Acne Vulgaris occurs due to the formation of comedones, nodules, papules and pustules due to the inflammation and obstruction of pilo-sebaceous units, i.e. the hair follicles and sebaceous glands. It is more common among adolescents and can be diagnosed by physical examination of the patient. The treatment of this condition involves topical agents and systemic medications that reduce the production of sebum and prevent inflammation and infection.
Causes of Acne Vulgaris
The commonest trigger factor for Acne Vulgaris is puberty. The hormonal changes at puberty, like an increase in androgen. can stimulate the production of sebum and the proliferation of keratinocytes. Some hormonal changes during menstruation period and pregnancy can also result in Acne. Excessive use of cosmetic agents, cleansing agents, humidity and increased sweating can also lead to this condition. Some dietary items like chocolate and fried food increase the risk of Acne Vulgaris.
Symptoms of Acne Vulgaris
Some cases of Acne Vulgaris result in formation of cysts that are very painful. The occurrence of pain is less than in other forms of Acne Vulgaris, but they can cause mental distress to the patient.
Some patients may develop comedones which appear as blackheads or whiteheads. Whiteheads or closed comedones are palpable, whitish, flesh colored lesions that are around 1-3 mm in diameter. The blackheads or open comedones look similar to whiteheads but have a dark center.
Pustules and papules are red colored lesions that are 2-5 mm in diameter. The follicular epithelium is damaged, in these cases, resulting in accumulation of neutrophils and lymphocytes. Once the epithelium ruptures, the contents of the comedones gives rise to a severe inflammatory reaction in the dermis. The inflammation is deep in the case of papules, whereas it is quite superficial in the case of pustules.
There may be a formation of nodules in some patients, which are deeper, larger and very solid in consistency. They resemble an inflamed cyst of the epidermis.
Some patients may show formation of cysts that are suppurative nodules. These cysts can get infected and result in abscess. This can also cause scarring resulting in deep and tiny pits called icepick scars.
Acne conglobata is a severe type of Acne Vulgaris. Its incidence is seen more in men than in women. Patients can develop abscesses, fistulated comedones, draining sinuses, atrophic scars and keloids in this case. It can affect the chest and the back also.
Acne fulminans is acute, ulcerative and febrile acne. It is characterized by sudden appearances of confluent abscesses causing hemorrhagic necrosis. Patients can complain of swelling and pain in joints along with leucoytosis in this case.
Pyoderma facale is a form of Acne Vulgaris and can occur suddenly on the middle part of the face of a female. The eruptions in this case consist of pustules, i.e. erythematous plaques on the cheeks, forehead and chin
Treatment of Acne Vulgaris
Treatment of Acne Vulgaris involves taking good care of the skin by washing the face with plain water several times in a day and avoiding intake of food like chocolates, fried items and alcohol. Patients can use a good topical agent for the treatment of Acne Vulgaris. For acne treatment peoples use Benzac AC cream also.
Azelex or its generic, AZELAIC ACID cream can be effectively used as a topical agent in case of mild to moderate Acne Vulgaris. The proper method to use Azelex cream is given below-
Skin is to be washed thoroughly and then patted dry. A thin film of this cream is then applied to the affected part, twice daily. The duration of treatment of Acne Vulgaris with Azelex cream depends on the severity of the case. Several patients can observe improvement in Acne Vulgaris within 3 – 4 weeks of starting treatment with this cream