Acne vulgaris is a common skin disorder that mainly affects adolescents. It is the chronic disease of the sebaceous follicle that primarily affects face, chest, and back most with the presence of oily skin. At puberty, androgens increase the production of sebum from enlarged sebaceous glands resulting in blockage and infection.
It is presented as follows:
Non-inflammatory lesions:
• Open comedones i.e. blackheads
• Closed comedones i.e. whiteheads
• Uninflamed nodules i.e. cysts
Inflammatory lesions:
• Papules i.e. small red bumps
• Pustules i.e. white or yellow squeezable spots
• Inflamed nodules i.e. large red lumps
Secondary lesions:
• Excoriation
• Erythematous macules
• Pigmented macules
• Scars
Both men and women are equally affected. The peak age of occurrence is adolescence between 16 to 18 years of age but it can also continue until the age of 30 years.
It is more common in whites than blacks.
• Family history of acne
• Increased androgen production
• Overactivity/hyperresponsiveness of sebaceous glands in response to androgens
• Propionibacterium acnes colonization
• Exposure to halogenated hydrocarbons
• Adolescence
• Greasy hair
• Oil-based cosmetics
• Excessive intake of skim milk in teenagers
• High use of contraceptive pills
• Sports equipment like helmet strap rubbing and occluding skin.
Acne commonly appears on the face and shoulders, but it may also occur on the trunk, arms, legs, and buttocks.
• Redness around the skin eruptions
• Scarring of the skin
• Blackheads or whiteheads
• Papules (small red bumps)
• Pustules
• Cysts
• Acne Rosacea
• Folliculitis
• Milia
• Perioral dermatitis.
• Pityrosporum folliculitis
• Complete case history
• Clinical examination (presence of comedones, papules, pustules, and nodules in the face, upper chest, back).
• Hormonal evaluation should be done if the female has dysmenorrhea or hirsutism along with acne.
• Total testosterone level should be measured if the patient is complaining of virilization.
• Skin lesion culture for patients who don’t respond to treatment.
• Oral antibiotics
• Topical antibiotics and antibacterial
• Retinoids are helpful in unclogging pores
• Cortisone injections
• Laser treatment
• Surgery
• Proper cleansing and skin care.
• Use water-based oil-free makeup products.
• Creams containing sulfur should be applied to the affected area.
• Consume high protein diet.
• Avoid fried food and alcohol.
• Increase water intake.
• Eat fruits rich in anti-oxidants.
• Food rich in fiber content should be consumed.
Antimonium crudum
• Small red pimples on the face.
• Acne in drunkards with gastric derangements, thirst and white-coated tongue.
• Face with a sad expression.
• Fat, fretful, cross and peevish.
Asterias Rubens
• Pimples on the face at the age of puberty.
• Flabby, lymphatic constitution, flabby with a red face.
• Nervous disturbances.
• Pimples on side of nose chin and mouth.
Kali bromatum
• Acne on the face, neck, and shoulders.
• Face flushed.
• Acne of the face.
• The general failure of mental power, loss of memory, melancholia, anesthesia of the mucous membranes.
• Itching of skin worse on chest, shoulders, and face.
Psorinum
• Greasy face.
• Pale, sickly look.
• Presence of blackheads.
• Small numerous pustules with itching.
• Itching after scratching vesicles.
• Acne worse during menses, from fats, sugar, coffee, meat.
Sulphur
• The skin is rough and hard.
• Great aggravation of water is the characteristic symptoms.
• The face is Pale, sickly color.
• Heat and spotted redness of face.
• Black pores.
• Itching intensely in evening and from warmth.