CLINACASE

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Createdon: 14 Mar 2023
Updatedon: 03 Apr 2023

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Author: Khoa Tran
Published Mar 14, 2023
Updated Apr 03, 2023

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Acne

Etymology and Pronunciation

Acne (k-nee)
akme - Greek for "point" or "spot"

History

In the 19th century, French dermatologist Louis-Anne-Jean Brocq described acne as a "disease of the sebaceous glands" and identified comedones (blackheads and whiteheads) as a key feature of the condition. Brocq also noted that acne was more common in adolescents and young adults, and that it was likely linked to hormonal changes.

In the early 20th century, researchers began to investigate the role of bacteria in the development of acne. In 1930, dermatologist James Fulton discovered that Propionibacterium acnes (now known as Cutibacterium acnes) was present in the skin of individuals with acne, and hypothesized that it played a role in the development of the condition.

In the decades that followed, researchers continued to study the underlying causes of acne, and developed a range of treatments for the condition. These include topical and oral medications, such as benzoyl peroxide, retinoids, and antibiotics, as well as various procedures and therapies, such as chemical peels, light therapy, and laser treatments.

Modern Understanding

Acne is a common skin condition that affects many people of all ages, but it is most commonly associated with teenagers. It occurs when the pores on the skin become blocked, causing inflammation and the formation of pimples, blackheads, and whiteheads. 

Although it is not a serious medical condition, acne can be very distressing for those who suffer from it, and it can also lead to scarring if it is not treated properly.

In this article, we will look at the causes, symptoms, and treatment options for acne, as well as some tips for preventing breakouts and keeping your skin healthy.

Different types of acne

Whiteheads Whiteheads are a type of acne that develops when the pores become clogged with dead skin cells, oil, and bacteria. Unlike blackheads, which are open and exposed to the air, whiteheads are closed and covered by a thin layer of skin. They appear as small, white or flesh-colored bumps on the skin, and they are most commonly found on the face, chest, and back. Whiteheads are caused by an overproduction of sebum, which is the oily substance that is produced by the sebaceous glands in the skin. They can be exacerbated by hormonal changes, stress, and certain medications. Treatment options for whiteheads include topical retinoids, benzoyl peroxide, and salicylic acid. In more severe cases, oral antibiotics or isotretinoin may be necessary. Blackheads Blackheads are another type of acne that develops when the pores become clogged with dead skin cells, oil, and bacteria. Unlike whiteheads, blackheads are open and exposed to the air, which causes the buildup of melanin to oxidize and turn black. They appear as small, dark spots on the skin, and they are most commonly found on the face, chest, and back. Blackheads are caused by an overproduction of sebum, which is the oily substance that is produced by the sebaceous glands in the skin. They can be exacerbated by hormonal changes, stress, and certain medications. Treatment options for blackheads include topical retinoids, benzoyl peroxide, and salicylic acid. In more severe cases, oral antibiotics or isotretinoin may be necessary. Papules Papules are a type of acne that appears as small, red, and tender bumps on the skin. They occur when the hair follicles become inflamed due to an overgrowth of bacteria. Unlike whiteheads and blackheads, papules do not contain pus. Papules can be caused by a variety of factors, including hormonal changes, stress, and certain medications. They can also be exacerbated by poor hygiene and a diet high in processed foods and refined sugars. Treatment options for papules include topical antibiotics, benzoyl peroxide, and salicylic acid. In more severe cases, oral antibiotics or isotretinoin may be necessary. Pustules Pustules are a type of acne that appears as small, red, and tender bumps on the skin that contain pus. They occur when the hair follicles become inflamed due to an overgrowth of bacteria, and they are more common in individuals with oily skin. Pustules can be caused by a variety of factors, including hormonal changes, stress, and certain medications. They can also be exacerbated by poor hygiene and a diet high in processed foods and refined sugars. Treatment options for pustules include topical antibiotics, benzoyl peroxide, and salicylic acid. In more severe cases, oral antibiotics or isotretinoin may be necessary. Nodules Nodules are a type of acne that appears as large, painful, and deep-seated bumps on the skin. They occur when the hair follicles become inflamed due to an overgrowth of bacteria, and they are more common in individuals

Causes

The development of acne is a complex process that is influenced by a variety of factors, including genetics, hormones, diet, stress, and environmental factors. In this article, we will explore the various causes of acne and the ways in which they can contribute to the development and exacerbation of this skin condition.

Genetics
One of the most significant factors in the development of acne is genetics. Research has shown that individuals who have a family history of acne are more likely to develop the condition themselves. This is because certain genes can make the skin more sensitive to androgen hormones, which can cause the sebaceous glands to produce more oil.

Hormones
Hormones also play a significant role in the development of acne. Androgens, which are male sex hormones that are also present in females, can stimulate the sebaceous glands to produce more oil. This can lead to the formation of comedones, which are the precursor to pimples and other forms of acne.

In addition to androgens, other hormones can also contribute to the development of acne. For example, women may experience acne flare-ups during their menstrual cycle due to changes in hormone levels. Hormonal imbalances can also occur during pregnancy, menopause, and as a side effect of certain medications.

Diet
Although the role of diet in the development of acne is still somewhat controversial, research has suggested that certain foods may contribute to the development of acne in some individuals. For example, high-glycemic-index foods, which are foods that cause a rapid spike in blood sugar, may stimulate the production of androgens, which can lead to increased oil production and the development of acne.

In addition to high-glycemic-index foods, dairy products have also been linked to the development of acne. This is thought to be due to the hormones present in dairy products, as well as the high levels of insulin-like growth factor 1 (IGF-1), which can stimulate the production of oil.

Stress
Stress is another factor that can contribute to the development of acne. When we are stressed, our bodies produce a hormone called cortisol, which can stimulate the sebaceous glands to produce more oil. In addition to this, stress can also weaken the immune system, making it more difficult for the body to fight off the bacteria that can cause acne.

Environmental Factors
Environmental factors can also contribute to the development of acne. For example, exposure to certain chemicals, such as those found in some cosmetics and skin care products, can irritate the skin and lead to the development of acne. In addition to this, exposure to pollutants and other environmental toxins can also contribute to the development of acne.

Medications
Certain medications can also contribute to the development of acne. For example, medications that contain corticosteroids can stimulate the production of oil and contribute to the development of acne. Similarly, some medications that are used to treat epilepsy, depression, and other conditions can also cause acne as a side effect.

Poor Skin Care
Finally, poor skin care can also contribute to the development of acne. When the skin is not properly cleansed, dead skin cells and other debris can accumulate on the surface of the skin, clogging the pores and leading to the development of acne. Similarly, using harsh skin care products can irritate the skin and contribute to the development of acne.

Treatments

Topical Treatments
Topical treatments are medications that are applied directly to the skin. They come in the form of creams, gels, or lotions, and they are often the first line of defense against mild to moderate acne. Some common topical treatments for acne include:

	a. Benzoyl Peroxide

	Benzoyl peroxide is an over-the-counter medication that works by reducing the amount of bacteria on the skin and unclogging pores. It is available in various strengths, ranging from 2.5% to 10%. Benzoyl peroxide can cause dryness and peeling of the skin, so it is important to start with a low concentration and gradually increase as tolerated.

	b. Salicylic Acid

	Salicylic acid is another over-the-counter medication that works by exfoliating the skin and unclogging pores. It is available in various strengths, ranging from 0.5% to 2%. Salicylic acid can cause mild irritation, so it is important to use it as directed.

	c. Retinoids

	Retinoids are a type of medication that works by increasing cell turnover and reducing the amount of oil produced by the skin. They are available in both prescription and over-the-counter formulations. Prescription retinoids, such as tretinoin and adapalene, are more potent than over-the-counter options. Retinoids can cause dryness, redness, and peeling of the skin, so it is important to use them as directed.

Oral Medications
Oral medications are medications that are taken by mouth. They are often used to treat moderate to severe acne and are only available by prescription. Some common oral medications for acne include:

	a. Antibiotics

	Antibiotics are medications that work by killing bacteria on the skin. They are often used to treat moderate to severe acne and are usually taken for several months. Some common antibiotics used to treat acne include doxycycline, minocycline, and erythromycin. Antibiotics can cause side effects such as nausea, vomiting, and diarrhea.

	b. Hormonal Therapy

	Hormonal therapy is a type of medication that is used to regulate hormone levels in the body. It is often used to treat acne in women who have hormonal imbalances. Some common hormonal therapies used to treat acne include oral contraceptives and spironolactone. Hormonal therapies can cause side effects such as weight gain, breast tenderness, and mood changes.

	c. Isotretinoin

	Isotretinoin is a powerful medication that is used to treat severe acne that has not responded to other treatments. It works by reducing the amount of oil produced by the skin and decreasing inflammation. Isotretinoin is only available by prescription and is usually taken for several months. Isotretinoin can cause severe side effects, including birth defects, depression, and liver damage, so it is important to discuss the risks and benefits with a healthcare provider.

Light Therapy
Light therapy is a non-invasive treatment that uses different types of light to target acne-causing bacteria and reduce inflammation. Some common types of light therapy used to treat acne include:

	a. Blue Light Therapy

	Blue light therapy is a non-invasive treatment that uses a specific wavelength of light to target the bacteria that cause acne. The blue light penetrates deep into the skin and activates a chemical called porphyrin, which is produced by the acne-causing bacteria called Propionibacterium acnes (P. acnes). When porphyrin is activated, it produces oxygen-free radicals that kill the bacteria.

	Blue light therapy is often used to treat mild to moderate acne that has not responded well to topical treatments. It is a safe and effective treatment option that does not have the same side effects as some oral medications used to treat acne. Blue light therapy is also a popular option because it is painless, non-invasive, and does not require any downtime.

	The treatment process typically involves sitting in front of a special lamp or device for about 15-30 minutes per session. The number of sessions required can vary depending on the severity of the acne, but most people require several sessions over the course of several weeks to see noticeable results.

	While blue light therapy is generally considered safe, some potential side effects may include mild redness, swelling, and dryness of the skin. These side effects are usually temporary and resolve within a few days of treatment. It is important to talk to a healthcare provider before starting blue light therapy to determine if it is a suitable treatment option for your specific type of acne.

	b. Red Light Therapy

	Red light therapy is a type of light therapy that is used to treat acne by reducing inflammation and promoting skin healing. It works by delivering a specific wavelength of red light to the skin, which penetrates the skin's surface and stimulates the production of collagen and elastin. This helps to improve skin texture and reduce the appearance of acne scars.

	In addition to promoting skin healing, red light therapy also has anti-inflammatory properties that can help to reduce acne-related inflammation. Inflammation is a major contributor to the development of acne, and reducing it can help to improve the overall appearance of the skin.

	Red light therapy is often used in combination with blue light therapy, which targets acne-causing bacteria. Blue light therapy works by delivering a specific wavelength of blue light to the skin, which kills the bacteria that contribute to the development of acne. When used in combination, red and blue light therapy can be a highly effective treatment for acne.

	Red light therapy is typically administered in a dermatologist's office, but it is also available as a home treatment option. Home devices are designed for personal use and are often less powerful than those used in a clinical setting. However, they can still be effective for mild to moderate acne and can be a convenient and cost-effective option for some people.

	It is important to note that red light therapy is not suitable for everyone. It should not be used by people who are pregnant, have a history of skin cancer, or are taking certain medications that make the skin more sensitive to light. It is also important to follow the manufacturer's instructions carefully and to use the device only as directed.

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