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TAILEM BEND PHARMACY
& KAROONDA PHARMACY DEPOT
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ALTERNATIVE NAMES
cystic acne; acne vulgaris; pimples
DEFINITION
An inflammatory skin condition characterized by superficial skin eruptions that are caused by plugging of the
skin pores.
CAUSES, INCIDENCE, AND RISK FACTORS
Acne is most common in adolescent boys, but it can occur in both sexes and at all ages. There seems to be a
familial tendency to develop acne. The condition usually begins at puberty and may continue for many years.
Three out of four teenagers have acne to some extent, probably caused by hormonal changes that stimulate the
sebaceous (oil producing) skin glands. Other hormonal changes, such as can occur with menstrual periods,
pregnancy, use of birth control pills, or stress, also aggravate acne.
Acne is caused when sebaceous glands within the hair follicles (pores) of the skin become plugged, because
secretion occurs faster than the oil and skin cells can exit the follicle. The plug causes the follicle to bulge
(causing whiteheads), and the top of the plug may darken (causing blackheads). If the plug causes the wall of the
follicle to rupture, the oil, dead skin cells, and bacteria found normally on the surface of the skin can enter the
skin and form small infected areas called pustules (also known as pimples or "zits").
If these infected areas are deep in the skin, they may enlarge to form cysts. A sebaceous cyst forms when the
sebaceous gland continues to produce oil. Instead of rupturing the follicle wall, the follicle continues to enlarge
and form a soft, pliable lump (known as a cyst) under the skin. The cyst is usually not painful or discolored
unless it becomes infected.
Acne is not caused by dirt or by masturbation or other activities, but dirt and oil on the face can aggravate the
condition. Other factors that increase the chances of acne are hormonal changes, exposure to weather extremes,
stress, oily skin, endocrine disorders, certain tumors, and the use of certain drugs (such as cortisone, testosterone,
estrogen, and others). Acne is not contagious.
PREVENTION
The tendency to develop acne is inherited. Although acne cannot be prevented, careful cleanliness can help to
lessen the effects.
SYMPTOMS
- skin rash or lesion on the face, truck (chest) neck, back, or other area
- comedones (whiteheads or blackheads)
- pustules
- cysts
- papules
- nodules
- redness (erythema) of the skin lesions or skin around a lesion
- inflammation around the skin eruptions
- crusting of skin eruptions
- scarring of the skin
SIGNS AND TESTS
Diagnosis is primarily based on the appearance of the skin. No testing is usually required.
TREATMENT
Treatment is designed to prevent formation of new lesions and aid the healing of old lesions.
Topical medications that dry up the oil and/or promote skin peeling may contain benzoyl peroxide, sulfur,
resorcinol, salicylic acid or tretinoin, or retinoic acid (Retin-A).
Antibiotics (such as tetracycline or erythromycin) may be prescribed if the skin lesions appear infected. Topical
antibiotics such (applied to a localized area of the skin) such as clindamycin or erythromycin are also used to
control infection.
Synthetic vitamin A analogues (isotretinoin, Accutane) have been shown to be of benefit in the treatment of
severe acne. However, pregnant women should not take oral (by mouth) acne medications!
Other medications may include topical or injected forms of cortisone.
Surgical intervention may include professional (chemical) skin peeling, removal of eruptions or scars
(dermabrasion), or removal and/or drainage of cysts.
A small amount of sun exposure may improve acne. However, excessive exposure to sunlight or ultraviolet rays
is not recommended because prolonged exposure increases the risk of skin cancer.
Home treatment may lessen the effects of acne:
- Clean the skin gently but thoroughly with soap and water, removing all dirt or make-up. Wash as often as
needed to control oil, at least daily and after exercising. Use a clean washcloth every day to prevent bacterial
reinfection.
- Use steam or warm, moist compresses to open clogged pores.
- Shampoo hair at least twice a week. Use a dandruff shampoo if necessary.
- Comb or pull hair back to keep hair out of the face.
- Use topical astringents to remove excess oil.
- Don't squeeze, scratch, pick, or rub lesions. These activities can increase skin damage. Wash your hands before
and after caring for skin lesions to reduce the chance of infection.
- Don't rest your face on your hands. This irritates the skin of the face.
- Identify and avoid anything that aggravates acne. This may include foods, lotions, make-up, and so on. Avoid
greasy cosmetics or creams, which can aggravate acne.
- Acne often improves in the summer, so some foods that aggravate acne may be tolerated in the summer but not
in the winter.
EXPECTATIONS (PROGNOSIS)
Acne is usually chronic from puberty to adulthood, but eventually lessens. Acne generally responds well to
treatment after a few weeks, but may flare up from time to time. Acne is not medically dangerous except for
untreated, severe infection.
COMPLICATIONS
- cyst
- skin abscess
- permanent facial scars
- keloids
- skin pigment changes
- psychological damage to self-esteem, confidence, personality, social life
- side effects of Accutane (including liver damage and damage to the fetus)
- side effects of other medications
CALL YOUR HEALTH PROVIDER IF
Apply home treatment and call your health care provider if there are signs of complications or if acne is severe
and progressively worsening.
Call for an appointment with your health care provider if new symptoms develop, including large or painful cysts.