Acne is the most common problem with which our teens suffer from. It is viewed as a normal physiological reaction of the skin. The commonest type of acne appears during the teenagers and rarely persists into the third decade. Though it is more common in women than in men, the severity is known to be more in men.
Acne is one of the self limited disorders of the skin, usually occurring after puberty, due to a reaction of the skin to various triggering factors. In persons prone to acne, when their skin is exposed to any of such agents, the size of the sebaceous glands (glands present in the skin) increases, resulting in increased production of sebum (an oily secretion of the sebaceous glands).
Causes and risk factors:
• The main cause of onset of acne at puberty is due to increased production of androgens (Hormones) in both males and females.
• Cosmetics and certain medications block the hair follicles and hence promote the formation of comedones (which we commonly denote as blackheads or whiteheads), which are the clinical hallmark of acne vulgaris (the variety which is commonly seen in the teens).
• As the comedones are blocked, the sebum has no outlet; it gets accumulated in the comedones and hence becomes prone to infection. Due to infection with yeast and bacteria, the comedones become inflamed and this worsens the condition.
• Friction and trauma lead to rupture of the comedone wall and hence the oily sebum comes out. This adds to the oiliness of the face. Hence, an oilinessacne cycle ensues.
• Much of the times, acne appears before or during menstruation due to the hormonal changes which occurs during that period.
• Fatty food increases the oiliness of the face and hence is one of the causes.
• Mental stress, anxiety may also lead to development of acne.
Screening and diagnosis:
Acne vulgaris:• It is characterized by non inflammatory to mildly inflamed comedones, which are the earliest lesions.
• Such lesions are self limited, though they may progress to form large inflamed nodules (boil –like).
• These nodules may rupture and may produce unhealthy scars.
• Face is the most commonly affected region; though forehead, cheeks, chin, nose and back may also be affected in many people.
• This type of acne is characterized by erythema (flushing), telangiectasis (a lesion formed due to dilatation of the blood vessels in the affected area) and superficial pustules (a small elevated skin lesion filled with pus like matter).
• Comedones are seen rarely in these cases.
• Face is the most commonly affected area. Unlike acne vulgaris; chest and back are not usually involved.
• Subsequently, it may lead to inflammation of the eyes (keratitis, iritis), which may even lead to blindness.
Diagnosis of this condition is clearly based on clinical findings.
• The patients should take enough care of their skin by washing it regularly; but limit the use of soap.
• They should avoid touching the affected skin constantly.
• The use of cosmetics should be limited.
• Avoidance of the agents which flare up the lesions.
• Do not pick at the acne this may lead to further aggravation and scarring of the skin.
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