Why do i still have ACNE? - Human & Disease

Why do i still have ACNE?

 

ACNE

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.
Acne







¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders.


¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle.  Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore. 


What are the causes of acne?

The main factors cause acne:
¤ Excess oil (sebum) production.

¤ Hair follicles clogged by oil and dead skin cells.

¤ Bacteria.

¤ Inflammation.

¤ May exist transiently during neonatal period

¤ Commonly begins during early puberty with increased activity throughout the teens with spontaneous resolution thereafter (strong genetic influence recognized).
¤ May begin at or persist into later ages

¤ May result from exposure to various oils, greases, etc. found in cosmetics, pomades, or industry.

¤ May result from or be exacerbated by hormones - Polycystic ovary disease, insulin resistance, hyperandrogenism, Cushing’s disease.

¤ Complication of various drugs: corticosteroids, lithium, iodide/bromide, anticonvulsants.

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.






What are the common types of acne?

- Whiteheads. Also known as “closed comedones,” whiteheads are one of the most typical forms of acne. ...

- Blackheads. 

-Papules. 

- Pustules. 

- Nodules. 

- Cysts. 

- Milia.

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.









Signs & Symptoms of acne:

¤ Primary lesion = microcomedo (clinically unrecognizable = microscopic plugging of pilosebaceous unit).

¤ First clinically recognizable lesions are open comedones (“black-heads”) or closed comedones (“whiteheads”).

¤ Earliest stages most common on forehead and across nose and chin.

¤ Later stages of development include inflammatory papules (1–5 mm) and pustules.

¤ Most advanced lesions are cystic and/or nodular (> = 5 mm) with a predilection for lateral cheeks, chin and in more severe cases the chest and upper back (acne conglobata)

¤ Evaluate for signs of endocrinologic disease- hirsutism, striae, Cushingoid facies.

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.






Tests:

¤ Laboratory – routine: none except when indicated for specific therapies

¤ Screening: Woman with severe or recalcitrant acne (or the onset or recurrence of acne beyond their late twenties) should have at least a measurement of their free testosterone and dehydroepiandrosterone sulfate levels to consider polycystic ovarian disease or Stein-Leventhal syndrome.

Differential diagnosis:
¤ Pityrosporum or bacterial folliculitis more likely to occur on trunk, buttocks, and proximal extremities with follicular-based papules or pustules

¤ Acne keloidalis nuchae occurs as firm 2- to 5-mm papules on the occiput of African-American men.

¤ Pseudofolliculitis barbae occurs as firm papules and occasionally pustules to beard areas of African-American men.

¤ Hidradenitis suppurativa occurs within the axillae, under the breasts and the inguinal areas with larger cysts and sinus tract formation.

¤ Rosacea more central facial and/or perioral, more common in adults, lack of comedones management.

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.






What to Do First:

¤ Assess type and distribution of acne lesions – comedonal v. inflammatory v. cystic

General Measures:
¤ Keratolytic or antibacterial cleansers: salicylic acid, benzoyl peroxide, sulfur

¤ Topical vitamin A acid (and similar agents): tretinoin, Adapalene, tazarotene

¤ Topical antibiotics: erythromycin, Clindamycin, sulfacetamide preparations (both erythromycin and clindamycin may be combined with benzoyl peroxide).

¤ Oral antibiotics: Tetracycline, Doxycycline, or Minocycline

¤ Less commonly: sulfones, sulfamethoxazole-trimethoprim, Erythromycin, ampicillin or cephalosporins

¤ Oral retinoids: Isotretinoin 1 mg/kg/d for 16–20 weeks for severe cases

¤ Other Therapies:

¤ Azaleic acid (topical), spironolactone, intralesional triamcinolone acetonide for individual inflamed lesions, very rarely oral corticosteroids.

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.






What kills acne bacteria ?

Benzoyl peroxide.

This ingredient kills bacteria that cause acne, helps remove excess oil from the skin and removes dead skin cells, which can clog pores. Benzoyl peroxide products that you can buy without a prescription are available in strengths from 2.5% to 10%.


specific therapy:


¤ Keratolytic agents: Indicated for early acne forms, side effects may include irritation

¤ Topical vitamin A acid: indicated for early and more advanced acne stages. For pregnant patients discuss use with obstetrician.

¤ Topical antibiotics: Best for early papulopustular acne. Cream, lotion and gel bases

¤ should be matched with patient’s tolerance and preference, irritation possibly

¤ Oral antibiotics: Indicated for moderate to severe papulopustular acne and early stages of cystic acne.

° Minocycline use rarely complicated by pigment deposition, a lupus-like syndrome and reports of depression.

¤ Oral Retinoids

° Indication: Severe, recalcitrant nodulocystic acne +/− scarring.

¤ Laser/related modalities: limited by availability and cost restraints.

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.






How to remove acne scars ?

Acne scars: 

- Home skin care. Using sunscreen can help limit the contrast between unscarred skin and a scar.
- Soft tissue fillers.

- Steroid injection.

- Laser resurfacing.

- Other energy-based  procedures.

- Dermabrasion.

- Chemical peel. 

- Skin needling.

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.




ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.






follow-up:

¤ Allow 6–8 weeks for topical or oral antibiotic therapies to take effect.

¤ Expect gradual improvement over months with these agents.

¤ Add to or alter these regimens at 6-8 week intervals.

¤ Once control is established, may need to see patient only every 6–12 months.

¤ With oral retinoid use, patients should be seen monthly with appropriate laboratory studies to include: CBC, liver function panel, lipid panel, +/− pregnancy test, +/− BUN and creatinine.

(Note: registration in the “iPLEDGE” program now mandatory for those prescribing, taking or dispensing Isotretinoin.)

¤ Standard course of Isotretinoin is 5 months, but may be repeated in selected individuals.

complications and prognosis:

A- Complications:

¤ Scarring: Occurs in nearly 100% of untreated cystic acne patients

° Occurs in approximately 25–50% of papulopustular patients (increased risk if lesions are excoriated or otherwise manipulated).

¤ Keloid formation: 10–20% of cystic patient, especially prominent on central chest and shoulders.

¤ Psycho-social considerations

° Depression or withdrawal occurs in a minority of patients.

° Does not necessarily correlate with severity of acne.

° Should be monitored for at each visit with early intervention, if indicated.

B- Prognosis:

¤ Excellent with early, appropriate level of intervention.

ACNE ¤ Acne is a common skin condition that happens when hair follicles under the skin become clogged. Sebum-oil that helps keep skin from drying out-and dead skin cells plug the pores, which leads to outbreaks of lesions, commonly called pimples or zits. Most often, the outbreaks occur on the face but can also appear on the back, chest, and shoulders. ¤ Acne is an inflammatory disorder of the skin, which has sebaceous (oil) glands that connects to the hair follicle, which contains a fine hair. In healthy skin, the sebaceous glands make sebum that empties onto the skin surface through the pore, which is an opening in the follicle. Keratinocytes, a type of skin cell, line the follicle. Normally as the body sheds skin cells, the keratinocytes rise to the surface of the skin. When someone has acne, the hair, sebum, and keratinocytes stick together inside the pore.






FAQs.

How do I remove acne?

¤ Ways to Get Rid of Pimples Fast.

- Apply Ice to the Pimple.

- Apply a Paste of Crushed Aspirin to the Pimple.

- Use An Over-the-Counter Acne Spot Treatment.

- Use Makeup with Salicylic Acid to Conceal Pimples.

- Apply a Face Mask for Acne.

- Get a Cortisone Injection to Quickly Get Rid of a Pimple.


Can acne go away naturally?

Most pimples take 1-2 weeks to go away on their own. Some can take up to 6 weeks. Although they can't be cured overnight, they can be treated with many different methods that have been proven to work such prescription acne treatment like tretinoin and topical antibiotics.


How can I remove acne at home?

Mix 1 part apple cider vinegar and 3 parts water (use more water for sensitive skin). After cleansing, gently apply the mixture to the skin using a cotton ball. Let it sit for 5 to 20 seconds, rinse with water and pat dry. Repeat this process 1 to 2 times per day, as needed.


What foods help clear skin?

Some skin-friendly food choices include:

- yellow and orange fruits and vegetables such as carrots, apricots, and sweet potatoes.

- spinach and other dark green and leafy vegetables.

- tomatoes.

- blueberries.

- whole-wheat bread.

- brown rice.

- quinoa.

- turkey.


What is the best cream for acne?

Benzoyl peroxide

It also helps to reduce the number of whiteheads and blackheads, and has an anti-inflammatory effect. Benzoyl peroxide is usually available as a cream or gel. It's used either once or twice a day. It should be applied after washing to all of the parts of your face affected by acne.


What is the strongest acne treatment?

Isotretinoin is a powerful drug that's used to treat the most severe cases of acne. Your doctor may recommend this drug if you have severe acne that doesn't get better with other medications, including antibiotics.



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