ACNE
Definition And Treatment
In Simple Terms
By Robyn E. Glaesser, M.D.
One of the most
common reasons for seeking dermatologic care is for
the evaluation and management of acne. Although primarily
a disease of adolescence, acne can afflict infants,
young adults and people in their forties and fifties.
In simple terms, acne results from the action of
hormones and other substances on the sebaceous (oil)
glands and hair follicles. The sebaceous glands make
an oily material called sebum that normally empties
onto the surface of the skin via openings in the
hair follicles (pores). Oil and cells that line the
follicle (keratinocytes) can plug the opening. This,
in turn, allows bacteria that live on the skin surface
to grow and produce chemicals that attract inflammatory
cells. The wall of the hair follicle can then rupture,
spilling sebum, keratinocytes and bacteria into the
surrounding skin. This results in the formation of “pimples”.
There are several
types of acne. Comedones are plugged follicles without
associated inflammation. Papules are small inflamed
acne lesions that are red and tender. Nodules and cysts
are deeper, painful inflammatory lesions that can lead
to scarring.
The cause of acne
is unknown and probably multifactorial; nevertheless,
there are many myths on the subject. Chocolate and
greasy foods do not cause acne, nor does dirt on the
skin. However, there are things that can exacerbate
acne in those with the disease: changing hormones (in
adolescence or before menstrual periods), stress, oil
in skin products, pressure from sports helmets, squeezing
acne lesions and scrubbing of the skin.
Just as there are
multiple types of acne, many treatments exist. There
are over-the-counter and prescription medications that
are very effective in treating acne. Depending on the
type and severity of the condition, your doctor may
recommend topical therapies, oral medications or both.
The mainstays of therapy are topical retinoids (vitamin
A derivatives) to unclog pores and topical or oral
anti-inflammatory medications and antibiotics. For
girls and women with acne, oral contraceptives and
other medications that regulate hormones are used.
The treatment of choice for scarring acne is isotretinoin
(Accutane), and use of this very effective medication
must be monitored closely by a dermatologist.
In addition to medications,
there are cosmetic procedures which can improve acne.
Chemical peels with exfoliating substances such as
glycolic acid can be quite beneficial as an adjuvant
to traditional acne therapy. Some relatively new, innovative
treatments for acne using certain wavelengths of light
and lasers are becoming more popular.
About the author
Doctor Robyn E. Glaesser is a practicing Dermatologist
at Ironwood Dermatology located at 1735 E. Skyline
Drive • Tucson, AZ 85718 • 520-618-1630 • Fax:
520-618-1636
www.ironwooddermatology.org
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