Acne Vulgaris

Acne vulgaris, also known as common acne, is a chronic skin disease characterized by the occurrence of comedones (blackheads and whiteheads), papules, pustules, nodules, and cysts.

Causes and Risk Factors

• Hormonal fluctuations: Increased levels of androgens, such as testosterone, can stimulate oil production in the skin, leading to clogged pores and acne.
• Genetics: Family history plays a significant role in the development of acne vulgaris.
• Puberty: The onset of puberty is often accompanied by an increase in sebum production, which can lead to acne.
• Stress: Stress can increase the production of hormones, such as cortisol, which can contribute to acne.
• Certain medications: Such as corticosteroids, testosterone, and certain antidepressants, can cause or exacerbate acne.

Symptoms

• Comedones (blackheads and whiteheads): Small bumps on the skin that occur when pores become clogged with dead skin cells and oil.
• Papules: Small, pink bumps that occur when the walls of the pores break, allowing bacteria and other debris to spill into the surrounding skin.
• Pustules: Similar to papules, but filled with pus, which is a mixture of dead white blood cells, bacteria, and cellular debris.
• Nodules: Large, painful bumps that occur when the pores become severely clogged and inflamed.
• Cysts: Large, painful bumps that are filled with pus and can cause scarring if left untreated.

Diagnosis

Acne vulgaris is typically diagnosed based on a physical examination of the skin and a review of the patient's medical history. A dermatologist may also use specialized tools, such as a Wood's lamp or a dermatoscope, to examine the skin more closely.

Treatment Options

• Topical retinoids: Derived from vitamin A, these medications help prevent clogged pores and reduce inflammation.
• Benzoyl peroxide: Kills bacteria on the skin and helps to dry up pimples.
• Salicylic acid: Helps to unclog pores and reduce inflammation.
• Antibiotics: Oral or topical antibiotics may be prescribed to help control bacterial infections and reduce inflammation.
• Hormonal treatments: For women, hormonal therapies such as birth control pills or spironolactone may be used to help regulate hormones and reduce acne.
• Isotretinoin: A powerful oral retinoid that is reserved for severe cases of acne that have not responded to other treatments.

Complications

• Scarring: Severe acne can lead to permanent scarring, including ice pick scars, boxcar scars, and rolling scars.
• Post-inflammatory hyperpigmentation (PIH): A condition in which the skin becomes discolored after an acne lesion has healed.
• Psychological effects: Acne can have a significant impact on self-esteem and mental health, particularly during adolescence and young adulthood.

Prevention

• Keep the skin clean: Wash the face twice daily with a gentle cleanser to remove dirt and oil.
• Use non-comedogenic products: Choose products that are labeled "non-comedogenic" or "oil-free" to reduce the risk of clogged pores.
• Avoid picking or popping pimples: This can lead to further inflammation, scarring, and prolonged healing time.
• Wear sunscreen: Protect the skin from UV rays, which can exacerbate acne and increase the risk of scarring.