What Is Acne

Definition and Clinical Features

• A common inflammatory pilosebaceous disease categorized with respect to severity

Type a) comedonal, sparse, no scarring

Type b) comedonal, popular, moderate + little scarring

Type c) comedonal, popular, and popular, with scarring

Type d) nodulocystic acne, risk of sever scarring

• Predilecation sites: face, neck, upper chest, and back

• Epidemiology

I. Common during the teen years

II. Sever disease affects males 10x more frequently than females

III. Incidents decreases in adults life

Pathogenesis (the production and development of disease):

• Increased sebum production

• Sebum is comedogenic, an irritant, and is covered to free fatty acids (FFA) by microbial lipases made by anaerobic diphtheroid

• Free fatty acids + bacteria

Exacerbating Factors (to increase the severity, bitterness, or violence):

• Menstruation/hormonal factors (androgens increase sebum production)

• OCP: specifically those containing progestins with significant androgenic effects

• Topical acnegenic agents

I. Steroids, tars, ointments, greasy cosmetics, etc.

• Systemic meds: lithium, phenytoin, steroids, halogens (chloracne), androgens, iodids, etc.

• NB: foods are not a major aggravating factor

Acne Treatments and Mechanisms of Action:

• MILD ACNE

Topical therapies

• MODERATE ACNE

After topical treatments have failed, add oral antibiotics, such as tetracycline. Antibiotics require 3-6 months of use before assessing efficacy. May also consider hormonal therapy, including antiandrogens.

• SEVERE ACNE

After attempting the above, consider systemic retinoids.