Acne Symptoms, Self-care, Treatment Options And Complications

 

What is acne?

acne vulgaris is a chronic inflammatory skin condition affecting mainly the face, the back, the chest, but it can affect other parts of the body as well. It's characterized by blockage and inflammation of something called the pylos sebaceous unit.

 

what is the pylos sebaceous unit? 

This is the medical term for the hair follicle. The hair shaft, and the sebaceous gland. So now we know what acne vulgaris is, but it's a chronic inflammatory skin condition.

What are the clinical features that we need to look out for?

already mentioned, acne most commonly affects the face, but it can spread to involve the neck, the chest, the back, and sometimes even more extensively over the body.

Types of acne

Several different types of acne spots. So curb often at the same time, we can break these down into superficial lesions, deep lesions, and finally, secondary lesions. So let's take a look at these now and here you're going to see lots of clinical photographs to help illustrate the points that I make. So first of all, let's start off by discussing superficial lesions.
 

Superficial lesions

open and closed comedones (Blackheads and whitehead): which are small tender red bumps. Pu joles, which are white or yellow spots that look like they could be squeezed, but don't squeeze them.

Deep lesions

Nodules: which are large and painful red lumps.

Pseudocyst: which are cyst like flu swellings.

secondary features

Excoriations: which means pick at or scratch. At spots, you can get

Erythematous maulas: which are red marks from recently healed spots, which are best seen in fair skin.

Pigmented macules: These are dark marks from old spots, mostly affecting those with darker skin.

Scars: Various types of scars that can result from acne, such as ice pick scars, boxcar scars, or rolling scars.

So individual acne lesions usually last less than two weeks, but the deeper papules and nodules may persist for months. Acne's also graded by severity ranging from mild.

What should you do at home to try for manage Acne?

Well, according - to the UK National Institute for Clinical Excellence guidelines, also known as nice, all people with acne should be advised to avoid overc cleaning the skin.

That's because overc cleaning can cause dryness and irritation, and you want to try and avoid that because remember, acne is an inflammatory skin condition. It's also important to use a non alkaline skin wash product twice daily on acne prone skin. If you're unsure on what, which particular skin product to use, speak to your local pharmacist who should be able to advise you, well on this. You should also avoid oil based skincare products, makeup and sunscreens, and if makeup is used, you should remove it. At the end of the day, persistent picking or scratching of lesions can also increase the risk of scarring. So although it might be tempting to pick at spots, try to avoid this if you can. So despite all of these measures at home, you may still find your acne as troublesome, and if you do, then there are medications available and the medication options vary depending on the severity of the acne.

In the uk, people with mild to moderate acne should be offered a 12 week course of one of the following first line options, which should be applied once daily in the evening.

First option that is available is a fixed combination of topical dalene with topical benzo peroxide. That can also be offered a fixed combination of topical tretinoin with a topical clindamycin and clindamycin is an antibiotic. Or the third option is to offer someone a fixed combination cream of topical benzo peroxide with topical clindamycin.

Now, these three options of medications are medications that you apply directly over the skin by rubbing it on, and they're quite effective, but they can take up to eight weeks to work and they may irritate the skin, especially at the start of the treatment. So that's something that is really important to be aware of at the very start of these treatments.

Sometimes your skin can feel a bit more irritated and it could look a bit redder. So if you've got moderate to severe acne, then patients should be offered a 12 week course of one of the topical agents that we've already just mentioned.

So one of those three different cream options plus either an oral antibiotic like oral ly cycline or oral doxycycline. And again, these are taken once a day. Alternatively, there can be a topical, a SAIC acid applied twice daily with either oral ly cycline or oral doxycycline once a day as well. So follow up should be arranged at 12 weeks to assess whether or not the person's acne has improved and whether they've got any adverse effects.

Now, in certain circumstances, it might be necessary to refer a patient to a dermatologist. This is gonna be needed if mild to moderate acne has not responded to two completed courses of treatment or moderate to severe acne has not responded to previous treatment. That includes the oral antibiotic or they have acne with scarring, or the person has acne with persistent pigmentary changes or their acne severity or acne related scarring is causing or contributing to persistent psychological distress or a mental health disorder because acne can really damage a person's confidence and also can lead to long-term consequences on the mental health.

What are the potential complications of acne?

Well, complications of acne include skin changes such as scarring, postinflammatory hyper pigmentation, where the skin might look darker or DP pigmentation, as well as psychosocial problems that I've already mentioned such as depression or anxiety.

Finally, urgent referrals should be made for people who've got something called acne mns, and that needs to be done on the same day to the on call hospital dermatology team. That person needs to be incest within 24 hours. Acne is a very severe form of acne, which is associated with systemic symptoms such as fever, malaise, and loss of appetite.

 

So that brings us to the end of this topic where we've covered a definition of acne, clinical features, what you can try, try, do to manage the condition at home as well as treatment options, and finally, complications that you should remain vigilant.

 

All information by: Doctor O'Donovan

 

 

 

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