⚔️ The War With Acne

⚠️ Acne is a multi-factorial skin condition that usually appears on your face, chest, back and shoulders. When your body produces an excess amount of sebum and dead skin cells, the two can build up in the hair follicles. They form a soft plug, creating an environment where bacteria can thrive. If the clogged pore becomes infected with bacteria, inflammation results. 🔬 Acne pathogenesis is complicated by 1) Hormonal activation of sebaceous glands 2) Plugged sebaceous follicles (comedones) 3) Infection by the bacteria Propionibacterium acnes 📈 Risk increases with the following: 👪 Family history 💊 Medications - steroids and lithium 🏥 Endocrine disorders - eg. polycystic ovarian syndrome 😤 Stress 👧 Menstruation 💄 Oily cosmetics 🔎 Diagnosis: 🔸 Comedonal acne: open and closed comedones w/o inflammatory papules or nodules 🔸 Mild acne: comedones and a few papules and pustules 🔸 Moderate acne: numerous comedones, inflammatory papules, and pustules 🔸 Nodulocystic acne: comedones, inflammatory lesions, and large nodules greater than 5 mm in diameter. Scarring is often involved 💊 Medical management is dependant on severity: 🔹 Benzoyl peroxide - first line indication for comedones 🔹 Tretinoin (Retin-A) - combined with benzoyl peroxide for more severe cases 🔹 Topical antibiotics - indicated for inflammatory cysts (eg. erythromycin or clindamycin) 🔹 Systemic antibiotics - tetracycline and erythromycin for difficult cases 🔹 Isotretinoin (Accutane) - Used in severe acne. Improvement in majority of cases. High teratogenic potential. Patient must take pregnancy test prior to treatment. Must monitor cholesterol, TGs and LFTs 📉 Ways to reduce breakouts: 💧Wash affected areas with gentle cleanser. Too much washing irritates the skin 💄 Oil-free, water-based skin care products. 💊 OTC acne meds- containing benzoyl peroxide or salicylic acid 🚿 Shower after strenuous activities 👉🏼 Avoid touching or picking the face

Photo by Anna Nekrashevich

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