Acne Vulgaris: Causes, Grades, and Effective Treatment Options

Acne Vulgaris: Causes, Grades, and Effective Treatment Options

Question. Write short note on acne vulgaris.

Answer.

Acne vulgaris

Acne vulgaris is a disease in which the pilosebaceous follicle becomes oversensitive to normal levels of testosterone.

Etiology

• Androgens
• Follicular keratinization
• Hereditary
• Propionibacterium acnes
• Immunological factors
• Environmental factors

“Understanding acne vulgaris through FAQs: Causes, grades, and treatments explained”

Exacerbating Factors

Acne worsens with stress and in premenstrual period.

In patients with aggressive or recalcitrant acne, underlying cause may be a virilizing syndrome in women, acromegaly,occupational exposure to acnegenic agents.

Drugs that worsen acne are steroids, hormones (androgen and progesterone), antiepileptic drugs, iodides; can follow facial massage.

Genetic and hormonal factors also play a role.

“Importance of studying acne vulgaris for dermatology students: Questions explained”

Grading

• Mild disease: Open (black heads) and closed (white heads) comedones with sparse inflmmatory lesions.
  Some comedones are deep­seated (submarine comedones).
• Moderate: Numerous papules and pustules
• Severe: Polymorphic eruption with comedones, papules,pustules, nodules and cysts.

“Factors influencing success with acne vulgaris knowledge: Q&A”

Management

• Topical therapies are the mainstay of treatment for mild acne:
• Benzoyl peroxide 5% has antibacterial and keratolytic properties. It treats both inflmed and non-inflmed lesions.
• Topical antibiotics, i.e. 1% clindamycin and 2% erythrmomycin are used.
• Topical retinoids, i.e. tretinoin cream or gel (0.25 to 1%), Adelphane (0.1%) cream or gel or solution applied in night to entire face and leave it for 20–30 minutes and then wash of with mild soap
• Sulphate calamine lotion can be used.
• Salicylic acid can be used as adjunctive therapy.
• Azelaic acid (20%) cream possess anti–microbial, anti inflmmatory and comedolytic properties.

“Common challenges in managing acne vulgaris effectively: FAQs provided”

Systemic therapy

• Antibiotics: Therapy is given for 3–6 months.
  Tetracycline 500 mg BD or doxycycline 100 mg BD for 2 weeks to 10 months.
  If tetracycline is not tolerated by the patient, erythromycin 500 mg BD can be given
• Corticosteroids: Prednisolone or dexamethasone once at night is useful in patients with severe acne unresponsive to conventional therapy.
• Other drugs: Oral contraceptives, spironolactone,fltamide help in young women
• Adjunctive therapy: Intralesional steroids for neurocystic lesions. Comedone extraction, chemical peels,dermabrasion, LASER and light therapy.