ACNE VARIENTS

DESCRIPTION

• Acne also known as acne vulgaris caused by multiple factors.
• Overproduction of a sebum that is skin natural oil increase under the influence of hormones. 
• This pair with shedding of exfoliating dead skin cells and plugs hair follicles.
• The plug follicle become inflamed increased the growth of normal skin bacteria. 
• Medications such as, lithium, iodides, cortisone hormones, seizure medications or isoniazid can cause acne lesions.
• There is no cure for acne, but certain measures prevent more breakouts. Acne can result in scarring that so minimizing breakouts is important.
  

ACNE VARIANTS

Childhood acne – childhood acne may be of three type: 

1. Neonatal acne
2. Infantile acne
3. Early onset acne vulgaris.
   

Neonatal acne – This is very common usually involves open and closed comedones, or some papules and pustules. 

• The development appears to be related to hormonal activity in utero and will resolve spontaneously 12-13 months after delivery without scarring. 
• No specific treatment is required except reassurance for parents.
  

Infantile acne – This usually develop at the age of 3-6 months.

• They may be more extensive and inflammatory and does require treatment. 
• It may resolve spontaneously or persist.
  

Early onset Acne Vulgaris – In acne susceptible families, lesions start to become more from the age of 6 to 7 years and persist throughout adulthood. 

• Inflammation usually occurs at puberty may precede several years. 
• Inflammatory acne in children should warn underlying disorder.

Follicular Occlusion Triad – This includes three variants, one or more may be present in individual patients. All these represent inflammatory form of acne which consist of: 

1. acne conglobata, 
2. hidradenitis suppurativa,
3. Dissecting cellulitis. 

Acne conglobate – This is a very serious form of inflammatory acne that is characterized by large cysts, large interconnecting comedones, draining abscesses and sinus tract formation. 

• Extreme scarring is common and difficult to prevent. 
• Aggressive treatment is essential. 

Hidradenitis suppurativa – This is chronic inflammatory variant.

• Major area affected are the axillae, groin, and perianal skin. 
• The lesions are deep cysts, nodules and form sinus tract. 
• Scarring is common and secondary infection occur. 

Dissecting cellulitis of the scalp – nodules, cysts, and interconnected sinuses are present.

• The scalp may be accompanied by scarring and irreversible hair loss.
• Secondary infection is common.
• Aggressive treatment is required.

SIGNS AND SYMPTOMS

• Acne results in a variety of lesions. 
• The most common acne locations include the face, neck, chest, and back, where sebaceous glands are located. 
• Blackheads and whiteheads are follicular plugs that are either sitting below the skin surface known as whitehead or being exposed to the air known as blackhead.
• Papules are pink to reddish-brown bumps that is small in size.
• Pustules are pus-filled lesions, 
• Nodules are deeper pus-filled lesions.
• Mild acne is consists of few papules/pustules and/or comedones. 
• Moderate acne increased the number of lesions. 
• Severe acne may include whiteheads, blackheads, papules, pustules, and may have painful nodules.
• Acne can result in permanented scars, which can appear to be depressions in the skin, dark red or brown flat marks where the acne lesions were.
  

FOUR GRADES OF ACNE

• Grade 1: Comedones, occasional papules. 
• Grade 2: Papules, comedones, few pustules. 
• Grade 3: Predominant pustules, nodules, abscesses. 
• Grade 4: Mainly cysts, abscesses, widespread scarring.
  

ACNE TYPE

Clogged pores cause acne. These may be attributed to:

• Excess production of oil (sebum)
• Bacteria
• Hormones
• Dead skin cells
• Ingrown hairs
• Acne is usually associated with hormonal fluctuations mostly experienced during teenage but adults can experience acne. Acne may be non-inflammatory or inflammatory. Subtypes of acne within these two categories include:
• Blackhead
• Whiteheads
• Papules
• Pustules
• Nodules
• Cysts
  

SELF CARE GUIDELINE

• Traditional treatments can help to prevent acne. 
• Wash acne prone areas with gentle soaps or cleansers. 
• Avoid skin irritants such as rubbing, abrasive scrubs and greasy products.
• Water-based or noncomedogenic based products will help to reduce clogged pores.
• There are also a variety of over-the-counter medications that may help to reduce the pimples, should be applied in a thin layer to the entire skin area on a regular basis improve acne but complete results seen after a few months.