is a skin inflammatory condition that particularly affects the face, neck, chest and upper back. Commonly known as pimples or spots, it is a common type of acne. It develops during early puberty persisting to become severe in adults.
Acne vulgaris is the skin lesions that develop in the hair follicle and its oil gland. This can range in severity from a mild condition that can heal without scarring to a severe form created with intense inflammation causing disfiguring. In the western society, acne afflicts around 79 – 95% of the adolescent populations. Individuals over the age of 25 have some degree of this condition at 40 – 54% continuing to middle age in 12% of the female population and 3% in men. This condition can have severe social and psychological impact on the individual hence treatment should be carried in its early stage.
One of the several causes associated with acne includes the high level of sex hormones in individuals after puberty. Some factors associated with acne development include;
- Presence of bacteria within the hair follicle causing inflammatory lesions
- The sex hormones trigger the oil glands in the skin to enlarge.
- Any blockage of the skin pores and inflammation causes comedones (small bumps).
- Inflammation occurs when the hair follicles wall rupture.
- Genetically predisposed to develop this condition particularly by having close family members with acne.
- Stress and depression
- Polycystic ovaries
- Certain enzyme deficiency
- Exposure to certain chemicals particularly with cosmetics
- Consumption of excessive sugars, protein and dairy products
Acne vulgaris commonly affects the face, chest and the back. It is characterized by the presence of blackheads (black spots) and whiteheads (white spots). The secondary skin changes include the red, white and brown patches. In severe cases, cysts develop which are large lesions in the skin and abscess containing pus from inflamed infection. Scarring may occur because of the picking, squeezing or with the severe inflammation and deeper cysts. Touching the acne should be avoided to prevent the spread of bacteria causing pimples. Recurrent outbreaks are evident along the jaw line, neck and lower cheeks in this type of acne. These skin lesions can be painful and tend to heal slowly. This occurs mainly in women and the pre-menstrual onset is often common.
There are 4 levels of gradation the dermatologists use to assess the severity of acne. The blackheads, whiteheads, red bumps and pustules are observed with a physical examination. In order to rule out other disorders exhibiting similar signs, the individual will be assessed based on their medical history, exposure to certain substances, medications, occupational exposures such as helmets and stress. This ensures a proper diagnosis and in planning the appropriate treatment plan.
The treatment is usually based on the age of the individual, their response to previous treatments, severity and duration of acne. The treatment aims to reduce the number of acnes, skin discoloration, inflammation and the prevention of scarring. There are several effective treatments available but may take up to 8 weeks to notice an improvement. Some cases may take several months to completely to clear the condition. The medication to treat the acne includes antibiotics to destroy the excess skin bacteria by reducing the inflammation, retinoids to clear the blockages of the hair follicles, combined oral contraceptives and anti-androgen agent for women. The scars cannot be completely erased but can improve the appearance.