Skin Diseases Acne Vulgaris Review and Detailed Information

Acne: the right questions to ask your doctor

The treatment of a debilitating acne is a step in time, and it is important that a quality relationship be established between the patient and his doctor. This relationship is often based on the questions asked and the explanations provided during the consultation. It is therefore important to prepare your consultation by noting the points you wish to discuss with your doctor.

The better the patient knows about his illness and his treatments, the more he can be an active partner in his treatment, and the more it will be effective.

Skin Diseases Acne Vulgaris Tips and Recommendations

Acne exams

Acne is easily recognizable because it combines different characteristic lesions. She is diagnosed by clinical examination. In the follow-up of the treatment, para-clinical examinations may be necessary.

Acne vulgaris treatments

Acne: the eye of the dermatologist

The diagnosis of acne is most often done by the doctor on a simple clinical examination. The presence of blackheads (excessive accumulations of sebum) is characteristic of acne and their absence should cast doubt on the diagnosis. No further examination is usually required in the investigation of juvenile acne.

In women, a hormonal assessment may be required to search for a possible cause of hypersecretion of male hormones, but only if clinical signs of virilism are associated (significant hair loss, hair loss, menstruation or weight gain) . The assessment consists of a blood test of certain sex hormones and their derivatives. Sometimes it is supplemented by an ultrasound of the ovaries to eliminate an anomaly of the morphology of these glands. For example, the presence of numerous fluid pockets is characteristic of a disease called “polycystic ovaries”. This type of ovarian involvement can lead to and therefore explain a woman’s late acne.

You can also read:

Skin Diseases Acne Vulgaris Guide for Patients

Acne: examinations for the safety of isotretinoin treatment.

Some treatments used to treat acne can not be prescribed without a rigorous control of precise biological parameters (biological analyzes, pregnancy test, …). This is particularly the case of isotretinoin, when the drug is used orally.

With isotretinoin treatment, the risk of fetal malformation is real. Examinations are therefore necessary before starting these drugs in young women of childbearing age:

A compulsory pregnancy test. It must be done within 3 days before each consultation. It will allow the doctor to prescribe or renew treatment with isotretinoin. And this treatment must be associated with oral contraception (contraceptive pill). A last pregnancy test will be performed 5 weeks after the end of the treatment.

A blood test (biological assessment) which makes it possible to verify certain dosages (cholesterol, triglycerides and liver enzymes, transaminases) must also be carried out regularly in the case of treatment with isotretinoin. The dosages are done when you start, then a month later, and every 3 months, throughout the treatment.

Isotretinoin can not be prescribed in case of liver malfunction (liver failure). Therefore, certain enzymes that are characteristic of a liver problem should be dosed regularly: transaminases, designated by the acronyms SGPT (or ALAT) and SGOT in the results of the biological assessment.

Definition of acne

Acne is a skin disease characterized by the eruption of red pimples, blackheads and cysts. It affects most often the face and the thorax, but also the back, the torso even the scalp.

Acne is a reflection of reactions that take place in the sebaceous glands. Housed in the skin, these glands produce sebum, a lubricating substance. If it lacks sebum, the skin will be dry and easily chapped. It is sometimes more difficult to cure the acne in adults.

Acne vulgaris causes

Acne Vulgaris Cause: Who is affected by acne?

Acne vulgaris a different skin problem when compared the others. Boys are more affected than girls. Here the other details:

Causes of acne pimples

Here are some elements that can contribute to its appearance.

The hormonal thrust at puberty. At the time of puberty, whatever the sex, the sex hormones increase; especially androgenic hormones (which cause the appearance of male sexual characteristics). Under this effect, the sebaceous glands produce more sebum. This increase in sebum production creates a fertile ground for the multiplication of the Propionibacterium acnes bacteria that feed on it.

Hormonal fluctuations in women. Contraception can also have a positive or negative role: women who start taking some contraceptive pills containing including progestins potentially acneigenic type gestodene, desogestrel, norgestrel, levonorgestrel, norgestrienone, norethisterone, lynestrenol … can see their acne to accentuate or, on the contrary, the cessation of contraception (for a wish of pregnancy for example) can also be provider of acne. Pregnancy and menopause may also be responsible;

You can also read:

Acne Vulgaris Cause and Affects

A disorder of the functioning of the ovaries or adrenal glands. This most often causes signs other than acne (hair growth, irregular periods …) Other factors can also cause acne or worsen the symptoms.

As a general rule, the treatment will be applied at bedtime and will be followed in the morning by applying a moisturizer. Indeed, these treatments may possibly have drying or irritating effects, which will be offset by the appropriate moisturizer (which will be non-comedogenic, as cosmetology, tinted cream type, foundation …). The frequency of application of the treatment will depend on the principle used, the shape of the acne and the local tolerance of the application. Do not forget: the effectiveness of a local treatment can not be judged before at least 2 months of treatment scrupulously followed. And if it is effective, it will often have to be continued until the disease disappears.

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.

You can also read:

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.