deeper into the skin and cause inflammation , youll see small, red bumps. The medical word for this type of acne blemish is a papule. They feel hard. If you have a lot of papules, the area may feel like sandpaper.
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What Is Unique About Yale Medicine’s Approach To Treating Acne
Yale Medicine dermatologists work closely with each patient to tailor an acne care regimen optimized for their particular situation. No two patients are exactly alike, and here at Yale Medicine we strive to take the various factors outlined above, such as gender, age, type of acne, scarring, pigmentation, location of acneface, chest, back, buttocks, etc.and other medical conditions into account when we treat patients, says Dr. Bunick. This holistic approach to treating acne enhances the doctorpatient relationship and leads to better treatment outcomes for our patients.
Signs And Symptoms Of Acne:
The signs and symptoms of acne vary based on the type and severity of the condition. However, you may note the following if you have acne-prone skin:
- Clogged pores with white or transparent lesions
- Redness and inflammation in the form of bumps and rashes
- Painful pus-filled pimples
- Scar and pigmentation
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How Is Acne Treated
Your healthcare provider may suggest some non-prescription medications for your condition. Depending on the conditions severity, your age, the type of acne you have and how effective the over-the-counter remedies have been, you may need stronger prescription medications.
The use of certain contraceptives can sometimes help a womans acne go away. The Food and Drug Administration has approved three types of birth control pills for treating acne. All four contain a combination of estrogen and progesterone .
Various medications and therapies have proven to be effective. They target the underlying factors that contribute to acne. You might require at least one or multiple, depending on the severity of your condition.
Medications applied topically:
Medications taken orally :
Depending on your condition, your healthcare provider might suggest one of these specialized therapies, possibly combined with medication.
Are There Any Special Concerns For Women Of Childbearing Age With Acne
Many topical and oral acne treatments are contraindicated during pregnancy. If youre a woman in your childbearing years, its important to discuss acne treatments with your healthcare provider and alert them if you become pregnant. Isotretinoin is known to cause severe birth defects and therefore, two methods of birth control are required while on this medication.
Hormone therapy is helpful for some women with acne, especially for those that flare-up with menstruation or those with signs and symptoms of excess androgen . Hormone therapy consists of low-dose estrogen and progesterone or a medication called spironolactone that blocks the effect of male hormones at the level of the hair follicles and oil glands.
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