Berkey British
Acne vulgaris
Terminology
Different types of acne vulgaris: A: Cystic acne on the face, B: sink tropical acne log, C: complete acne on chest and shoulders.
The term acne comes from a corruption of the Greek (acne in the sense of a rash the skin) in the writings of Atius Amidenus. Used by itself, the term "acne" refers to the presence of pustules and papules. The most common of acne is known as "acne vulgaris", meaning "common acne." Many teenagers get this type of acne. The use of the term "Acne vulgaris" implies the presence of comedones.
The term "acne rosacea" is a synonym for rosacea, however, some people have almost no acne pimples associated with rosacea and prefer therefore the term rosacea. Chloracne is associated with exposure to the compounds polyhalogenated.
Causes of Acne
Acne develops as a result of blockages in follicles. Hyperkeratinization and training a plug of keratin and sebum (a microcomedones) is the first change. The enlargement of the sebaceous glands and increased sebum production occur more androgens (DHEA-S) production of adrenarche. The microcomedones may enlarge to form an open comedones (blackheads) or closed comedones (Whitehead). Whiteheads are the direct result of the sebaceous glands become clogged with sebum, a naturally occurring oil, and dead skin cells. Under these conditions, the natural form large as commensal bacteria Propionibacterium acnes can cause inflammation, leading to inflammatory lesions (papules, pustules, infected, or nodes) in the dermis microcomedones whole or comedo, which results in redness and may result in scarring or hyperpigmentation.
The primary causes
A teenager 16 years old with acne on the cheek.
Acne is known to be partly inherited, but not a particular genetic cause has been identified. Acne is not contagious or infectious. Several factors are known to be linked to acne:
• Family history / genetics. The tendency to develop acne runs in families. For example, school children with acne often have other members of their family with acne as well. A family history of acne is associated an earlier occurrence of acne and a greater number of acne lesions retentional.
Hormonal activity, such as menstrual cycles and puberty. During puberty, the increase in male sex hormones called androgens cause the glands to grow follicular and produce more sebum.
Inflammation, irritation the skin or scratches of any kind will activate inflammation.
Stress. While the connection between acne and stress has been discussed, scientific research indicates that "increased acne severity is" significantly associated with increased stress. " The National Institutes Health (U.S.) list as a stress factor that "may cause an outbreak of acne." A study of adolescents in Mexico, "noted a difference statistically significant] positive [correlation between stress levels and acne severity. "
Hyperactive sebaceous glands secondary to the three hormone sources above.
Bacteria in the pores. Propionibacterium acnes (P. acnes) is the anaerobic bacteria that causes acne. resistance in P. vitro acnes to commonly used antibiotics has been increasing.
The use of anabolic steroids.
Exposure to certain chemicals. Chloracne is particularly linked to toxic exposure to dioxins, namely Chlorinated dioxins. [Citation needed]
Acne arm.
Several hormones have been linked to acne: the androgens testosterone sulfate, dihydrotestosterone (DHT) and dehydroepiandrosterone (DHEAS) and factor insulin growth factor 1 (IGF-I).
Development of acne vulgaris in recent years is rare, although this is the age group for Rosacea which may look similar. True acne vulgaris in adult women may be a feature of an underlying condition such as pregnancy and disorders such as Down syndrome polycystic ovary syndrome or Cushing's weird. Acne menopause occurs associated with the production of the hormone estradiol natural anti-acne ovarian failure menopause. The lack of estradiol also causes thinning hair, hot flashes, thin skin, wrinkles, vaginal dryness, and predisposes to osteopenia and osteoporosis, as well as triggering acne (known as climacteric acne in this situation.)
Diet
Chocolate
The popular belief that intake of chocolate, in itself, is a cause of acne is not supported by scientific studies. As discussed below, several studies suggest that chocolate, but the nature of high glycemic index of foods containing simple carbohydrates as a cause of acne. Chocolate itself has a low glycemic index.
Milk
Recently, three epidemiological studies from the same group of scientists found an association between acne and milk consumption partly powder, instant breakfast drinks, sherbet, cottage cheese and cream cheese. The researchers hypothesize that the association may be caused by hormones (such as several sex hormones and bovine factor insulin growth factor 1 (IGF-1)) or even iodine in cows' milk.
Carbohydrates
The long-held belief that there is a link between diets high in refined sugars and processed foods and acne, has recently been questioned. The previous belief was based on previous studies (some with chocolate and Coca-Cola) that were methodologically flawed. The recent low-glycemic-load hypothesis postulates that rapidly digested carbohydrate foods (like soft drinks, sweets, white bread) produce an overload of blood glucose (hyperglycemia) that stimulates secretion insulin, which in turn triggers the release of IGF-1. IGF-1 has direct effects on the pilosebaceous unit (and insulin at high concentrations can also bind to the receptor IGF-1) and has been shown to stimulate hyperkeratosis and epidermal hyperplasia. These events facilitate the formation of acne. Sugar consumption can also influence the activity of androgens via a decrease in the concentration of sex hormone binding globulin.
In support of this hypothesis, a test controlled trial of a low glycemic load diet improves acne and weight reduction, the activity of androgen and growth factor levels similar to insulin-a binding protein. High levels of IGF-1 and mild insulin resistance (which causes higher levels of insulin) had previously observed in patients with acne. The high levels of insulin and acne are also two features of polycystic ovary syndrome.
According to this hypothesis, the absence of acne some non-Westernized societies could be explained by the low glycemic index diets of these cultures. Genetic reasons may account for the absence of acne these populations, although similar populations (such as American Indians or Pacific Islanders) develop acne. Note also that the populations studied not consume milk or other dairy products.
More research is needed to determine whether a reduced consumption of foods with high glycemic index, or treatment that results in insulin sensitivity (like metformin) can significantly alleviate acne, though consumption of high glycemic index foods, in any case be kept to a minimum, for general health reasons. Avoid junk food with high fat and sugar content is also recommended.
Vitamins A and E
Studies have shown that newly diagnosed acne patients tend to have lower levels of circulating vitamin A in their bloodstream than those that are free of acne. In addition people with severe acne also tend to have lower blood levels of vitamin E.
Hygiene
Acne is not caused by dirt. This error probably comes from the fact that blackheads look like dirt stuck in the openings of pores. Color black is not dirt but simply oxidised keratin. In fact, the blockages of keratin that cause acne occur deep within the narrow follicle channel, where is impossible to wash. These plugs are formed by the failure of the cells lining the duct to separate and flow to the surface in the sebum created by the body. oil urbanized of the skin can block the ducts of these pores, so standard washing of the face may flush the old oil and help unblock the pores.
Treatments
Available treatments
There are many products available for the treatment of acne, many of which lack any scientific fact tested. In general, successful treatments show little improvement in the first two weeks, instead taking a period of approximately three months to improve and begin to flatten. [Citation needed] Many treatments that promise big improvements within two weeks is likely to be largely disappointing. [Citation needed] However, short bursts of cortisone can give very fast results, and other treatments can rapidly improve some active spots, but usually not all active sites. [Citation needed]
Modes of improvement are not necessarily included in the treatments, but it is generally believed that the work in at least four different ways (with many of the best treatments providing multiple simultaneous effects):
standardization shedding into the pore to prevent blockage
Propionibacterium acnes killing
effects inflammatory
ADT
A combination of treatments can reduce the number and severity of acne in many cases. Treatments they are most effective tend to have more chance of side effects and require a greater degree of monitoring, so a step by step approach is often taken. Many people consult with doctors to decide what treatment to use, especially when considering the use of any combination treatment. There are a series of treatments that have proven effective:
Benzoyl peroxide cream.
Hygiene
Proper cleaning and skin care can help eliminate bacteria and oils that cause acne. Anecdotal reports suggest placing a clean towel over his own pillow every night can help prevent contamination with bacteria pillow that causes acne, and reintroduction to the face. In addition, the cleaning hands before touching the affected area can prevent transmission of bacteria from one part of body to another. [Citation] Need
Topical antibacterial
counter products widely available that contain peroxide bactericidal benzoyl can be used in mild to moderate acne. The gel or cream containing benzoyl peroxide applied twice daily, within the pores in the affected region. Soaps bar or washes may also be used and vary from 2% to 10% of the workforce. In addition to its therapeutic effect as a keratolytic (a chemical that dissolves keratin plugging the pores) benzoyl peroxide also prevents new lesions by killing P. acnes. In one study, approximately 70% of participants using a solution 10% benzoyl peroxide had a reduction in acne lesions after six weeks. Unlike antibiotics, benzoyl peroxide has the advantage of being a strong oxidant and therefore does not appear to generate bacterial resistance. However, usually causes dryness, local irritation and redness. A regime wise may include the daily use of low concentration (2.5%) benzoyl peroxide preparations, combined with suitable non-comedogenic moisturizers to prevent drying.
Care should be taken when using benzoyl peroxide as it can very easily bleach any fabric or hair it contacts.
Other antibacterials that have been used include triclosan or chlorhexidine gluconate. Although these treatments are often less effective, they also have fewer side effects.
Products containing azeleic acid are also used in the treatment of P. acnes. It is available in the United States as a 20% concentration and does not generate resistance bacteria.
therapeutic concentration, benzoyl peroxide preparations do not necessarily differ with respect to the maximum concentration of the ingredient active (10%), but the drug is made available dissolved in a vehicle that deeply penetrates the pores of the skin.
Topical antibiotics
Externally applied antibiotics such as erythromycin, clindamycin, or tetracycline kill bacteria that are harbored in the blocked follicles. While topical use of antibiotics is as effective as oral use, this method avoids possible side effects such as upset stomach and drug interactions (eg not affect the use of oral contraceptive pill), but may be inefficient to implement on large areas that only the face alone.
Antibiotics oral
Oral antibiotics used to treat acne include erythromycin or one of the tetracycline antibiotics (tetracycline, oxytetracycline absorbed better, or one of the once daily doxycycline, minocycline or lymecycline). Trimethoprim is also sometimes used (off-label use in the United Kingdom). However, the reduction P. acnes bacteria will not, in itself, do something to reduce oil secretion and abnormal cell behavior that is the root cause of the blocked follicles. In addition to antibiotics are becoming less and less useful as resistant P. acnes are becoming more common. Acne can return soon after the end of treatmentays later in the case of topical applications and weeks later, in the case of oral antibiotics. In addition, side effects tetracycline antibiotics can include yellowing of teeth and an imbalance of intestinal flora, so it is only recommended after topical products were discarded.
It was found that sub-antimicrobial doses of antibiotics such as minocycline also improve acne. It is believed that anti-inflammatory effect Minocycline also prevents acne.
Hormone treatments
In women, acne can be improved with hormonal treatments. Estrogen combined common hormonal contraception progestogen have some effect, but the antiandrogen, Cyproterone, in combination with an estrogen (Diane 35) is particularly effective in reducing levels of the hormone androgen. Diane-35 is not available in the U.S., but a new oral contraceptive containing the progestin drospirenone is now available with fewer side effects than Diane 35 / Dianette. Both can be used in blood tests show abnormally high levels of androgens, but are effective even when this is not the case. Along with this, treatment with low dose spironolactone can have anti-androgenic properties, especially in patients with polycystic ovary syndrome.
If a grain is large and / or does not seem to be affected by other treatments, a dermatologist may administer an injection of cortisone directly into it, which usually reduce redness and inflammation almost immediately. This has the effect of flattening the grain, making it easier to hide with makeup, and can also help in the healing process. Side effects are minimal but may be a temporary whitening of the skin around injection site, sometimes forming a small depression, which may persist, although often fills eventually. This method also has a much lower risk of scarring from surgical removal.
Topical retinoids
A group of medications for normalizing the lifecycle of follicle cells are topical retinoids such as tretinoin (brand name Retin-A), adapalene (brand name Differin) and tazarotene (brand name Tazorac). Like isotretinoin, which are related to vitamin A, but administered as topical and generally have much milder side effects. They can, however, cause irritation significant skin. The retinoids appear to influence the cell creation and death lifecycle of cells in the lining of the follicle. This helps prevent hyperkeratinization of these cells that can create a blockage. Retinol, a form of vitamin A, has similar but milder effects and is used in many sales-creams moisturizers and other topical products. Effective topical retinoids have been used more than 30 years, but only available on prescription so are not as widely used as other topical treatments. Topical retinoids often cause an initial outbreak of acne and facial flushing.
Oral retinoids
Main article: Isotretinoin
One day oral intake of vitamin A derivative isotretinoin (marketed as Accutane, Amnesteem, Sotret, Claravis, Clarus) over a period of 46 months can cause long-term resolution or reduction of acne. It is believed that isotretinoin works primarily by reducing secretion of oil glands, however, some studies suggest it affects other acne-related factors as well. Isotretinoin has been proved very effective in treating severe acne and may improve or clear over 80% of patients. The drug has a much longer effect than anti-bacterial treatment and often cure acne for good. The treatment requires close medical supervision by a dermatologist because the drug has many known side effects (Many of which may be severe). About 25% of patients may relapse after treatment. In such cases, a second treatment for another 46 months may be indicated to obtain the desired results. Often it is recommended that you stop spending a few months between the two treatments, because the condition can improve a little while after discontinuation of treatment and waiting a few months also gives the body a chance to recover. Occasionally a third or even a fourth course, that is, but the benefits are often less important. The most common side effects are dry skin and occasional nosebleeds (secondary to dry nasal mucosa). Oral retinoids also often cause an initial outbreak of acne in a month or so, which may be severe. There are reports that the drug has damaged the liver of patients. For this reason, we recommend that patients have blood samples taken and examined before and during treatment. In some cases, treatment is terminated or reduced because of liver enzymes in the blood, which could be related to liver damage. Others argue that the reports of liver damage squares are unsubstantiated, and routine testing is considered unnecessary by some dermatologists. blood triglycerides should also be monitored. However, routine tests are part of the official guidelines for drug use many countries. Some press reports suggest that isotretinoin may cause depression, but in September 2005 there is no agreement in the literature about the risk. The drug also causes birth defects if a woman becomes pregnant while taking or take it during pregnancy. For this reason, patients should use two separate forms of birth control or to vote, while the withdrawal of the drug. Because of this, the drug is supposed to be given to women as a last resort after milder treatments have proven insufficient. Restrictive rules (see iPLEDGE program) for use were put into effect in early U.S. in March 2006 prevent misuse, causing widespread editorial comment.
Sulfur
Sulphur has an inhibiting effect on the growth of Propionibacterium acnes and, when combined with sodium sulfacetamide (5% and 10% respectively) has been shown to reduce acne with only mild side effects.
Dermabrasion
Dermabrasion is a medical cosmetic procedure which removes the skin surface by abrasion (sanding). Is used to remove damaged skin by the sun and eliminate or lessen scars and dark spots on the skin. The procedure is very painful and usually requires general anesthesia or twilight anesthesia, "in which the patient is still partly conscious after the skin is very red and raw looking, and that takes several months for skin to grow back and heal. Dermabrasion is useful for scar removal when the scar is raised above the surrounding skin, but is less effective with sunken scars.
In the past, dermabrasion was done using a small, sterilized, electric sander. In the last decade it has become more common to use a CO2 or Er: YAG. Laser dermabrasion is much easier to control, much easier to measure, and is practically bloodless compared to classic dermabrasion.
From microdermabrasion dermabrasion technique mentioned. Microdermabrasion is a skin care who is a softer, less invasive technology for a skin peel. The aim of microdermabrasion is to remove the surface layer of skin called epidermis. If the surface of abraded skin is touched, a roughness of the skin is noticeable. The roughness is keratinocytes, which are better hydrated than the surface of corneocytes. Keratinocytes appear in the basal layer of the proliferation of keratinocyte stem cells. They are pushed through the cells of the epidermis, undergoing progressive specialization until the stratum corneum, where they form a layer of dead, flattened, highly keratinized cells called squamous cells. This layer creates an efficient barrier to entry of foreign substances and infectious elements in the body and reduces moisture loss. The keratinocytes are detached and continuously restored from the stratum corneum.
The transit time of the basal layer of detachment is usually a month. Corneocytes are cells derived from keratinocytes in the past specialized terminal stages of the squamous epithelium. Microdermabrasion is done to eliminate some of the corneocytes. These cells are responsible for the impermeability of the skin. The elimination or minimization of scarring, skin lesions, spots and streaks on the skin can be an easy process using the exfoliation of the skin. The outcome depends on how well the procedure known as "skin remodeling" works. The results are good, and fewer treatments are needed to the most recent and / or superficial scars. However, microdermabrasion can be used on scars that occurred during the years of puberty or later.
Phototherapy
'Blue' and red light
Exposure to light has been used as a short-term treatment for acne. Recently, visible light has been used successfully to treat mild to moderate acne (phototherapy or therapeutic deep penetration of light) – in particular intense violet light (405-420 nm) provided by fluorescent lamps commonly used built, dichroic bulbs, LEDs or lasers. Used twice a week, this has been shown to reduce the number of acne lesions by about 64% and even more effective when applied daily. The mechanism appears to be that a porphyrin (coproporphyrin III) produced within P. acnes generates free radicals when irradiated by 420 nm and wavelengths of light. Particularly when applied over several days, these free radicals ultimately kill bacteria. Since porphyrins are not otherwise present in the skin, and no UV light is used, which appears to be safe, and has been licensed by U.S. FDA.
The treatment apparently works even better when used with a mixture of violet light and visible red light (660 nm), resulting in a reduction of 76% lesions after three months of daily treatment of 80% of patients, and total clearance was similar or better than benzoyl peroxide. Unlike most treatments, if any other negative side effects often experienced, and the development of bacterial resistance to treatment seems very unlikely. After treatment, the firm can be more durable than is typical of treatment with topical or oral antibiotics, several months is not uncommon. The equipment or treatment, however, is relatively new and quite expensive to buy initially, although the total cost of ownership can be similar to many other treatment methods (such as total cost of peroxide benzoyl, moisturizer, lava) for a couple of years of use.
Photodynamic Therapy
In addition, basic science and clinical work by dermatologists Yoram Harth and Alan Shalita and others has produced evidence that intense blue / violet (405-425 nm) can decrease the number of inflammatory lesions acne by 60-70% in four weeks of treatment, especially when the P. acnes is pretreated with delta-aminolevulinic acid (ALA), which increases production porphyrins. However this photodynamic therapy is controversial and apparently not published in a refereed journal. A Phase II, but showed improvement occurred, did not show a better response compared with the violet, blue / solo.
Surgery
For patients with cystic acne, boils can be drained by aspiration surgery.
Subcision
Subcision is a process used to treat deep scars of material left by skin diseases or other acne. In essence, the process involves separating the skin tissue in the affected area from the deeper scar tissue. This allows the blood from pooling in the affected area, eventually causing the deep rolling scar to level with the rest of the area of the skin. Once the skin has leveled, treatments as laser resurfacing, microdermabrasion or chemical peels can be used to soften the scar tissue.
Laser Treatment
Laser surgery has been used for some time to reduce the scars behind by acne, but research has been done on lasers for prevention the formation of acne. The laser is used to produce one of the following effects:
to burn the follicle sac from which hair grows
to burn the sebaceous gland that produces oil
to induce the formation of oxygen in the bacteria, killing them
Since lasers and intense pulsed light sources cause thermal damage to the skin, there are concerns that laser or intense pulsed light treatments for acne hyperpigmentation induced macules (spots) or cause long term dryness of the skin.
In the United States, the FDA has approved several companies, such as Candela Corp., to use a laser cosmetic treatment of acne. However, efficacy studies have used small sample sizes (less than 100 subjects) for periods of six months or less, and have shown conflicting results. Moreover, laser treatment is relatively new, protocols remain subject to experimentation and revision and treatment can be quite expensive. Also, some Smoothbeam laser devices had to be withdrawn from the market due to lack of coolant, resulting in painful burns patients.
Less widely used treatments
Aloe vera: there are acne treatments mentioned in Ayurveda using herbs such as aloe vera, Neem, Haldi (Turmeric) and papaya. There is limited evidence of medical studies on these products. Products from Rubia cordifolia, Curcuma longa (commonly known as turmeric) Hemidesmus indicus (known as ananthamoola or anantmula) and Azadirachta indica (Neem) have been shown to have anti-inflammatory effects, but not aloe vera.
Azelaic acid (Brand names Azelex, Finevin and Skinoren) is suitable for mild acne, comedones.
Calendula used in suspension is used as an anti-inflammatory agent.
Cortisone injection in the points, also cortisone pills are sometimes used.
Extraction of comedones
Peroxide oxidizing hydrogen that kills acne bacteria.
Heat: local heating may be used to kill bacteria in a developing grain and accelerate healing.
Naproxen or ibuprofen are used for some moderate acne for their anti-inflammatory effect.
Nicotinamide (vitamin B3) used topically in gel form, it has been demonstrated in a 1995 study to be of comparable efficacy to topical clindamycin topical antibiotic used for comparison. nicotinamide topic is available in both prescription and nonprescription. The property of topical nicotinamide benefit in the treatment of acne appears to be anti-inflammatory nature. Also meant to lead to increased synthesis of collagen, keratin, involucrin and flaggrin and also in accordance with a cosmetics company to be useful in reducing the hyperpigmentation of the skin (acne scars), increasing skin moisture and reduce fine wrinkles.
Pantothenic acid, (High doses of vitamin B5)
Rofecoxib was shown to improve premenstrual acne vulgaris in a placebo-controlled study.
Tea tree oil (Melaleuca oil) dissolved in a vehicle (5% strength) has been used with some success, which is comparable to benzoyl peroxide but without excessive drying, kills P. acnes, and has proved an effective anti-inflammatory in skin infections.
Zinc: Orally administered zinc gluconate has been shown to be effective in treatment of inflammatory acne, although less so than tetracyclines.
Detoxification is a common method used by alternative practitioners of medicine for the treatment of acne, although there have been no studies to prove its success. Detoxification is the process of cleansing the body of toxins allegedly caused for the environment, pharmaceuticals, foods and cosmetics.
History of some acne treatments
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Acne history dates back to the dawn of recorded history. In ancient Egypt, it is recorded that several pharaohs were acne sufferers. From Ancient Greece is "acne" the English word ("point" meaning or "peak"). Treatments for acne are also considerable antiquity:
Ancient Rome: bathing in hot, and often sulfurous, mineral water was one of the acne treatments available a few. One of the first texts to mention skin problems is De Medicina by the Roman writer Celsus.
1800: XIX century dermatologists used in the treatment of sulfur acne. It is believed that dry the skin.
1920: benzoyl peroxide is used
1930: Laxatives are used as a cure for what is known as "grains of chastity. "Radiation also was used.
1950: When antibiotics became available, was found to have beneficial effects on acne. They were taken orally, for starters. Much of the profit was not to kill bacteria, but anti-inflammatory effects of tetracycline and their families. The Topical antibiotics became available later.
1960: Under the radiation treatments are widely used.
1970: Tretinoin (original trade name Retin A) was effective for acne. This preceded the development of oral isotretinoin (sold as Accutane and Roaccutane) in 1980.
1980: Accutane is introduced in the United States, and later proved to be a teratogen, highly likely to cause birth defects if taken during pregnancy. In the United States more than 2,000 women became pregnant while taking the drug between 1982 and 2003, with the majority of pregnancies end in abortion or miscarriage. About 160 babies born with birth defects.
1990: Laser treatment introduced
2000: Blue / red light therapy
Future treatments
A vaccine against inflammatory acne has been successfully tested in mice, but not sure it would work similarly in humans.
A 2007 article in microbiology reporting the first genome sequence of Propionibacterium acnes bacteriophage (PA6) said this "in should greatly promote the development of a potential phage therapy to treat acne and therefore overcome the major problems associated with antibiotic therapy long term bacterial resistance. "
Talarozole, an agent of retinoic acid metabolism blocking, is currently under investigation for acne treatment in combination with tretinoin. [Citation needed]
Preference for the types of treatment of acne vulgaris
Comedonal (not inflammatory) acne: local treatment with azelaic acid, salicylic acid, topical retinoids, benzoyl peroxide.
(Inflammatory) Papulopustulosa Mild acne: benzoyl peroxide or topical retinoids, topical antibiotics (like erythromycin).
moderate inflammatory acne: peroxide benzoyl or topical retinoids in combination with oral antibiotics (tetracyclines). Isotretinoin is an option.
Severe inflammatory acne, nodular acne, acne resistant to the above treatments: isotretinoin also known as Accutane can be prescribed by a physician, or pills contraceptive for women with cyproterone or drospirenone with virilization.
Acne scars
Acne often leaves small scars, where the skin gets a "volcanic" shape.
Physical acne scars are often referred to as "Icepick" scars. This is because the scars tend to cause a small crater on the surface of the skin. A range of treatments available. Although very rare medical condition macular atrophy Varioliformis skin also results in "acne like" depressed scars on the face.
Ice pick scars: deep wells, which are most common and a classic sign of acne scars.
Box car scars: Angular scars that usually occur in the temple and cheeks, and can be superficial or deep, these are similar to chickenpox scars.
Rolling scars: Scars that give the skin a wavy appearance.
Hypertrophic scars: Thick scars or keloids.
Pigmentation
Pigmented scars is a slightly misleading term because it suggests a change in pigmentation the skin and scars that are true, however, is not true. Pigmented scars are usually the result of nodular or cystic acne (the painful 'shock' extends below the skin). They often leave behind an inflamed red mark. Often, the pigmentation scars can be avoided simply by avoiding aggravation of the nodules or cysts. When cysts treated patients 'pop' or nodules, scarring becomes significantly worse pigmentation [citation needed] and may even bruise the affected area. Pigmentation scars nearly always fade with time taking between three months to two years to do, but rarely may persist.
On the other hand, some peoplearticularly those with naturally tanned skin develop brown hyperpigmentation scars due to increased pigment production melanin. They also tend to fade over time.
Rating Scale
There are several grading scales for grading the severity of acne vulgaris, three of which are: Leeds acne score technique: Counts and classifies inflammatory lesions and non-inflammatory (ranges from 0 to 10.0). Scale Cook classification of acne: Use pictures to describe the severity of 0-8 (0 is the least severe and 8 is the most severe). Pillsbury scale: Simply classifies the severity acne from 1 (least severe) to 4 (most severe).
See also
Shin
Keratosis pilaris
Rosacea
Chloracne
Liamitus
List of skin conditions
References
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^ "510 (k) Summary: The light therapy device ClearLight CureLight "(PDF). FDA, Office of Device Regulation, Center for Devices and Radiological Health. 16.08.2002. Http://www.accessdata.fda.gov/cdrh_docs/pdf/k013623.pdf. Retrieved on 07/30/2009.
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^ Boils (skin abscesses), medicinenet.com
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^ "Report on application. "Remember, market withdrawals and safety alerts. FDA. 01.14.2004. http://www.fda.gov/Safety/Recalls/EnforcementReports/2004/ucm120279.htm. Retrieved on 07/30/2009.
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^ Grow Your Own Drugs – BBC2 James Wong
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^ AR Shalita, JG Smith, LC Parish, MS Sofman, Chalker DK (June 1995). "Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris" Int J. Dermatol 34 (6 ):… 4347 doi: .. ISSN 0011-9059 10.1111/j.1365-4362.1995.tb04449.x PMID 7657446 ..
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^ Z Khalil, AL Pearce, Satkunanathan N, E storekeeper, JJ Finlay-Jones PH, Hart (October 2004). "Regulation of wheal and flare by tea tree oil: complementary human and rodent studies," J. Invest Dermatol 123 (4 ):… 68.390 doi :…. ISSN 0022-202X 10.1111/j.0022-202X.2004.23407.x PMID 15373773 www.nature.com/jid/journal/v123/n4/full/5602507a.html http://.
Dreno ^ B, Amblard P, Agache P, Sirot S, Litoux P (1989). "Low doses of zinc gluconate for inflammatory acne" (Free full text). Acta Derm Venereol 69 (6): 5413. ISSN 0001-5555. PMID 2575335. http://www.nlm.nih.gov/medlineplus/acne.html.
Dreno ^ B, Moyse D, M Alirezai, P Amblard, N Auffret, C Beylot, I Bodokh, Chivot M, Daniel F, P Humbert, J Meynadier Poli, M (2001). "Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of zinc gluconate compared with minocycline hydrochloride in the treatment of inflammatory acne vulgaris "Dermatology 203 (2). 13,540 doi: 10.1159/000051728 .. .. ISSN 1018-8665 PMID 11586012
^ "The tretinoin. (Retinoic acid) in acne" (Free full text) The medical letter on drugs and therapeutics 15 (1):. 03 January 1973 ISSN 0025-732X http://www.nlm.nih.gov/ PMID 4265099 … medlineplus / acne.html.
^ Jones H, Blanc D, Cunliffe WJ (November 1980). "The acid 13-cis retinoic acid and acne. "Lancet 2 (8203): 10,489. Doi: 10.1016/S0140-6736 (80) 92273-4. ISSN 0140-6736. PMID 6107678.
^ Brard A, Azoulay L, Koren G, Blais L, Perreault S, Oraichi D (February 2007). "Isotretinoin, pregnancies, abortions and birth defects: a population-based perspective." British Journal of Clinical Pharmacology 63 (2): 196,205. doi: 10.1111/j.1365-2125.2006.02837.x. PMID 17214828.
U ^ Holmes SC, Bankowska, RM Mackie (March 1998). "The prescription of isotretinoin to women: is every precaution taken?". The British Journal of Dermatology 138 (3): 4505. doi: 10.1046/j.1365-2133.1998.02123.x. PMID 9580798.
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^ Farrar MD, Howson KM, Bojar RA, et al. (June 2007). "Sequence genome and analysis of a Propionibacterium acnes bacteriophage. "Journal of Bacteriology 189 (11): 41,617. doi: 10.1128/JB.00106-07. PMID 17400737.
^ Leeds, Pillsbury Cook and scales obtained from here
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Review articles and guidelines
Webster GF (August 2002). "Acne vulgaris". BMJ 325 (7362): 4759. doi: 10.1136/bmj.325.7362.475. PMID 12202330.
Gollnick H, Cunliffe W, Berson D, et al. (July 2003). "Management of acne: a report from a Global Alliance to Improve Outcomes in Acne." Journal of the American Academy of Dermatology 49 (1 Suppl): S137. doi: 10.1067/mjd.2003.618. PMID 12833004.
Feldman S, Careccia RE, Barham KL, Hancox J (May 2004). "The diagnosis and treatment Acne. "American Family Physician 69 (9): 212,330. PMID 15152959.
Haider A, Shaw JC (August 2004). "The treatment of acne vulgaris" JAMA 292 (6):. 72,635 doi: .. 10.1001/jama.292.6.726 PMID 15304471.
Katsambas, A, Cunliffe, W (2004). Commentary: Acne and its treatment "Clinics Dermatology 22:. 359 doi:. 10.1016/j.clindermatol.2004.03.003.
James WD (April 2005). "Clinical practice. Acne." New England Journal of Medicine 352 (14): 146,372. doi: 10.1056/NEJMcp033487. PMID 15814882.
"Drugs for acne, rosacea and psoriasis." Guides Treatment of the Medical Letter 3 (35): 4956. July 2005. PMID 15961971. http://www.medicalletter.org/scripts/articlefind.cgi?issue=35&page=49.
Sinclair W, Jordaan HF (November 2005). "Acne Guide 2005 Update." South African Journal of Medicine 95 (11 Pt 2): 88,192. PMID 16344888. http://blues.sabinet.co.za/WebZ/Authorize?sessionid=0:autho=pubmed:password=pubmed2004&/AdvancedQuery?&format=F&next=images/ejour/m_samj/m_samj_v95_n11_a21.pdf.
Zaenglein AL, Thiboutot DM (September 2006). "The expert committee recommendations for acne management." Pediatrics 118 (3): 118,899. doi: 10.1542/peds.2005-2022. PMID 16951015.
Purdy S, Berker D (November 2006). "Acne." BMJ 333 (7575): 94,953. doi: 10.1136/bmj.38987.606701.80. PMID 17082546.
JS Strauss, Krowchuk DP, Leyden JJ, et al. (April 2007). "Guidelines for the management of acne vulgaris attention." Journal of American Academy of Dermatology 56 (4): 65,163. doi: 10.1016/j.jaad.2006.08.048. PMID 17276540.
Reference books and chapters
Plewig, Gerd; Kligman, Albert M. (2000). Acne and rosacea (3 rd ed.). New York: Springer-Verlag. ISBN 3-540-66751-2.
Cunliffe, William J.; PM Gollnick, Harald (2001). Acne: diagnosis and treatment. London: Martin Dunitz. ISBN 1-85317-206-5.
Thiboutot, Diane M., Strauss, John S. (2003). "Diseases sebaceous glands. in Burns, Tony; Breathnach, Stephen, Cox, Neil; Griffiths, Christopher. Fitzpatrick's dermatology in general medicine (6 th ed.). New York: McGraw-Hill. 67,287 pp. ISBN 0-07-138076-0.
Zaenglein, Andrea L., Thiboutot, Diane M. (2003). "Acne vulgaris". in Bolognia, Jean L.; Jorizzo, Joseph L., Rapini, Ronald P. (Eds.). Dermatology. Madrid: Mosby. 53,144 pp. ISBN 0-32302-4092.
Habif, Thomas P. (2004). "Acne, rosacea, and related disorders. "clinical dermatology: a color guide to diagnosis and treatment (4 th ed.). Edinburgh: Mosby. pp 162 208. ISBN 0-323-01319-8.
Simpson, Nicholas B., William Cunliffe, J. (2004). "Disorders of the sebaceous glands. In Burns, Tony; Breathnach, Stephen, Cox, Neil; Griffiths, Christopher. Tower textbook of dermatology (7 th ed.). Malden, Massachusetts: Blackwell Science. 43,175 pp. ISBN 0-632-06429-3.
James, William D., Berger, Timothy G., Elston, Dirk M. (2006). "Acne." Andrews Diseases of the skin: clinical dermatology (10 th ed.). Philadelphia: Elsevier Saunders. 23,150 pp. ISBN 0-7216-2921-0.
External links
Wikimedia Commons has media related to acne
Acne vulgaris: beyond the skin (the psychological effects of acne)
Acne photo collection Dermnet
Acne of the National Library U.S. Medicine
Report on acne from the Better Health Channel
"AcneNet." American Academy of Dermatology. http://www.skincarephysicians.com/acnenet -. Dermatologist-reviewed information about acne.
Q & A on acne, National Institutes of Health.
EV
Acne-treating agents (D10)
Antibacterial
Azelaic acid, benzoyl peroxide blue light therapy tea tree oil
Keratolytic
Glycolic acid, salicylic acid, benzoyl peroxide, sulfur
Anti-inflammatory
Ibuprofen Aspirin Red light therapy
Antibiotics
Dapsone Clindamycin Erythromycin Minocycline Tetracycline sulfacetamide
Hormonal
Antiandrogens contraceptives
Retinoids
Tazarotene Adapalene Isotretinoin Tretinoin
Combinations
Ziana Duac BenzaClin physique Epiduo
EV
Diseases of the skin and appendages by morphology
Growth
Epidermal
seborrheic keratosis callus wart molluscum acrochordon actinic keratosis squamous cell carcinoma Basal cell carcinoma Merkel cell carcinoma trichoepithelioma sebaceous nevus
Pigmented
Freckles nevus lentigo melanoma melasma
Cutaneous and
subcutaneous
epidermal inclusion cyst, hemangioma, dermatofibroma, Kaposi's sarcoma lipoma keloid neurofibroma digital fibromatosis xanthoma child leiomyoma granular cell tumor circumscribed myxoid cyst lymphangioma
Eruptions
With
epidermal
participation
Eczematous
contact dermatitis, atopic dermatitis, seborrheic dermatitis, stasis dermatitis, lichen simplex chronicus, Darier's disease glucagonoma syndrome Langerhans cell histiocytosis, lichen sclerosus pemphigus foliaceus Wiskott-Aldrich syndrome, Zinc deficiency
Scale
psoriasis tinea (faciei cruris corporis manuum pedis) Pityriasis rosea mycosis fungoides secondary syphilis systemic lupus erythematosus, pityriasis rubra pilaris, parapsoriasis ichthyosis
Scorching
herpes simplex herpes varicella zoster acute pemphigus vulgaris Impetigo Bullous contact dermatitis herpetiformis, bullous pemphigoid, dermatitis, porphyria cutanea tarda epidermolysis bullosa simplex
Papular
scabies, insect bites, heat rash reactions keratosis pilaris lichen lichen planus spinulosus transient acantholytic dermatosis Pityriasis lichenoides and lichen nitidus acute Varioliformis
Pustular
acne rosacea, folliculitis, impetigo, acne vulgaris gonococcemia coccidioidomycosis subcorneal pustular dermatosis dermatophytes candidiasis
Hypopigmented
tinea versicolor, vitiligo, pityriasis alba postinflammatory hyperpigmentation tuberosa sclerosis, idiopathic guttate hypomelanosis leprosy hypopigmented mycosis fungoides
No
epidermal
participation
Red
Whitening
Erythema
Generalized
drug eruptions, viral exanthems toxic erythema lupus erythematosus
Localized
erythema nodosum cellulitis abscess boil carcinoid syndrome Fixed Drug Eruption
Specialized
erythema, urticaria (gyratum multiforme annulare centrifugum migrans ab igne repens)
Nonblanchable
Purple
Macular
actinic purpura thrombocytopenic purpura
Papular
disseminated intravascular coagulation, vasculitis
Indurated
scleroderma / morphea, granuloma annular atrophic lichen sclerosis necrobiosis lipoidica
Several
disorders
Ulcers
Hair
telogen effluvium, androgenic alopecia Tinea trichotillomania, alopecia areata, systemic lupus erythematosus lichen capitis loose anagen syndrome planopilaris decalvans folliculitis nuchae acne keloidalis
Nails
onychomycosis psoriasis toenail paronychia
Mucous
membrane
aphthous stomatitis, lichen planus, leukoplakia candidiasis mucous membrane pemphigoid, pemphigus vulgaris, cicatricial pemphigoid, syphilis, herpes virus Coxsackie virus systemic histoplasmosis, squamous cell carcinoma
EV
Disorders of skin appendages (L60-75, 700-709)
Nails
thickness: Onychogryphosis Onychauxis
color: lines Beau, yellow nail syndrome Leukonychia Azure lunula
form: Koilonychia Clubbing
Others: Ingrown Toenails Anonychia
Hair
Hair loss
Alopecia areata (Alopecia totalis, Alopecia universalis, Ophiasis)
Telogen effluvium, androgenic alopecia Hypotrichosis Lichen traction alopecia Planopilaris Trichorrhexis nodosa
Hypertrichosis
Hirsutism
Acne / Rosacea
eruption acneiform (acne vulgaris, chloracne, shin) Rosacea (Perioral dermatitis, Rhinophyma)
Follicular cysts
trichilemmal cyst epidermoid cyst Multiplex Steatocystoma sebaceous cyst
Inflammation
Hidradenitis suppurative folliculitis barbae pseudofolliculitis
Sweat glands
eccrine (Miliaria, anhidrosis) apocrine (Body odor, Chromhidrosis, the Fox-Fordyce disease)
Appendix skin routes: Anat, noncongen / Congenital / neoplasia, symptoms, signs + / namesake, proc
title link
Categories: Categories Acneiform eruptionsHidden: Wikipedia pages protected movement due to vandalism | All articles with no source statements | Articles with statements without power October 2008 | Articles with unsourced statements from June 2009 | Articles with statements without power in December 2009 | Articles needing additional references from December 2007 | All articles lacking sources | Wikipedia articles with statements from July 2009 | Articles with statements without power from February 2010 About the Author
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