Understanding Acne

What is acne?

Acne is a dermatologic condition; the largest occurrence is associated with acne vulgaris affecting 85% of young adults age 12-24 years.

Acne is one of the most recognisable skin condition which causes social embarrassment, acne associated physical and psychological scarring and can be life changing.

What is acne vulgaris?

Acne vulgaris is a simple identifiable dermatological condition that starts when oil and dead skin cells clog up your pores. The most common names for acne are blackheads, blemishes, whiteheads, pimples, spots or zits. When you have just a few red spots, or pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. Or it can be bigger, solid, red lumps that are painful (cysts).

Small non-inflammatory acne lesions may not be more than a minor annoyance, but anyone with more harsh inflammatory nodular acne can suffer soreness. The resulting social embarrassment, as well as acne associated physical and psychological scarring, can be life changing.

How does acne form?

Acne VulgarisAcne vulgaris starts with the formation of a microcomedo as shown in the diagram. Stage two consists of non-inflammatory lesions, closed comedones (whiteheads) and open comedones (blackheads). The non-inflammatory lesions can turn into inflammatory lesions. Dependent on the degree of severity, the inflammatory lesion range comprises of papules, pustules and nodulocystic lesions.

The stimulus for microcomedo formation is still uncertain. The strongest leads implicate androgen hormones, alterations in follicular linoleic acid levels, and the inflammatory cytokine interleukin-1a. Other factors, such as genetic predisposition, stress, and diet, may also affect the development and severity of acne.

Is there a cure for acne?

There is no cure for acne, however acne can be successfully treated and controlled with the right treatment routine. Doctors and dermatologists can recommend medication that will help tackle acne but they are not a cure, so even after your skin is clear and breakouts are a thing of the past you must continue to use your medications regularly to keep acne from returning.

Does diet affect acne breakouts?

A few small studies have shown a correlation between certain food groups and acne severity (such as dairy products and carbohydrates with a high glycemic index), but there aren't any foods that actually cause acne. A diet high in protein and carbohydrates with a low glycemic index has been shown to improve acne breakouts.

What are the present therapeutic approaches to acne?

Topical and systemic therapies are the major therapeutic strategies for the treatment of acne today.

More details on therapies: click to expand

Dependent upon the severity of the lesions a single or combined therapy is applied. In general, the topical and systemic therapies aim at inhibition of hyperkeratosis, follicular plugging, diminishment of sebum production, reduction of bacterial load (e.g. Propionibacterium acnes) and inflammatory responses. The main active compounds of therapies (in gel, cream and solution formulations) consist of retinoids and antibiotics. Hormonal treatment is occasionally used for most types of acne in both adult and adolescent females. These therapies are often accompanied by adverse side effects.

Of the current acne treatments most have minimal information on the mechanism of action. The mechanism of action in the treatment of acne with Benzoly peroxide is unclear, although the antibiotic activity is believed to be predominate. The exact mechanism of action of oral retinoids in acne treatments is also not known.

 

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