One of the most recognisable skin conditions is acne, the largest occurrence is associated with acne vulgaris affecting 85% of young adults age 12-24 years.
...a dermatologic condition which causes social embarrassment, acne associated physical and psychological scarring and can be life changing.
Acne vulgaris is a simple identifiable dermatologic condition.
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.
Acne
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.
Topical and systemic therapies are the major therapeutic
strategies for the treatment of acne today.
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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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