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Acne

What is acne?

Acne, also called as pimples or zits, is a common teenage problem that is experienced by more than 90% of the population mostly during their teens. Although an adolescent problem, in some cases, the condition may persist beyond teenage or in some, its onset maybe during adulthood.

What causes acne?

There are multiple factors indicated for causing acne. An increased hormonal level during puberty is the main triggering factor for the onset of adolescent acne. The skin of individuals with acne produces excessive sebum (natural oil produced by the skin). They also have an increased number of bacteria on their skin called as Propionibacterium acnes (P. acnes) which is the infectious agent responsible for causing acne. Apart from these factors, there are other factors which could aggravate acne. These include: cosmetics that are greasy or oily, hot climates, excessive exposure to heat (as in chefs and glass furnace workers), certain medications and excessive friction. Some women experience a pre-menstrual flare of acne. Hormonal acne is caused due to hormonal imbalances in a woman’s body; its onset is mainly during adulthood and maybe associated with other signs of hormonal imbalances such as hirsutism, irregular menstrual cycle and thinning of scalp hair.

What does acne present as?

The first stage in the development of acne is either a blackhead or a whitehead (medically called as a comedone). With further inflammation, red raised boils (papules) or pus filled boils (pustules) appear. Severe, deep seated lesions are big in size and often painful (nodules and cysts). Acne typically involves the face and may also involve other areas such as the back, upper shoulders or buttocks. The lesions may clear without any telltale signs or may resolve with black spots (post acne pigmentation) or scarring.

What are the complications associated with acne?

Acne poses to be a persistent problem running with frequent relapses in many individuals. Severe acne are often painful and leave behind scarring which could be quite disfiguring. Due to multiple factors responsible for acne, treatment involves more than one drug and may need to be repeated with every relapse. All these factors may affect patient’s compliance to therapy. Patients need to be aware of the reasons for frequent relapses and the need for adequate therapy.

What are the treatment options for acne?

Acne therapy may be with either topical or oral drugs or both, depending upon the severity of lesions. Topically, an antibiotic cream containing clindamycin, nadifloxacin or benzoyl peroxide may be used for controlling the infection. Blackheads and whiteheads need to be treated with a retinoic acid cream or adapalene gel; they also need physical extraction for a faster clearance. Severe lesions require oral antibiotics or oral retinoids (vitamin A derivatives). Other treatments include procedures such as chemical peels, microdermabrasion, blue light therapy and laser therapy. Scars may need surgical intervention. Hormonal acne needs treatment with hormonal medications. Apart from treating acne, preventing new ones is important. Hence, general skin care measures with avoidance of aggravating factors go a long way in keeping the condition at bay.

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