When the hair follicles of face, chest and back gets infected it results in formation of acne. It commonly occurs during puberty.
The area of the skin in which sebaceous glands are abundant commonly gets infected.
Bacteria play a role in its development but are not responsible for its cause. It appears on skin in different forms, such as, blackheads, whiteheads, cysts, tender bumps or pustules.
Following factors are responsible for the development of acne:
• Hyper proliferation of epidermal follicle and plugging of the follicle.
• Excessive production of sebum.
• Presence of bacteria.
Sebaceous glands attached to hair follicles gets stimulated by hormones at the time of puberty.
Sebum is a natural oil substance that lubricates and protects the skin. Increased sebum production clogs the skin pores. Clogged pores enlarge to produce bump.Due to enlargement the skin wall rupture through which irritating substances and bacteria enter the deeper layer of the skin resulting in inflammation.
In some cases following factors may contribute in causing acne:
• Pressure on the skin.
• Some medications.
• Exposure to industrial irritants.
• Some cosmetics.
Following are the commonly recognized types:
• Acne vulgaris:
This is an inflammatory disease of the skin which varies in shape, size and different colors.
• White heads
These appears when a pore is entirely blocked then oil,bacteria and dead skin cells causing a white appearance on the surface.
These appear when a pore is partially blocked,allowing the oil, bacteria, and dead skin cells to slowly drain to the upper layer of the skin. Black color is caused by dirt.
These are small, inflamed painful, red, bumps with no head.
This is similar to a whitehead, but is red with yellow pus in the center.
These lesions are much larger, more painful, lodged deep within the skin and sometimes lasts from few weeks to months leaving scars.
This type appears similar to a nodule, but larger than a pustule. These lesions are deep, pus filled very painful and leaves scars.
• Acne rosacea:
This is commonly found in females over age of 30 years of age. It appears as a bumpy, red rash on the cheeks, nose , forehead and chin.
• Acne conglobata :
This is the most severe form of acne. It is more common in males between the age group of 18 and 30 years. It occurs in numerous large lesions, which causes severe damage to the skin.
• Acne cosmetica:
This type is commonly found in women who use cosmetics. It is usually the reactions of chemicals.
• Acne fulminans:
This is an ulcerating form of Acne. It is most common in young males. It can cause scars with fever and joint aches.
• Acne medicamentosa:
This type of acne are usually result of starting or stopping of medicines by causing changes in the hormones.
• Acne keloidalis nuchae:
This type is found on scalp and the posterior part of the neck which sometimes discharge. These lesions are often painful and cosmetically disfiguring.
It 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)
• Physical Examination
Acne vulgaris is characterized by comedones, papules, pustules, and nodules in face, upper chest, back.
• Laboratory Studies.
– Hormonal evaluation should be done if females have dysmenorrhea or hirsutism along with acne.
– Total testosterone level should be measured if patient is complaining or virilization.
• Oral antibiotics
• Topical antibiotics and antibacterial
• Retinoids are helpful in unclogging pores.
• Cortisone injections
• Laser treatment
• Acne responds well to treatment in 6 to 8 weeks.
• It may flare up after treatment.
• Scars may occur in cases of severe acne.
• It may go away on its own after teen-age.
• Proper cleansing and skin care.
• Use water based oil-free make-up 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.
• The skin is rough and hard.
• Great aggravation from water is the characteristic symptoms.
• Face is pale, sickly color.
• Heat and spotted redness of face.
• Black pores.
• Itching intensely in evening and from warmth.
• Acne on the face, neck and shoulders.
• Face flushed.
• General failure of mental power, loss of memory, melancholia, anesthesia of the mucous membranes.
• Itching of skin worse on chest, shoulders, and face.
• Small red pimples on face.
• If present in Drunkards with gastric derangement’s, thirst and white-coated tongue.
• Face with sad expression.
• Fat, fretful, cross and peevish.
• Pimples on the face at the age of puberty.
• Flabby, lymphatic constitution, flabby with red face.
• Nervous disturbances.
• Pimples on side of nose, chin and mouth.
• Greasy face.
• Pale, sickly look.
• Presence of black heads.
• Small numerous pustules with itching.
• Itching after scratching vesicles.
• It worsens during menses, from fats, sugar, coffee, meat.
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