Acne complex

Truly, Acne is a complex type of disease. Both the sexes have to suffer from this irritating problem. Let us discuss about acne and its treatment in detail. I shall try to simplify the medical terminology as far as feasible.

Acne is of two types – Acne vulgaris and Acne rosasea. Acne vulgaris is the principal form that we see regularly. We shall know about both of them, but first Acne vulgaris.

It is a self-limiting disorder primarily of the adolescents and the teenagers, though there are some adults who face the same disease. The etiology of the disorder is increased production in the sebum from the sebaceous glands which is situated in the epidermis (the part of the skin just below the keratinized layer of the skin). This excess production is usually seen when the child attains puberty. Comedones, a tiny cystic structure form in the opening of the hair follicles as there is obstruction due to retention of sebum and some keratinized debris. This is the time when the normally occurring bacteria turn hostile and play some deleterious role. They dissolve the sebum and other materials inside the comedones. This releases some free fatty acids which are irritable to the skin. Ultimately the cyst ruptures. The end result is what as we as acne.

Acne vulgais most commonly occur in face. But the chest and the back side can also be involved. In most of the cases, acne remains mild and does not necessarily cause scar formation. It is notices in some patients that the tiny cysts collapse together and major scar formation occurred.

Now let us discuss about the treatment of acne. The affected area of the skin must be kept clean and dry. You should clean our face three to four times a day. Any brand of good quality oil free face wash will suffice. However, there is no need to scrub actively. It may aggravate the situation by opening up the cysts that would not rupture in normal course. Specific antimicrobial creams (which contain Azelaic acid, Benzoyl peroxide, Clindamycin or Erythromycin cream) are the first line of medicine. It should be applied over the whole affected area three times a day after washing with oil free face wash. The technique should not involve rubbing, only gentle laying keeping a thin layer will do. Some topical creams such as Benzoyl peroxide and Retinoic acid are also helpful. They act via changing the pattern of desquamation of skin, as a result lowering the formation of comedones. The dose of these two creams is also same – three times a day. In women, synthetic estrogen cream or oral contraceptive pills are prescribed. Estrogen acts by inhibiting the production of androgen in body. Low level of androgen will reduce the chance of production of sebum. In resistant cases of acne, use of synthetic retinoids is extensively prescribed. Only drawback of synthetic retinoids is that it can not be used in the pregnant women as there is chance of fetal anomaly.

Now let us discuss something about Acne rosasea –

Acne rosasea is mostly seen in the women although most severe cases are found in the men. Persons, who suffer from flush or blush, are prone to develop the disease. After a prolonged and active flushing period, rosasea develop. The other triggering factors are alcohol, spicy food, emotional stress and hot drinks.

It responds well to sodium sulfacetamide or metronidazole cream. More severe and resistant cases may require oral tetracycline.