Acne vulgaris cause and treatment today will be reviewed on our web site. Acne vulgaris corresponds to the formation of comedones, papules, pustules, nodules and / or cysts, due to obstruction and inflammation of the pilosebaceous units (the hair follicles and their associated sebaceous glands) . Acne develops on the face and upper trunk. It most often affects adolescents. The diagnosis is based on clinical examination. Treatment is based on severity, and may include various topical and systemic agents to reduce sebum production, comedone formation, inflammation and bacterial count, and to normalize keratinization.

Acne is the most common skin disease in the United States and affects 80% of the population at one time or another in life.

Acne Vulgaris Cause- Pathophysiology

Acne occurs through the play of 4 main factors:

  • Excessive sebum production
  • Follicular obturation with sebum and keratinocytes
  • Follicular colonization by Propionibacterium acnes (a normal human anaerobe)
  • Release of multiple inflammatory mediators

Acne can be classified as:

  • Non-inflammatory: characterized by comedones
  • Inflammatory: characterized by papules, pustules, nodules and cysts

Acne Vulgaris Cause- Non-inflammatory acne

Comedones are sebaceous plugs that block the follicles. Comedones are said to be open or closed, depending on whether the follicle is open or closed on the surface of the skin. The caps are easily extruded from open comedones, but are more difficult to remove from closed comedones. Closed comedones are the precursor lesions of inflammatory acne.

Acne Vulgaris Cause- Inflammatory acne

The rupture of inflamed follicles in the dermis (sometimes precipitated by physical manipulation or hard rubbing), where the content of comedones triggers another local inflammatory reaction, producing papules. If the inflammation is intense, coarsely purulent pustules appear.

Nodules and cysts are other manifestations of inflammatory acne. Nodules are deeper lesions that can affect follicle, and cysts are large, fluctuating nodules.

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Acne Vulgaris Treatment

Acne Vulgaris Cause and Treatment

Comedones: topical tretinoin

Moderate inflammatory acne: topical retinoid alone or with a topical antibiotic and / or benzoyl peroxide

Moderate acne: oral antibiotics plus topical treatment as for mild acne

Severe acne: oral isotretinoin

Cystic Acne: Intralesional Triamcinolone

  • It is important to treat acne to reduce the importance of the disease, scars, and psychological distress.
  • The choice of treatment is usually based on gravity; the options are summarized in the Table Drugs Used to Treat Acne. See guidelines for the management of acne vulgaris from the American Academy of Dermatology.
  • Affected areas should be cleaned daily, but additional washes, use of antibacterial soaps and rubbing are unnecessary.
  • A diet containing a lower glycemic intake and a moderation of milk consumption may be considered to treat the adolescent’s resistant acne.
  • Exfoliating agents such as sulfur, salicylic acid, glycolic acid and resorcinol may be useful therapeutic additions, but they are no longer frequently used.
  • Oral contraceptives are effective in the treatment of inflammatory and noninflammatory acne, and spironolactone (starting at 50 mg po 1 time / day, increased to 100 mg po 1 time / day after a few months, if necessary) is another anti-androgen that is sometimes helpful in women. Various light therapies, with and without topical photosensitizers, have been used effectively, especially in cases of inflammatory acne.
  • Treatment should include patient training and a realistic therapeutic program for the patient. Treatment failure can often be attributed to a lack of protocol adherence and also to a lack of follow-up. The consultation of a specialist may be necessary.

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