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Acne Vulgaris

Acne vulgaris is an inflammatory disease of the skin glands and hair follicles. It's characterized by comedones, pustules, nodules, and nodular lesions. This disorder affects nearly 75% of adolescents, although lesions can appear as early as age 8. Boys are affected more often and more severely, but acne occurs in girls at an earlier age and tends to affect them for a longer time, sometimes into adulthood. It tends to run in families. With treatment, the prognosis is good.

Causes

Acne starts when oil and dead skin cells clog the skin's pores. If germs get into the pores, the result can be swelling, redness, and pus.

For most people, acne starts during the teen years. This is because hormone changes after puberty make the skin more oily.

You do not get acne from eating chocolate or greasy foods. But you can make it worse by using oily skin products that clog your pores.

Acne can run in families. If one of your parents had severe acne, you are more likely to have it.

Symptoms

Acne can occur anywhere on the body. However, acne most often appears in areas where there is a high concentration of sebaceous glands, including the following:

  • face
  • chest
  • upper back
  • shoulders
  • neck

The following are the most common symptoms of acne. However, each child may experience symptoms differently. Symptoms may include:

  • blackheads
  • whiteheads
  • pus-filled lesions that may be painful
  • nodules (solid, raised bumps)

The symptoms of acne may resemble other skin conditions. Always consult your child's physician for a diagnosis.

Diagnostic tests

The presence of characteristic lesions, predisposing factors, and scarring confirms the diagnosis of acne vulgaris.

Treatment to get rid of acne

Common therapy for patients with acne includes benzoyl peroxide (a powerful antibacterial) or clindamycin or erythromycin antibacterial agents alone or in combination with tretinoin (retinoic acid or topical vitamin A), a keratolytic. Benzoyl peroxide and tretinoin agents can irritate the skin. Systemic antibiotics such as tetracycline are used to decrease bacterial growth until the patient is in remission; a lower dose is used for long-term maintenance. Exacerbation of pustules or abscesses during either type of antibiotic therapy requires a culture to identify a possible secondary bacterial infection.

ALERT Tetracycline is contraindicated during pregnancy and childhood because it discolors developing teeth. Erythromycin is an alternative for these patients.

Oral tretinoin combats acne by inhibiting sebaceous gland function and keratinization. Because of severe adverse effects, however, the 16- to 20-week course of tretinoin is limited to patients with severe papulopustular or cystic acne or to those who don't respond to conventional therapy.

ALERT Because oral tretinoin is known to cause birth defects, the manufacturer, with Food and Drug Administration approval, recommends pregnancy testing before dispensing, dispensing only a 30-day supply, repeat pregnancy testing throughout the treatment period, effective contraception during treatment, and informed consent of the patient or parents regarding the danger of the drug. A serum triglyceride level should be drawn before therapy with tretinoin begins and at intervals throughout its course.

Female patients may benefit from the administration of birth control pills (such as Ortho-tricycline) or spironolactone because these drugs produce antiandrogenic effects.

Other treatments for acne vulgaris include intralesional corticosteroid injections and home remedies to get rid of acne

Prevention
  • Eat regularly, exercise regularly, and wash oily skin gently everyday with medicated acne soap and water.
  • Don't rub or massage acne, and avoid chin straps, shoulder pads, straps, and spandex garments that rub the skin where acne is present.
  • Don't use over-the-counter medication while taking prescription medication unless your doctor knows.
  • Use cosmetics, suntan lotions, and shampoos that are oil free.
 

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