Understanding Acne: Symptoms, Causes, and Treatment

Acne is an inflamed skin condition that affects many people, mostly within the age of 30 years. It occurs when hair follicles become clogged due to dead skin cells and oil, and commonly affects the neck, face, chest, and back areas. This article discusses the symptoms, causes, risk factors, diagnosis, and treatment options for acne.

What is acne?
Inflamed skin condition affecting many people mostly
within the age of 30 years
The condition occurs when hair follicles become clogged
due to dead skin cells and oil
Commonly affects the neck, face, chest and back areas
Symptoms of acne
 Blackheads (open plugged
pores)
 Whiteheads (closed plugged
pores)
 Pimples (papules with pus at
the tips)
 Cysts (solid and large lumps
beneath the surface of the skin)
Figure: Difference between the signs of acne
Remember
 Climate changes make individuals prone to develop acne
 Reduced application of grease-containing cosmetics
reduces the chances of developing acnes
 Touching the areas of acne break out delays recovery
 Chemical treatment might be considered for removing
spots developed due to acne
 Consult with the clinician as soon as possible
References
Akhnikh, S., de Korte, N., & de Winter, P. (2014). Anterior cutaneous nerve entrapment
syndrome (ACNES): the forgotten diagnosis. European journal of paediatrics,
173(4), 445-449.
Costill, D., & Eichenfield, L. F. (2015). Use of antibiotics for acne exceeds guideline
recommendations. Infectious Diseases in Children, 28(12), 20.
Danby, F. W. (2015). Acne: causes and practical management. John Wiley & Sons.
Harris, V. R., & Cooper, A. J. (2017). Modern management of acne. The Medical journal of
Australia, 206(1), 41-45.
Lam, K., & Vasey, C. (2018). Diagnostic dilemma: think about anterior cutaneous nerve
entrapment syndrome (ACNES) in patients with atypical abdominal pain and
Crohn's disease. BMJ case reports, 2018.
Thiboutot, D. M., Dréno, B., Abanmi, A., Alexis, A. F., Araviiskaia, E., Cabal, M. I. B., ... & El
Ouazzani, T. (2018). Practical management of acne for clinicians: An
international consensus from the Global Alliance to Improve Outcomes in
Acne. Journal of the American Academy of Dermatology, 78(2), S1-S23.
Effect on daily life
 Low level of
confidence
 Awkwardness in
public places
 Effect on romantic
relationship
 Pain and itching
related to health concern
Diagnosis of acne Symptoms such as
pimple and blackhead Occurrence of lesions
on face, arms and other areas Consultation with
physician
Causes of acne
The four main causes of acne are-
 Excess production of oil
 Clogged hair follicles by dead skin cells and oil
 Bacterial colonization
 Excess secretion of hormone such as androgen
Human skin has pores in the skin that have oil glands under
them. Follicles connect the glands to the pores which are
small sac responsible for secreting liquid. The glands
produce oily secretion known as sebum that carries dead
skin through the follicle to the skin surface. When the
follicles are blocked the oil is build up under the skin and
pimples occur. Hair, sebum and skin cells clump together
into a plug that can get infected with bacteria.
Risk factor for acne
 Age- while all individuals are at risk of developing acne,
women below the age of 30 years is at increased risk
 Hormonal changes- such changes are more common in
women and those using medications containing lithium or androgen
 Stress- while stress might not be a direct cause of acne, it
can make existing acne worse. The underlying rationale is that stress
causes increase in the level of hormone in the body that are related to
excess production of sebum
 Family history- genetics play a role in acne and if parents
have this condition the individual is at increased risk of developing the
condition
 Cosmetics- certain cosmetics clog the pores on the skin and
cause section of oil from underneath the skin
Treatment for acne
 Retinoid- These are gels, creams and lotions that have been
derived from vitamin A. the mode of action is through prevention of plugging
of the hair follicles.
 Antibiotics- The drugs act by inhibiting bacterial growth in the skin
and reduce the related inflammation. The best choice of drug is erythromycin
and clindamycin. It might be advisable to administer both an antibiotic and
retinoid.
 Salicylic acid- The acids have antibacterial properties and might be
used along with an antibiotic such as erythromycin. Salicylic acid particularly
helps in the prevention of plugged hair follicles. Side effects are skin
discoloration
 Dapsone- Inflammatory acne is treated with dapsone, especially in
adult females. Side effects are dryness and redness.
 Chemical peel- The process involves application of a chemical
solution on a long lasting basis