Acne Vulgaris

Definition

Definition of Acne Vulgaris
Acne vulgaris (or cystic acne) is a common human skin disease, characterized by areas of skin with seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), pustules (pimples), Nodules (large papules) and possibly scarring. Acne affects mostly skin with the densest population of sebaceous follicles; these areas include the face, the upper part of the chest, and the back. Severe acne is inflammatory, but acne can also manifest in noninflammatory forms. The lesions are caused by changes in pilosebaceous units, skin structures consisting of a hair follicle and its associated sebaceous gland, changes that require androgen stimulation.

Symptoms

Symptoms of Acne Vulgaris
Acne commonly appears on the face and shoulders, but it may also occur on the trunk, arms, legs, and buttocks.

1. Blackheads
2. Crusting of skin bumps
3. Cysts
4. Papules (small red bumps)
5. Pustules
6. Redness around the skin eruptions
7. Scarring of the skin
8. Whiteheads

Causes

Causes of Acne Vulgaris
Acne occurs when tiny holes on the surface of the skin become clogged. These holes are called pores.

1. Each pore opens to a follicle. A follicle contains a hair and an oil gland. The oil released by the gland helps remove old skin cells and keeps your skin soft.
2. When glands produce too much oil, the pores can become blocked. Dirt, bacteria, and cells build up. The blockage is called a plug or comedone.
3. If the top of the plug is white, it is called a whitehead.
4. If the top of the plug is dark, it is called a blackhead.
5. If the plug breaks open, swelling and red bumps occur.
6. Acne that is deep in your skin can cause hard, painful cysts. This is called cystic acne.

Diagnosis

Diagnosis of Acne Vulgaris
There are multiple grading scales for grading the severity of acne vulgaris, three of these being:

1. Leeds Acne Grading Technique: Counts and categorises lesions into inflammatory and non-inflammatory (ranges from 0–10.0).
2. Cook's Acne Grading Scale: Uses photographs to grade severity from 0 to 8 (0 being the least severe and 8 being the most severe).
3. Pillsbury Scale: Simply classifies the severity of the acne from 1 (least severe) to 4 (most severe).

Prognosis

Prognosis of Acne Vulgaris
Acne usually goes away after the teenage years, but it may last into middle age. The condition often responds well to treatment after 6 - 8 weeks, but it may flare up from time to time.

Scarring may occur if severe acne is not treated. Some people, especially teenagers, can become very depressed if acne is not treated.

Treatment

Treatment of Acne Vulgaris
Many different treatments exist for acne including benzoyl peroxide, antibiotics, retinoids, antiseborrheic medications, anti-androgen medications, hormonal treatments, salicylic acid, alpha hydroxy acid, azelaic acid, nicotinamide, and keratolytic soaps. They are believed to work in at least 4 different ways, including: normalising shedding into the pore to prevent blockage, killing Propionibacterium acnes, anti-inflammatory effects, hormonal manipulation.